How Neck Arthritis Is Diagnosed
Your doctor will start by taking a history and doing a physical exam. Theyll check the range of motion in your neck and test your strength, sensation, and reflexes to find out if there is pressure on your nerves or spinal cord. Theyll ask when your symptoms started, when the pain happens, and what makes the pain better and worse.
Your doctor may order an X-ray to assess alignment and look for arthritic changes, says Dr. Shah. If there is a concern of compression of spinal nerves or the spinal cord, you may need an MRI to look at the neutral structure and discs, says Dr. Shah.
A CT scan may be ordered to look at the bone more closely, especially to see if any bony outgrowths are causing compression. However, X-rays and MRIs are the tests that are usually ordered, says Dr. Shah. A CT scan with a myelogram may be used if an MRI cant be done.
An electromyography, or EMG, may be ordered to assess for nerve compression, says Dr. Shah. An EMG tests the electrical conduction of the nerves in the arms. This test would be helpful if you have multiple nerves being compressed or compression of nerves at the neck and in the arm, he says.
Your doctor may order blood tests to see if you have any antibodies or systemic inflammation that would reveal inflammatory arthritis, such as rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis.
What Are The Complications
Cervical spondylosis can be complicated by myelopathy or radiculopathy, although cervical disc prolapse, plexopathy, motor neurone disease, or other diseases can cause similar symptoms magnetic resonance imaging, electrodiagnostic tests, and other investigations may be needed to exclude other diagnoses. Neurological complications can occur in established cervical spondylosis or can be the presenting feature of the disease.
Myelopathy causes clumsiness of the hands or gait disturbance, or both, as a result of sensory ataxia or spastic paraparesis of the lower limbs, with bladder dysfunction being a late symptom. Examination of the upper limbs may show an increase in tone, with a pronator catch or increased tone in finger flexors . Wasting and fasciculation of biceps or triceps are occasional findings. The lower limbs usually show an increase in tone with spasticity, but little true weakness. Tendon reflexes are characteristic, with reduced or even inverted biceps or supinator jerks , and an increase in triceps jerks, finger jerks, and all lower limb reflexes, with upgoing plantar responses. A positive Hoffman’s sign and ankle clonus are also common findings. Sensory changes vary, but tend to affect vibration and joint position sense in the hands more than the feet.
Fig 3 Dermatomal distribution of cervical and upper thoracic nerves
Box 3 Red Flag Features And The Conditions They May Suggest
Malignancy, infection, or inflammation
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History of inflammatory arthritis, malignancy, infection, tuberculosis, HIV infection, drug dependency, or immunosuppression
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Excruciating pain
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Exquisite tenderness over a vertebral body
Myelopathy
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Gait disturbance or clumsy hands, or both
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Objective neurological deficitupper motor neurone signs in the legs and lower motor neurone signs in the arms
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Sudden onset in a young patient suggests disc prolapse
Other
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Drop attacks, especially when moving the neck, suggest vascular disease
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Intractable or increasing pain
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Who Gets Neck Pain
About two thirds of the population have neck pain at some time in their lives,w5w6 and prevalence is highest in middle age. In a general practice survey of adults in the United Kingdom, 25% of women and 20% of men reported current neck pain.w7 In a Norwegian survey of 10000 adults, 34% of responders had experienced neck pain in the previous year.w8 After back pain, neck pain is the most frequent musculoskeletal cause of consultation in primary care worldwide. In the UK about 15% of hospital based physiotherapy and in Canada 30% of chiropractic referrals are for neck pain.w9w10 Epidemiological studies of neck pain are mostly based on questionnaire or population surveys and may overestimate the frequency of the condition. Despite these methodological difficulties, they do provide evidence that neck pain places a heavy burden on individuals, employers, and healthcare services.
Signs Your Knee Pain Comes From Your Spine
Unless you have suffered a traumatic injury to your knees, the knee pain you feel is not an inflammation or a problem with your joints. Most likely, the discomfort in your knees is a symptom of the underlying cause and theres a good chance your spine is the real culprit.
Here are four signs that can help you determine if your knee pain is a sign of a spinal condition:
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Cervical Stenosis And Hip Pain
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Cervical stenosis is when the hole for the spinal cord in the neck bones becomes too small due to wear-and-tear arthritis. The discs, facets, or joints called uncovertebral can place pressure on the cord . Since the job of the spinal cord is to carry signals to and from the body to the brain, placing pressure on the cord can result in a disruption of those signals.
Its sometimes hard for patients to understand how pressure in the neck can make someone believe that a distant area is hurting however, a light-bulb-wiring analogy may help. If you mess with the wires that go to a light bulb at any point from the switch to the bulb, the bulb will go out.
From the perspective of the bulb, all it knows is that its not working. Its ignorant to whether the issue is at the connection with the bulb, halfway there, or right after the switch. In the same way, pressure on the nerves at any point from the hip to the brain will be perceived by the brain as being in the hip.
The upshot? Can your neck cause hip pain? Yes. I now know this intuitively, which is a bit different from knowing it academically. My issue is managed well by using platelet lysate epidurals to keep the nerves and spinal cord in tip-top shape and avoiding certain positions I know cause my bone spurs to bump into my spinal cord. In the meantime, I lead a normal and very active life without surgery!
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References
Dtsch Arztebl IntChris Centeno, MD
Make Swimming Part Of Your Routine
If you’re looking for a great way to keep your knees strong, swimming might just be the workout for you.
“Swimming is a great zero-impact way to keep your legs strong and healthy. Water provides great resistance that your quads and hamstrings have to work against to move. It’s refreshing, calming, beneficial, and great for you physically and mentally,” says Gray.
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Three Signs That Your Knee Pain May Be Originating In Your Back
by Harbor View | Mar 3, 2016 | back, knee, nerves, Uncategorized |
Just about everything you think you know about your knee pain probably is wrong. Most physicians hold fast to what they learned in medical school, but the science of medicine is constantly evolvingfinding less invasive ways to treat our ailments and discovering the root causes of our pain.
An important thing to understand is that what hurts is not necessarily the problem, but a symptom of the problem. If your knee pain isnt the result of traumatic injury, a strong possibility exists that it could be caused by a problem in your back. Not determining the root cause of your pain could lead to an unnecessary knee replacement that doesnt address the source of the pain. Research studies consistently show an unacceptably high percentage of patients continue to have chronic pain after knee-replacement surgeries.
Your back houses the nerves that drive the muscles around the knees. A problem with a nerve in your back can affect how those muscles work. Low-level nerve irritation usually isnt noticed by patients as back or leg pain. It just causes the muscles to misfire, destroying the otherwise needed protection for the knee joint.
There are three signs that your back could be causing your knee pain.
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Knee Pain As A Symptom Of Lung Cancer
Both monoarthritis and polyarthritis have been identified as possible signs of lung cancer. Sometimes, these symptoms can be misdiagnosed.
The connection between knee pain and lung cancer can easily be missed because the rate of arthritis problems occurring with lung cancer is very low.
- Arthritis symptoms due to a paraneoplastic syndrome occur in approximately 0.24% of lung cancer patients.
- HPOA incidents among lung cancer patients range from 0.72% to 17%.
- Researches have only reported 48 cases of synovial metastasis, and only a fraction of those incidents are related to knee pain.
If you have lung cancer, your knee pain is more likely to be related to other causes and is rarely a symptom of your lung cancer.
If you have rheumatoid arthritis , your knee pain is likely related to your arthritis. However, you should discuss your risk of lung cancer with your doctor. Those with RA are eight times more likely to develop interstitial lung disease, which puts you at risk for lung cancer.
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Chronic Stress And Long
Aches and pains are common symptoms of stress, however, ongoing pain or stiffness may be a sign of a more serious problem.
A 2018 study published by PubMed revealed Stress-related disorders were significantly associated with risk of subsequent autoimmune disease.
Autoimmune diseases cause your immune system to produce antibodies which attack and damage the bodys healthy tissue instead of fighting infection. In certain conditions, such as rheumatoid arthritis and lupus, the antibodies attach to connective tissue within the joints leading to pain, stiffness, swelling, andwithout treatmentpotentially permanent joint damage.
Autoimmune diseases are often incurable however, early intervention and treatment can help prevent further damage and joint deterioration.
Foot Pain Caused By A Spinal Problem
Nerve root irritation or compression in the lumbar or sacral spine may cause sciatica pain to radiate down your leg and into the foot.1 Specifically, compression of the S1 nerve root, also called classic sciatica, can cause pain along the outer side of your foot.2
Nerve roots may be compressed or irritated due to a number of causes. Common examples include3:
- Lumbar herniated disc: Leaking of the inner contents of an intervertebral disc
- Lumbar degenerative disc disease: Age-related changes causing narrowing and shrinkage of the disc
- Spondylolisthesis: Slipping of a vertebra over the one below it
- Lumbar spinal stenosis: Narrowing of the bony openings for spinal nerves and/or the spinal cord
The inability to lift the front part of your foot or frequent tripping while walking may be due to a condition called foot drop. This condition is typically caused due to compression of the L5 nerve root. Rarely, compression of the L4 and/or S1 nerve roots may also cause foot drop.4
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Does Back Pain Cause Knee Pain
As one of the most complex joints in the body, the knee allows the entire leg to move, flex, and have a good range of motion. Meanwhile, with its vertebrae and shock-absorbing discs, the back has a myriad of responsibilities it holds you physically together and secures the high-speed conduit for your complex and delicate nervous system.
Together, the knees and the back provide flexibility, motion, and support. However, they also rely on each other to maintain balance and equilibrium. Therefore, when your back hurts, so might your knees.
How Can I Know If I Have Sciatica
Sciatica is linked to certain conditions including pregnancy, osteoarthritis, degenerative disc disease, and herniated or bulging discs. Doctors who suspect their patients have sciatica may ask their patients to perform some exercises or undergo x-rays and similar tests.
Physicians will also ask questions several questions including:
- Where do you feel discomfort?
- What is the pain like?
- How often are you uncomfortable?
- How long does the pain last?
- What triggers the discomfort and what helps it go away?
- Do you sit for a long period of time?
- Do you do any lifting or strenuous physical activities for your job?
- Do you have an active lifestyle?
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How Does The Body Respond To Stress
When faced with danger, a chemical reaction occurs in your body which allows you to act quickly. This reaction, also known as the fight-or-flight or stress response, is your bodys way of keeping you safe from harm. Unfortunatelythe body cant always discern between a legitimate threat and the pressure of daily life.
Any stressful situationfrom narrowly avoiding a head-on collision to being stuck in a traffic jamcan trigger this response causing the heart rate to increase, blood pressure to rise, and muscles to tighten.
Symptoms Of Stress And Anxiety
Stress can wreak havoc on your mind and body. In small doses, the stress response can improve alertness and sharpen senses however, chronic stress can lead to serious problems such as cardiovascular disease, gastrointestinal problems, and autoimmune disease. Be sure to talk to your doctor if you experience any of the following symptoms on an ongoing basis.
Mental/Emotional Symptoms:
- Frequent colds or infections
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Your Hips Or Quadriceps Feel Weak
Your quads are a group of muscles located at the front of your thigh. The three vastus muscles and rectus femoris make your thighs, one of the most powerful parts of the body, as they allow you to extend your knees and move your hips.
On the other hand, each hip is a ball-and-socket joint responsible for bearing most of your bodys weight. The hips have many ligament attachments for stability and muscular attachments to help control the motion of your leg and knee joints. The rectus femoris muscle crosses over from the quads and connects to the hip so if a problem occurs with the quad muscles, your hips will be affected.
Now, the parts of the human body are connected like a chain. Even if you didnt experience an injury or a major trauma to your hips and quadriceps, you may suddenly feel like youre unable to move them at full strength. This is a condition that may be caused by a spinal problem since the nerves that control the motor functions of the quads are located between the vertebrae of the lumbar spine.
If those nerves become irritated or get pinched by the vertebrae, the movement of your hips and quads will be affected. Weakness in these areas will cause the knee joints to work harder and wear out faster, which explains the knee pain you might be feeling.
How Do I Treat Cervical Spondylosis Complicated By Neurological Abnormality
Most patients with neurological abnormality will need magnetic resonance imaging of the cervical spine at an early stage, particularly if they have progressive myelopathy, radiculopathy, or intractable pain. Neurosurgical intervention also needs to be considered, but the outcome of decompressive surgery is often disappointing, especially for myelopathy complicating cervical spondylosis. While progression of the neurological deficit may be slowed by surgery, lost function may not recover or symptoms may progress at a later date. Poor outcome after surgery may reflect irreversible damage to the cervical cord ) or compromise to the vascular supply to the cord.
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Could It Be Your Back Causing Your Knee Pain
An important thing to understand is that what hurts is not necessarily the problem, but a symptom of the problem. For knees, the first thing to consider if knee pain isnt the result of traumatic injury is, are issues in your back causing your knee pain? Not determining the root cause of your pain could sadly result in a shiny, new knee replacement that doesnt actually address the source of your pain. And as weve seen in research studies, an unacceptably high percentage of patients still have chronic pain after knee replacement.
How To Know If Your Knee Pain Comes From Your Spine
Many people assume knee pain is always caused by a problem in the knee joints. However, that is not necessarily the case. If youre suffering knee pain or discomfort, there is a possibility that a problem with your spine is the cause.
So how do you know if your knee pain comes from your spine? The muscles around your knees are connected to the nerves in your lower spine so if these nerves are irritated or compressed, your knees may be affected by symptoms such as intermittent back pain, hamstring tightness, weakness in the hips or quads, and the development of bunions on your feet.
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Emotional Issues Directly Linked To Knee Pain
If you are suffering from knee pain, energy blockages or traumatic emotions might not spring to mind as being linked to it. But ask yourself if you have any of these worries or fears. I think youll be surprised!
- Fear of change of life direction.
- Lack of ease of movement.
- Unable to be flexible.
- Not wanting to bend, usually to authority.
- Ego gets in the way.
- Pride gets in the way.
What Do I Need To Know About Neck Anatomy
You dont need to memorize the physiology and anatomy of your neck to improve its function and reduce pain, but its helpful to have a general understanding of your cervical spine.
Neck mobility is matchless. Although you wont get any Exorcist-style head spinning, it is capable of moving the head in many directions: 90° of flexion , 90° of extension , 180° of rotation , and almost 120° of tilt to either shoulder.
But all that mobility comes at the cost of complexity. First youve got your seven vertebrae , each cushioned by an intervertebral disc and connected by facet joints. There are also 32 muscles, plus the tendons that attach them to bones, that help move and stabilize the neck, as well as a number of ligaments attaching bones to each other. Thats a lot of action in a comparatively small area.
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