If you experience neck pain as a symptom of rheumatoid arthritis (RA), you’re not alone. Although the condition tends to affect the smaller joints in the hands, wrists, and knees, it can affect almost every joint in the body — including those in the neck.
RA is a chronic (ongoing) autoimmune disease that occurs when an overactive immune system attacks the body’s healthy tissues. When RA affects the neck, it can cause symptoms such as pain, swelling, and stiffness. Fortunately, some treatments can bring relief to your neck.
The causes of RA in the neck are the same as the causes of RA in any other joint. In people with RA, the immune system mistakenly attacks the joints in the same way it would normally fight viruses or bacteria. The body’s defenders (white blood cells and antibodies) attack the joint’s tissues, as well as the synovial membrane lining the joints — which has a lubricating function. This attack causes inflammation, erodes cartilage and bone, and weakens the muscles, tendons, and ligaments. The damage and inflammation, in turn, lead to symptoms of RA-like joint pain.
When RA affects the joints in the cervical spine (the neck region of the spine), mild or severe neck pain may occur. Rheumatologists will use a physical exam, as well as imaging tests like an X-ray, MRI, or CT scan, to look for inflammation and damage to the cervical spine. To determine if it’s RA, doctors may also perform a blood test to look for the presence of rheumatoid factor in your blood.
Neck pain is the primary symptom of RA in the neck joints. Unlike pain from a neck injury, which may improve over time, the symptoms of RA in the neck can be chronic. They may worsen when left untreated. And even if a person’s symptoms improve, swelling, stiffness, and inflammation can return.
Although the severity and type of pain can vary from person to person, it is often reported as dull, throbbing, or aching. One myRAteam member said that this pain is constant, writing that their neck hurts “every day and night” but is particularly bad “in the middle of the night.” Another member had a similar experience, sharing that the “pain in their neck and shoulder will not let up.”
For many people, swelling and stiffness in the neck joints can make it difficult to move their neck from side to side. “I feel as though something fell on my head and pushed it into my neck and shoulders. It hurts to turn my neck in any direction,” wrote a myRAteam member.
Aside from the pain, swelling, and stiffness typical of RA, people with RA in the neck can also experience two additional symptoms: radiculopathy and myelopathy. Radiculopathy is weakness, numbness, pain, or electrical sensations through an extremity (hand or foot) coming from pressure on the spinal nerve. Myelopathy, a disease process affecting the spinal cord, develops over time. The symptoms of myelopathy can include those seen in radiculopathy, as well as radiculopathy itself.
If you experience RA symptoms in your neck, seek medical advice by talking to a rheumatologist. RA in the neck joints can cause several complications, so you should receive prompt diagnosis and treatment. Your doctor will be able to determine what treatment or combination of treatment options could help ease your pain and reduce swelling.
Your rheumatologist may prescribe or recommend the following to treat RA in the neck.
Your doctor may recommend a combination of systemic drugs, which treat the underlying disease, and over-the-counter or prescription pain relievers.
Nonsteroidal anti-inflammatory drugs (NSAIDs) can help relieve pain and reduce inflammation caused by RA. These drugs include over-the-counter medications, like ibuprofen (Advil) or naproxen, as well as other options available by prescription.
Systemic medications, including disease-modifying antirheumatic drugs (DMARDs) like methotrexate and biologics, work to treat RA by slowing disease progression and preventing joint damage and deformities. Systemic medications treat the underlying inflammatory response that causes RA, helping to ease symptoms.
If you’re experiencing a flare-up of RA symptoms in your neck, your rheumatology provider may advise steroid-based injections or nerve blocks — a local anesthetic injection. Both treatments can be effective for pain that seems to radiate from the neck.
One type of injection is known as an epidural steroid injection. It works by delivering a combination of corticosteroids and a local anesthetic directly into the area of the spinal canal that surrounds the nerve roots. The combination of these medications helps relieve pain and reduce inflammation.
If RA affects your facet joints (the joints that allow the bones of the spine to twist and bend), you may receive a combination of local anesthesia and corticosteroids injected directly into the joints.
A nerve block involves injecting a local anesthetic near a targeted nerve or group of nerves to block pain signals. The type of nerve block you receive depends on where you’re experiencing pain. Some people may need several nerve block treatments before they find relief.
Your rheumatologist may recommend physical therapy to help improve flexibility, strength, and range of motion. Physical therapy for arthritis in the neck involves performing exercises designed to stretch and strengthen weak, strained muscles and improve range of motion and posture.
Although moving your neck may feel like the last thing you want to do when you’re in pain, it can actually help. Being inactive can increase neck stiffness, further decreasing the joints’ mobility.
The military chin tuck is one exercise that may help improve posture. To perform this exercise, tuck your chin toward your neck for 10 to 20 seconds and repeat 10 times each day. Strengthening the shoulders can also help provide additional support to the neck. Exercises like shoulder rolls can help keep the joints in the shoulders and neck flexible.
Both heat and cold can help lessen the symptoms of arthritis. Heat therapy helps loosen the muscles around the joint and increase flexibility and circulation, while cold reduces inflammation and dulls the pain.
For hot therapy, the Cleveland Clinic recommends showering or soaking in a warm bath for 20 minutes or using a heating pad. Applying a moist dishcloth warmed in the microwave for 20 seconds can work in the same way.
Cold therapy can be applied for 20 minutes at a time using a gel-filled ice pack, frozen peas, or a baggie filled with ice.
One myRAteam member recommended trying a moist heating pack: “Get a Bed Buddy hot/cold pack. … It’s the best for when pain is out of control.”
Another member recommended trying a heated neck wrap around the neck and shoulders for similar relief.
By joining myRAteam — the social network for people living with RA and their loved ones — you can connect with more than 197,000 members who come together to offer support, give advice, and share stories of everyday life with rheumatoid arthritis. Many myRAteam members discuss neck pain caused by RA and how they manage it.
Have you experienced neck pain caused by RA? What have you used to ease pain, swelling, or stiffness? Share your tips in the comments below or by posting on myRAteam.