Rheumatoid Arthritis in the Neck: Causes, Symptoms, and Treatment

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 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, there are treatments available that can bring relief to your neck.

What Causes RA in the Neck?

The causes of rheumatoid arthritis 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 the symptoms of RA.

What Does RA in the Neck Feel Like?

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 do 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 the 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) stemming 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.

Pain Management and Treatment Options for RA in the Neck

If you experience RA symptoms in your neck, it is important that you seek medical advice by talking to a rheumatologist. RA in the neck joints can cause several complications, so you should aim for a prompt diagnosis and swift treatment. Your doctor will be able to determine what treatment or combination of treatments could help alleviate your pain and reduce swelling.

Your rheumatologist may prescribe or recommend the following to treat rheumatoid arthritis in the neck.

Medications

Your doctor may recommend a combination of systemic drugs, which treat the underlying disease, and over-the-counter (OTC) or prescription pain relievers.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs can help relieve pain and reduce inflammation caused by RA. These drugs include OTC medications, like Advil (ibuprofen), as well as other options available by prescription.

Systemic Arthritis Medications

Systemic medications, which include disease-modifying antirheumatic drugs (or DMARDs) and biologics, work to treat rheumatoid arthritis by slowing disease progression and preventing joint damage and deformities. Systemic medications treat the underlying inflammatory response that causes RA, helping to alleviate symptoms.

Steroid Injections and Nerve Blocks

If you’re experiencing a flare-up of RA symptoms in your neck, your doctor may advise steroid-based injections or nerve blocks — local anesthetic injections. 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 will depend upon where you’re experiencing pain. Some people may need several nerve block treatments before they find relief.

Physical Therapy and Exercises

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.

Heat and Cold Therapy

Both heat and cold can help alleviate the symptoms of arthritis. Heat therapy helps loosen the muscles around the joint and increase flexibility and circulation, while cold reduces inflammation and dulls 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 bag 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.

Find Your Community

By joining myRAteam — the social network for people living with RA and their loved ones — you can connect with more than more than 144,000 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 the ways they manage it.

Have you experienced neck pain caused by RA? What have you used to alleviate pain, swelling, or stiffness? Share your tips in the comments below or by posting on myRAteam.