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Back and neck MediBilbao Salud

Arthritis in the Neck (Cervical Spondylosis): Symptoms, Exercises and Treatment

Arthritis in the neck, called cervical spondylosis, describes the wear-and-tear changes of the discs, joints and bones of the cervical spine that happen with age. Most people over 60 have some of these changes on X-rays, but many have no symptoms. When symptoms occur, they are usually neck pain and stiffness that respond well to exercise. Less commonly, bone spurs or discs press on nerves or the spinal cord. This guide explains, from a physiotherapy point of view, the symptoms of neck arthritis, what helps, and the warning signs that need medical attention.

Topic
Physical therapy
Updated
Reading time
5 minutes
Reviewed by
Dr. Itziar Gotxi Erezuma · Medical doctor (ENT) · Bizkaia Medical Association no. 484809757

What happens in neck arthritis

  • The discs between vertebrae lose water and height.
  • The facet joints at the back of the spine develop arthritis.
  • Bone spurs form at the edges of vertebrae and joints.
  • Ligaments may thicken and stiffen.

These changes are a normal part of ageing and do not always cause pain. X-ray findings correlate poorly with symptoms.

Symptoms

  • Neck pain and stiffness, often worse in the morning or after long periods in one position.
  • Reduced ability to turn the head, for example when reversing a car.
  • Grinding, clicking or cracking with movement.
  • Headaches at the back of the head.
  • Pain spreading to the shoulders or between the shoulder blades; see pain between shoulder blades.

Bone spurs in the neck

Bone spurs (osteophytes) are smooth bony growths that form as the body responds to joint changes. Most cause no symptoms. When they narrow the openings where nerves exit the spine, they can cause arm pain, tingling or weakness. Rarely, large spurs at the front of the spine cause difficulty swallowing.

Nerve compression (radiculopathy)

When a nerve root is irritated, pain travels down the arm, often with pins and needles, numbness or weakness in a specific area of the arm or hand. It may be worse when looking up or turning towards the painful side.

See pinched nerve in shoulder and disc prolapse in neck.

Spinal cord compression (myelopathy)

  • Clumsy or numb hands, dropping things, difficulty with buttons or writing.
  • Unsteady walking or balance problems.
  • Electric shock sensations down the spine when bending the neck.
  • Changes in bladder or bowel control.

These symptoms need prompt medical assessment, as early treatment can prevent permanent damage.

How it is diagnosed

Diagnosis is based on history and examination of movement, strength, reflexes and sensation. X-rays show bone changes but do not predict pain. MRI is used when there are nerve or spinal cord symptoms or before surgery.

Exercises for neck arthritis

  • Chin tucks: gently draw the chin back, hold 5 seconds, repeat 10 times.
  • Rotations: slowly turn the head to each side within comfort.
  • Side bends: tilt the ear towards the shoulder.
  • Shoulder rolls and blade squeezes.
  • Upper back extension over a chair.
  • Deep neck flexor strengthening as guided by a physiotherapist.

Do exercises little and often. Mild discomfort is fine; sharp pain or arm symptoms mean stop and seek advice. See forward head posture.

Daily habits that help

  • Set up your screen at eye level and take regular breaks.
  • Use a pillow that supports the neck in a neutral position.
  • Use heat packs for stiffness.
  • Stay active with walking, swimming or other exercise.
  • Avoid holding the phone between ear and shoulder.

Medical treatment

Painkillers and anti-inflammatory gels or tablets may help during flare-ups. Medicines for nerve pain are used for radiculopathy. Steroid injections are occasionally used for persistent nerve pain. Surgery, such as removing bone spurs or a disc and fusing vertebrae, or disc replacement, is considered for spinal cord compression or severe nerve compression that does not improve.

Outlook

Most people with neck arthritis have periods of pain and stiffness that settle, with good function between episodes. Regular exercise reduces flare-ups. Nerve symptoms often improve within weeks to months without surgery.

Sleep and neck arthritis

Morning stiffness is common, partly from staying still overnight. A pillow that keeps the neck level with the rest of the spine, sleeping on the back or side rather than the front, and a few gentle neck movements before getting up can ease it. A warm shower in the morning helps loosen stiff joints. See neck pain from sleeping.

When to seek urgent help

  • Clumsy hands, balance problems or bladder or bowel changes.
  • Progressive weakness in an arm.
  • Neck pain with fever, weight loss or a history of cancer.
  • Severe pain after an injury.
  • Neck pain with severe headache, dizziness or vision changes.

Key points to remember

  • Neck arthritis is common with age and often painless.
  • Pain and stiffness respond well to exercise and staying active.
  • Arm pain and tingling suggest nerve irritation.
  • Clumsy hands, balance or bladder changes need urgent assessment.

Questions about arthritis in the neck

These answers are general information and do not replace an examination or individual medical advice.

What does arthritis in the neck feel like?

Stiffness and aching, often worse in the morning, with grinding when turning the head.

Can neck arthritis cause headaches?

Yes, typically at the back of the head.

Can neck arthritis cause dizziness?

Neck problems can contribute to a sense of unsteadiness, but dizziness should be assessed for other causes.

What is the best sleeping position for neck arthritis?

On your back or side with a pillow that keeps the neck in line with the spine.

Can bone spurs in the neck be removed?

Yes, surgically, but only when they press on nerves or the spinal cord.

Is massage good for neck arthritis?

It can ease muscle tension, combined with exercise.

Does neck arthritis get worse?

The changes progress slowly, but symptoms often fluctuate and can be managed well.

Sources

  1. NHS · Cervical spondylosis
  2. OrthoInfo (AAOS) · Cervical spondylosis (arthritis of the neck)
  3. NHS · Neck pain

This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.