If you have neck arthritis, you likely deal with joint stiffness and pain every day. Most treatment plans for spinal arthritis include exercise as a way of managing these symptoms. Exercise may also play a role in slowing the progression of the disease.
So what does the average person with neck arthritis need to know about exercise? I mean we all know it's good for you. But how specifically should you exercise so that your symptoms abate? What should be included and what should be emphasized?
To answer these questions definitively, I spoke with two physical therapists who shared their programs and techniques with me. They were Hagit Rajter, M.S.P.T., physical therapist, Joint Mobility Center, Hospital for Special Surgery, New York City; and Debbie Turczan, M.S.P.T., clinical specialist in physical therapy, New York-Presbyterian/Weill Cornell Medical Center, New York City.
"Any good exercise program addressing neck arthritis has two main components," says Rajter. "To manage pain and other symptoms, you need to increase range of motion in the neck and strengthen the neck muscles."
About Neck Range of MotionAccording to Rajter, the most important exercise goal for a person with neck arthritis is developing range of motion. Range of motion simply means flexibility around your joints. It’s generally associated with stretching, but simple movements in all directions can help develop range of motion, too.
Working on your neck range of motion with exercise may help keep arthritis pain under control, says Turczan, adding, "Moving the joint helps break up adhesions, which can be thought of as the joints' internal cob webs."
Increased range of motion decreases stiffness and helps interrupt the "vicious cycle," as Rajter calls it, of pain, immobility, joint changes, reduced muscle tone, spinal instability and increased risk of muscle strain or ligament sprain, common in cases of arthritis. This cascade of changes in the arthritic spine not only increases your risk for pain and injury, it also increases the likelihood of arthritis-related disability.
Other symptoms related to progressed neck arthritis include pinched nerve in your neck and radiculopathy, says Rajter. All of these changes and symptoms tend to perpetuate one another as time goes on, she says.
Unless you intervene, that is. And exercise is one of the best ways to intervene, if not the best.
As far as the neck is concerned, Rajter says range of motion exercises are given to help restore space and integrity to the joint (called remodeling), as well as the soft tissue. This remodeling process increases blood flow to the area, which assists nutrients to pass directly into the joint. A well-nourished joint is key for a healthy joint, she says. "The remodeled joint is also more mobile."
Basic Neck Range of Motion Program for Spinal Arthritis
So what are the best range of motion exercises to do for neck arthritis? Turczan and Rajter agree that simple movements are generally the most effective. Below is Rajter’s general maintenance program. (Consult with your doctor or physical therapist before trying to be sure the this program is right for you.)
Note: If you have more than one spinal condition or another health condition along with your arthritis, or if you have specific athletic goals, you should make an appointment with a physical therapist to get an exercise program that’s tailored specifically to your needs. The program that follows is one that’s safe for nearly everyone, but is not necessarily the most aggressive. If you are at all resolute in your goals for therapy and/or fitness, Rajter suggests meeting with a qualified health professional, such as a physical therapist, in person.
On the other hand, if doing any of the following exercises increases radiculopathy symptoms, stop and consult your doctor or physical therapist.
When you do the neck exercises (i.e., flexion/extension, neck tilts and rotation), Rajter says you should expect to feel pain toward the end of the movement. When you bring your head back to the start position, the pain should disappear. This is how you know when you’ve reached what physical therapists call the "end range" of joint motion. By gently pushing through stiffness at the end range, you may increase mobility and decrease pain, she tells me.
Also, to get the joint remodeling benefit discussed above, Rajter says doing this exercise program for four to six weeks is necessary, according to the McKenzie protocol.
Neck Flexion and Extension
Neck flexion, also called cervical flexion, refers to the action of bending your head forward. Neck extension (cervical extension) is the action of bringing your head back.
Stand or sit for this exercise. Bring your neck into flexion by moving your chin toward your chest. Then bring your head back up so that you are looking at the ceiling. (Your neck will be in extension at this point.)
If your neck is stiff or immobile, Rajter suggest doing this exercise five times. Repeat every four hours to keep your neck mobile.
Lateral flexion of the neck refers to the action of tilting your head to one side. If you tilt your head to your right, it’s called right lateral cervical (remember, cervical means neck) flexion and if you tilt it to the left, it’s called left lateral cervical flexion.
As with the first exercise, you can either sit or stand for the lateral flexion exercise. Bring your right ear toward your right shoulder as far as you can. Then bring your head back up. Repeat several times, and then do the exercise to the left. As with the extension exercise, five repetitions every four hours may be suitable if your arthritis causes neck stiffness or immobility.
Neck Rotation Exercise
Cervical rotation refers to the action of turning your head. (When you turn your head, the twist occurs in your neck.)
Again, either sit or stand. Keeping your head level, turn your head all the way to your right. Hold for about five seconds, then return your head to the start position so that you are looking straight ahead. Do this about five times and then repeat on the other side. Repeating every four hours is generally a safe goal for people with arthritis, Rajter says.
The last exercise targets the upper back and shoulders, and is called the chest stretch.
With your arms straight down by your side, elbows relaxed and palms facing out, pinch your shoulder blades together in back. Hold that for five seconds, then slowly relax. Rest for five seconds, and repeat about four more times. As with the other range of motion exercises for you neck, doing five reps every four hours is a good way to keep you neck limber and address stiffness that comes with this condition.
Kinser, C., Colby, L.A., Therapeutic Exercise: Foundations and Techniques. 4th Edition. F.A. Davis Company. Philadelphia, PA. 2002.
Telephone Interview. Rajter, Hagit, PT, MSPT, Schroth Scoliosis Therapist, Cert. McKenzie Therapist, Advanced Clinician Physical Therapist, Joint Mobility Center, Hospital for Special Surgery, New York City. September 2011.
Email Interview. Turczan, Debbie, MSPT, MSPT, Clinical Specialist in Physical Therapy at New York Presbyterian Hospital/Weill Cornell Medical Center, New York City. September 2011.