If you have been diagnosed with rheumatoid arthritis and suffer from neck pain, this article will explain how to treat rheumatoid arthritis in the neck. Rheumatoid arthritis causes the destruction of the synovial joints, which are located on each side of the spinal canal. This makes the connections between the vertebrae unstable. The first symptom is pain in the base of the skull, which indicates irritation of the nerves coming from the skull and the upper spine. In addition, pressure on the arteries can lead to blackouts. If pressure on the spinal cord increases, balance and gait problems with walking may occur.
To determine if you have rheumatoid arthritis and the degree of compression on the spine, you will need:
- An x-ray of the cervical spine to determine instability
- An MRI to show damage to nerves and soft tissue
- An electrical test for spine functioning
- Once you are diagnosed with rheumatoid arthritis, seek out a specialist in this disease. There are many medications now available for rheumatoid arthritis. The specialist will help you determine which medications to take and manage them for you.
- If your x-rays show instability in your neck, the condition must be monitored to show any progression of the disease. If your condition shows only mild instability and no pressure on the spine or nerves, you may not need additional treatment. If you do show signs of instability, you may need a neck brace to prevent a cervical spine injury, especially when riding in a car.
- There are some options available in addition to medication. There may be some things you may want to try before resorting to any type of surgery. Chiropractic treatment for a realignment of the spine may relieve the pressure on the spinal nerves. The chiropractor may use electrical stimulation or ultrasound in addition to the traditional manual manipulation. Physical therapy can also help. Using cold, heat and electrotherapy can promote healing, reduce swelling and strengthen the neck. Finally, before getting surgery, you may want to try an epidural. This anti-inflammatory shot consisting of a steroid and an anesthetic is injected into the irritated area. This treatment may provide long-term, short-term or even permanent relief.
- In some cases, pressure on the spinal cord may require surgery. Surgery can stabilize the cervical spine, remove pressure on the spinal cord and relieve neck pain. This surgery can be risky, so be sure to get a complete evaluation and discuss the risks with your doctor.
- A cervical fusion may be performed if the instability is in the lower cervical spine. First, the vertebrae are roughened, then a bone graft from the hip is placed between and across the back of the vertebrae to be fused. The vertebrae are then held together by some type of hardware (most often wire), wrapped around the spinous process (bump) on the back of the vertebrae.
- A posterior fusion is used when there is instability between C1 and C2. Wedges of bone graft are placed between the vertebrae and they are then wired together. The fusion results in a single bone, which relieves pressure on the spinal cord and stops instability from getting worse.
- If settling has occurred and C1 and C2 are destroyed, paralysis or sudden death could occur. In order to stabilize this, fusion must be done between the skull and C1 to C3. Bone graft from the pelvis is used to cover this area. Wire or some other type of hardware is used to hold the graft in place.
- If posterior fusion is not enough to relieve pressure on the spine, the transoral approach may be used. This surgery is done through the back of the mouth and removes the pressure from the front of the spinal cord.
- Neck surgery carries risks, so be sure to research carefully before making a decision.
- If possible, try non-surgical methods of treatment and/or medications before considering surgery.
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