- How RA Affects the Spine
Yes, rheumatoid arthritis (RA) can affect the neck or cervical spine. It is the third most common site to be affected by RA, the top two being the small joints of the feet (metatarsophalangeal joints) and hands (metacarpophalangeal joints).
- Among the bones of the spine (vertebrae), the cervical region is most commonly affected by RA, whereas those in the upper and lower back region (thoracic and lumbar spine) are rarely affected.
- The medical term for this condition is rheumatoid spondylitis.
How does rheumatoid arthritis affect the cervical spine?
Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune condition. In autoimmune diseases, the immune system, which is supposed to fight infections and other harmful agents, mistakenly targets and attacks the body’s tissues. This results in chronic inflammation that causes damage to various tissues in the body, such as the joints, skin, eyes, heart, lungs, and kidneys.
The autoimmune attack in RA can target the bones of the spine, typically those in the neck or cervical region. This may cause three main types of abnormalities in the cervical spine:
- Atlantoaxial instability: Most common abnormality seen in RA that affects the cervical spine. The atlantoaxial joint is the joint between the atlas and axis (first two cervical bones or vertebrae). This abnormality results in the misalignment of the two cervical vertebrae.
- Superior migration of the odontoid: The odontoid process is a projecting bony part of the second cervical vertebra on which the first cervical vertebra rotates. This deformity can result in pressure on the lower part of the brain that may cause neurological dysfunction and even death in severe cases.
- Subaxial subluxation: Least common type of cervical spine deformity. It can result in compression of the spinal cord.
What are the symptoms of rheumatoid arthritis of the cervical spine?
The symptoms of rheumatoid arthritis (RA) of the cervical spine may vary depending on the type and severity of the abnormality caused.
Symptoms may include:
- Neck pain
- Neck stiffness
- Pain in the skull’s base or back of the head (occipital region)
- Vertigo or dizziness
- Facial pain (due to compression of certain nerves passing through the cervical vertebrae)
- Weakness or numbness
- Difficulty walking
- Dysphagia (difficulty swallowing)
- Tinnitus (ringing in the ears)
- Grating sensations or crepitations in neck movement
- A feeling that the head is “falling forward” while bending the neck
- Shock-like sensations through the body or limbs on neck movement (the Lhermitte’s sign).
How do doctors diagnose rheumatoid arthritis of the cervical spine?
Doctors usually diagnose rheumatoid spondylitis based on:
- The detailed medical history of patients, including the symptoms, history of injury, any family history of rheumatoid arthritis, any ongoing medications, and any underlying health issues
- Physical examination to look for reflexes, stiffness any bony abnormalities, etc.
- Investigations including:
How is rheumatoid arthritis of the cervical spine treated?
Treatment mainly focuses on preventing any serious complications. As the cervical vertebrae are close to the lower part of the brain, several nerves, and the spinal cord, untreated spondylitis can result in permanent neurological damage and even death. Most patients may be managed with conservative treatment; however, others may require surgery.
Surgery may help relieve pressure on the nerves, brain, or spinal cord. It may also reduce the symptoms while improving the stability of the cervical spine.
The non-surgical treatments generally include:
- Cervical collars
- Regular follow-up
- Physical therapy
- The nonsteroidal anti-inflammatory drug, such as ibuprofen and naproxen
- Corticosteroids, such as prednisone
- Disease-modifying antirheumatic drugs, such as sulfasalazine, methotrexate, and leflunomide
- Biological response modifiers or biologicals, such as abatacept, adalimumab, and tocilizumab
- Janus kinase inhibitors, such as baricitinib, tofacitinib, and upadacitinib
Top Can Rheumatoid Arthritis Affect the Cervical Spine Related Articles
11 Home Remedies for Rheumatoid ArthritisRheumatoid arthritis (RA) is a long-term disorder that progressively affects many parts of the body. Home remedies, diet, and lifestyle changes can help reduce pain and discomfort associated with RA alongside medical treatment. Home remedies alone cannot effectively treat RA or prevent the progression of the disease.
Back Pain: Common Spine ProblemsThat stack of little bones along the center of your back has a key role to support and control your body. What happens when something's not right with your spine?
What Is the Best Infusion for Rheumatoid Arthritis (RA)?Learn the four most effective DMARDs for rheumatoid arthritis infusion therapy, which aim to control RA symptoms, reduce complications, and improve quality of life and lifespan.
Can Rheumatoid Arthritis Affect Your Ability to Walk? 9 LimitationsRheumatoid arthritis can impair your walking ability and result in the following nine types of functional limitations.
Can Rheumatoid Arthritis Be Caused by Stress?Rheumatoid arthritis can be caused by and result in stress, as well as other conditions such as gastrointestinal problems (IBD).
Fractured Spine PictureFractures of the spine (vertebra) can cause severe "band-like" pain that radiates around from the back to the side of the body. See a picture of Fractured Spine and learn more about the health topic.
How Serious Is Rheumatoid Arthritis?Rheumatoid arthritis (RA) is a chronic inflammatory disorder that typically affects the joints and other body parts. If not diagnosed early and appropriately treated, RA can lead to permanent deformities, disabilities, and serious systemic complications.
Lower Back Pain (Lumbar Spine Pain)There are many causes of back pain. Pain in the low back can relate to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis, and abdomen, and the skin covering the lumbar area.
Lumbar LordosisLumbar lordosis or "swayback," lower back curvature), in children, adults, and women who are pregnant is an abnormal posture with a low back curve. Symptoms of lumbar lordosis in include lower back pain and discomfort, difficulty in moving certain directions due to back pain, and a large gap or arch between the lower back and a flat surface when you lay down.
Common causes of lumbar lordosis in children, adults, and during pregnancy include obesity, kyphosis, bad posture, genetics, and other disorders of the spine. Treatment for lumbar lordosis include exercise, weight loss, surgery, and pain medication. Lumbar lordosis can be reversed and cured; however, it depends on how severe the symptoms are. Lumbar lordosis treatments may help reduce pain and other symptoms or Mild lordosis in children may be cured without treatment, while severe lumbar lordosis needs surgery to fix. Lumbar lordosis can be reversed "cured" or go back to normal or near normal.
Rheumatoid Arthritis (RA)Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body.
Rheumatoid Arthritis: Alternative RA TherapiesLearn which alternative treatments show promise for rheumatoid arthritis.
RA QuizHow is rheumatoid arthritis different from other forms of arthritis, such as osteoarthritis and gout? Take the Rheumatoid Arthritis (RA) Quiz to rest your RA IQ.
Rheumatoid Arthritis: RA Food Myths and FactsIs there really an RA diet? Learn the truth from WebMD about which foods can ease your symptoms and which you should avoid.
RA Home RemediesPeople try all sorts of things to relieve rheumatoid arthritis pain. WebMD debunks some of the common ones and lets you know what needs more testing.
Rheumatoid Factor (RF)Rheumatoid factor is often measured in blood tests for the diagnosis of rheumatoid arthritis. However, rheumatoid factor can also be present in individuals with other conditions such as lupus, infectious hepatitis, syphilis, mononucleosis, tuberculosis, liver disease, and sarcoidosis.
What Are the Four Stages of Rheumatoid Arthritis?Rheumatoid arthritis is a chronic inflammatory disease categorized into the following four stages and classifications. Learn the causes, symptoms, and complications of RA below.