If you're reading this, you're probably familiar with neck stiffness. The kind that prevents you from turning your head. The morning pain that takes a long time to go away. Or the worry you feel after reading a report that mentions "osteoarthritis." As physical therapists, we see patients every day who fear that their neck is permanently damaged.

You are not alone. 98% of adults between the ages of 21 and 83 show signs of cervical osteoarthritis on MRI scans.¹ Even at age 21. However, not 98% of people have neck pain.

^- Osteoarthritis does not necessarily mean pain: 98% of people show signs on MRI scans, but most do not experience any symptoms^.1 - Wear and tear affects the entire joint: Cartilage, bones, ligaments, discs, and muscles can all be affected.3 - 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 resume your activities. For an overview, see our comprehensive guide to neck pain.

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.

Let's take a look at the symptoms that cervical osteoarthritis can cause.

What are the symptoms of cervical osteoarthritis?

The main symptoms include neck pain, morning stiffness, decreased flexibility, and cracking sounds when moving. Cervical osteoarthritis does not always cause symptoms.

Many people live with osteoarthritis without feeling any symptoms. Surprising? Yet it is quite common.

If you have headaches along with your neck pain, check out our article on cervicogenic headaches.

We frequently address this issue in physical therapy. Let's examine 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 see how to diagnose cervical osteoarthritis.

How is cervical osteoarthritis diagnosed?

The diagnosis is based on your symptoms and a clinical examination. An X-ray can confirm osteoarthritis, but is not mandatory. Imaging results do not always correspond to symptoms.

What shows up on an X-ray or MRI scan is not always relevant to your symptoms.

Your symptoms and clinical examination often matter more than the imaging results. Don't be alarmed if a report mentions osteoarthritis. It's expected and normal.

Let's see when to consult a physical therapist.

When should you see 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.

- Difficulty checking your blind spots when 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 physical therapist. If necessary, the physical therapist will refer you.

Let's take a look at the treatments available.

What are the physiotherapy treatments?

Movement is the best treatment for cervical osteoarthritis. The physical therapist will assess your mobility, nerve gliding, posture habits, movement quality, and strength. This assessment will be used to create a personalized plan.

For more details, see our guide to physical therapy for neck pain.

- 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.

- Regular walks - Neck and shoulder mobility exercises - Respect the pain (a little is okay, but not too much)

- Continue activities that do not cause too much pain - Listen to your body

- 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 see how to prevent or slow down osteoarthritis.

How can cervical osteoarthritis be prevented or slowed down?

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 get stronger with movement. It's like caring for a plant: regular care makes all the difference.

- Healthy weight: Varies depending on the individual - Avoid repeated injuries: Sprains, fractures, and surgeries accelerate wear and tear - Healthy diet: Consult a nutritionist or Canada's 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 to schedule an appointment.

Listen to the podcast "Parle-moi de santé" (Talk to me about health) by Alexis Gougeon, physiotherapist at Physioactif. Episode #15 discusses osteoarthritis in an accessible way.

Available on Spotify, Apple Podcasts, and Google Podcasts.

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/