# Cervical osteoarthritis: understanding, treating, and relieving this common condition If you're reading this, you're probably familiar with that stiffness in your neck. The one that prevents you from turning your head. That morning pain that takes a while to go away. Or that worry after reading a report mentioning "osteoarthritis." As physical therapists, we see patients every day who are afraid that their neck is worn out for good. You are not alone. 98% of adults between the ages of 21 and 83 show signs of cervical osteoarthritis on MRI. Even at age 21. Yet not 98% of people have neck pain. **Good news:** Cervical osteoarthritis is a normal part of aging. It is not a serious disease. Physical therapy completely eliminates symptoms in most cases, even if the osteoarthritis remains. **What science shows:** - **The presence of osteoarthritis does not mean pain:** 98% have signs on MRI, but most feel nothing. - **Wear and tear affects the entire joint:** Cartilage, bones, ligaments, discs, and muscles can all be affected. - **Movement is the best treatment:** Your joints are nourished and strengthened by movement. - **Symptoms are treatable:** Even with visible osteoarthritis, you can regain a pain-free neck. This guide will help you understand your condition and get back to your activities. For an overview, see our [complete guide to neck pain](/complete-guide/neck-pain-complete-guide). --- ## What is cervical osteoarthritis? Cervical osteoarthritis is the normal wear and tear of the joints in the vertebrae of the neck. It affects the cartilage, bone, ligaments, discs, and muscles. It is a natural aging process, not a serious disease. We often talk about wear and tear on the cartilage between the vertebrae. Cartilage acts as a cushion between the surfaces of your vertebrae. It allows your vertebrae to slide and move smoothly. Over time, this cartilage wears away. All structures of the joint can be affected. Cervical osteoarthritis affects the entire joint, not just the cartilage. **Key fact:** 98% of adults between the ages of 21 and 83 show signs of cervical osteoarthritis on MRI scans. Even at age 21, this process begins. It is normal and part of the natural aging process. Let's take a look at the symptoms cervical osteoarthritis can cause. --- ## What are the symptoms of cervical osteoarthritis? The main symptoms include neck pain, morning stiffness, decreased flexibility, and crackling sounds when moving. Cervical osteoarthritis does not always cause symptoms. Many people live with osteoarthritis without feeling anything. Surprising? Yet it is common. **Reassuring reminder:** 98% of adults show signs of osteoarthritis on MRI scans. That doesn't mean 98% have neck pain. Osteoarthritis on an image does not automatically mean symptoms. If you have headaches along with your neck pain, check out our article on [cervicogenic headaches](/resources/cervicogenic-headaches). We treat this issue frequently in physical therapy. Let's take a look at what causes cervical osteoarthritis. --- ## What are the causes and risk factors? Aging is the main cause of cervical osteoarthritis. By age 50, almost everyone has it. Risk factors include past neck injuries, being female, obesity, a sedentary lifestyle, and static work. Osteoarthritis does not develop overnight. It is a gradual process that takes place over several years. It is normal and natural. Osteoarthritis can sometimes cause cervical stenosis, a narrowing of the spinal canal. This is rare. Consult your doctor if your symptoms change or worsen. Let's look at how cervical osteoarthritis is diagnosed. --- ## How is cervical osteoarthritis diagnosed? The diagnosis is based on your symptom history and clinical examination. An X-ray can confirm osteoarthritis, but is not mandatory. Imaging results do not always correspond to symptoms. What the X-ray or MRI shows is not always relevant to your symptoms. **Reminder:** 98% of adults between the ages of 21 and 83 show signs of cervical osteoarthritis on MRI.^1^ Even at age 21. However, not all 98% have neck pain. Your symptoms and clinical examination often matter more than the image. Don't be alarmed if a report mentions osteoarthritis. It's expected and normal. Let's see when to consult a physical therapist. --- ## When to consult a physical therapist? Consult a physical therapist when pain or stiffness prevents you from performing your daily activities. For example, difficulty checking your blind spots while driving or bending over. You do not need to see a doctor first. **Specific examples:** - Difficulty checking your blind spots while driving - Difficulty bending over - Stiffness limiting your daily movements - Pain persisting for several weeks You do not need to see a doctor before consulting a physiotherapist. If necessary, the physiotherapist will refer you. Let's take a look at the treatments available. --- ## What are the treatments in physiotherapy? Movement is the best treatment for cervical osteoarthritis. The physical therapist will assess your mobility, nerve gliding, postural habits, quality of movement, and strength. This assessment will be used to create a personalized plan. For more details, see our [guide to physical therapy for neck pain](/complete-guide/physical-therapy-for-neck-pain). **Services offered:** - **Joint mobilization:** Reduces pain and improves movement - **Home exercises:** Treats the cause, not just the symptoms - **Education on dosage:** Adapts your activities to optimize healing - **Postural advice:** Prevents recurrence Physical therapy does not cure osteoarthritis. Wear and tear cannot be reversed. However, treatment can completely eliminate symptoms, even if the osteoarthritis remains present. You can regain a pain-free neck even with osteoarthritis visible on imaging. Let's see what you can do at home. --- ## What to do at home? Stay active. If you are sedentary, start with walking and neck mobility exercises. If you are already active, continue your activities while listening to your body. **If sedentary:** - Regular walks - Neck and shoulder mobility exercises - Respect the pain (a little is okay, but not too much) **If already active:** - Continue activities that do not cause too much pain - Listen to your body **Practical tips:** - **Painful movements:** Stop temporarily, then resume gradually - **Static positions:** Avoid staying in the same position for more than an hour. Move your neck and shoulders regularly. - **Pillow:** Choose a pillow that fills the hollow of your neck - **Sleeping position:** Avoid sleeping on your stomach if you experience morning stiffness Let's look at how to prevent or slow down osteoarthritis. --- ## How can you prevent or slow down cervical osteoarthritis? Regular physical activity prevents and slows down cervical osteoarthritis. Your joints are nourished by movement. Aim for 150 minutes of cardio activity per week, strength training twice a week, and maintain a healthy weight. Your joints are strengthened by movement. It's like caring for a plant: regular care makes all the difference. **Other tips:** - **Healthy weight:** Varies depending on the individual - **Avoid repeated injuries:** Sprains, fractures, and surgeries accelerate wear and tear - **Healthy diet:** Consult a nutritionist or the Canada Food Guide These tips will help you regardless of your age. Regular activity reduces your chances of experiencing symptoms, even if you already have osteoarthritis. --- ## Need professional advice? If your neck pain persists, our physical therapists can help. Contact Physioactif for a personalized assessment. Visit our [neck pain page](/pain/neck) to make an appointment. **For more information:** Listen to the podcast "Parle-moi de santé" by Alexis Gougeon, physiotherapist at Physioactif. Episode #15 discusses osteoarthritis in an accessible way. Available on [Spotify](https://open.spotify.com/show/1dQlDu0TDM2uE1O9X7kEGc), [Apple Podcast](https://podcasts.apple.com/ca/podcast/01-blaise-dubois-course-%C3%A0-pied/id1525206710?i=1000489820752&l=en) and [Google Podcasts](https://podcasts.google.com/feed/aHR0cDovL2JhbGFkb3F1ZWJlYy5jYS9wYXJsZS1tb2lkZXNhbnRlL3Jzcw?hl=fr_CA). --- ## References 1. Okada E, Matsumoto M, Fujiwara H, Toyama Y. Disc degeneration of cervical spine on MRI in patients with lumbar disc herniation: comparison study with asymptomatic volunteers. Eur Spine J. 2011;20(4):585-91. 2. Musumeci G, Aiello FC, Szychlinska MA, Di Rosa M, Castrogiovanni P, Mobasheri A. Osteoarthritis in the 21st century: risk factors and behaviors that influence disease onset and progression. Int J Mol Sci. 2015;16(3):6093-112. 3. Gellhorn AC, Katz JN, Suri P. Osteoarthritis of the spine: the facet joints. Nat Rev Rheumatol. 2013;9(4):216-24. 4. Canadian Society for Exercise Physiology. Canadian 24-Hour Movement Guidelines for Adults ages 18-64 years. 2021. Available from: https://csepguidelines.ca/adults-18-64/