Osteoarthritis in the cervical spine is a normal occurrence that rarely leads to severe pain or functional impairment. However, cervical spinal OA is often blamed for causing a wide range of symptoms, some of which seem completely illogical based on the minor structural changes demonstrated. Misdiagnosis of osteoarthritis as the cause of back and neck pain is a major problem in the treatment sector, helping to explain why therapy is often so utterly unsuccessful in its outcome.
Osteoarthritis is the technical name for common age and activity-related changes that affect the skeletal tissues in the spine, called vertebrae. These spinal bones contain several joints that move constantly, making them ideal locations for arthritic modifications to occur. It should be noted that most adults will demonstrate at least mild arthritic changes in multiple areas of the vertebra column, including the mid to low lumbar spine and the mid to low cervical spine, by the age of 40.
This focuses essay provides a much-needed objective overview of cervical spinal OA and its effects. We will concentrate on shedding lighting on why OA is such a diagnostic mainstay in the neck pain treatment sector, as well as what the diagnosis means to most patients.
Facts About Osteoarthritis in the Cervical Spine
OA is virtually always found in the cervical spine as people get older. Osteoarthritis is not a disease, as is commonly portrayed in medical media, but instead simply describes a set of natural processes that act on many of the major joints in the body. Osteoarthritis occurs due to the deterioration of the protective mechanisms in joints, including the loss of soft tissues and lubricating fluid.
In the spine, there are several sets of joints, so arthritic changes are often widespread and can be seen throughout the vertebral structures, including in and around the joints and inside the central spinal canal, in the lateral recesses and at the openings of the foraminal spaces. It is these specific locations of arthritic activity that are most noteworthy, since these are the regions where symptomatic activity can occur due to arthritic accumulations.
It is crucial to remember that arthritic changes are complete normal in the cervical spine. They are expected to occur by a certain age and are virtually universally experienced by every human adult. The main variables in their expression include the age of onset, the degree of arthritic formation and the potential effects produced on neurological tissue.
Osteoarthritis is easily diagnosed, since doctors know it will be almost surely be present in age-appropriate demographics and its accumulations can be readily visualized using any variety of advanced imaging, including x-rays, CT scan or MRI. Why all of these diagnostic tools can diagnose OA, MRI is best suited to determine the extent of the condition and it possible effects on the spinal neurological tissues, if any.
The manner in which the diagnosis is presented to the patient might have just as much to do with future symptomology as the actual physical ramifications of the condition. The bedside manner of the diagnostician may range terribly and the way in which the diagnosis is explained can set the tone for a lifetime of ever-increasing pain or can pave the way for minimal, if any, symptoms purely through the power of psychological programming alone. This is a perfect demonstration of the power of the mind when it comes to matters of health and wellness.
If the diagnostician imparts a nocebo effect upon the patient, the person is likely to be in for problems when it comes to back or neck pain. The nocebo effect has been widely studied and is proven to be able to originate, escalate or perpetuate symptoms through the power of the subconscious mind alone. Meanwhile, positively reassured patients might not develop any pain, or simply endure minor symptoms, even when an actual pathological process is present and negatively acting on the cervical spinal anatomy.
Osteoarthritis in the Cervical Spine Consequences
Patients who are diagnosed with arthritis in the cervical spine are usually those who already have neck pain and seek evaluation of the nature of the syndrome. These patients will typically undergo some form of imaging study and the arthritic changes will be noted. This is where the entire process stands at a precipice of paramount importance.
If the doctor sees something that can be objectively determined to be pathological in the arthritic changes, such as central spinal stenosis, definitive nerve compression due to foraminal or lateral recess stenosis, or obvious mechanical issues in the cervical spinal joints, then the condition can be explained and the patient placed into treatment that should be successful given the validity of the diagnosis. If not, then the patient should be told that they demonstrate completely normal age-related changes and further evaluation should be continued to ascertain the true nature of the painful complaint. During this process, it is important that the caregiver include studying the great possibility of a nonstructural causation, since a large number of patients are affected by conditions that will not show up during imaging studies or physical exams, such as regional ischemia.
If the patient is placed into treatment for normal arthritic changes, results are not likely to be good. Statistics show that the majority of care directed at spinal osteoarthritis is not needed, effective or even logical from a medical perspective. Instead, treatment is usually symptom-based, does nothing to act on the arthritis itself and disappoints almost universally. However, many of these treatments are very damaging, especially those of a pharmaceutical nature.
When neck surgery is involved, patients are literally butchered in order to modify the effects of spinal degenerative conditions that are not even the cause of their pain. This explains why even when focal areas of arthritis can be completely cleared, symptoms often remain or even intensify after an operation. Therefore, we warn all patients to never acquiesce to surgical intervention unless the diagnosis is definitive and objectively obtained from several quality care providers.
The primary lesson to be learned from this article is that cervical osteoarthritis is normal, not often the true cause of pain and usually does not require any treatment. For exceptional cases, the condition may be pathological and in these circumstances, treatment may be need and should be effectual. For patients who have tried many treatments to resolve arthritic pain in the neck, but have not enjoyed good results, I tend to advise that misdiagnosis may be the root cause. This is a very common problem in the larger back and neck pain treatment sector. When it comes to arthritis, many patients are led astray from day one of the diagnostic process simply for the sake of financial profit.
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