April 2025 Newsletter

OSTEOARTHRITIS IN THE NECK AND UPPER LIMBS

Weight bearing joints are by far the most common in showing signs of Osteoarthritis (OA). However, trauma predisposes any joint to this condition. it is not aging that causes it but an end result of abnormal mechanical, inflammatory, or metabolic factors. An accident, such as a fracture, repeated strain, or a bad jolt will certainly be a format to OA.

HANDS tend to be the most affected by OA. This is due to the fact that we obviously use them to a greater extent than other joints. If you think of all the varying angles of pressure we put on these small joints there’s no wonder they show signs of wear and tear in later life. Occupation plays a deciding factor myself for instance will be prone due to all the irregular pressures I have to use in manipulation and massage.

Osteoarthritis is easily identified in the hands. At the joint margins more bone is formed known as Heberden’s nodes. These tend to make their appearance after the age of 45.
The first joint of the thumb is commonly affected and obviously inhibits grip and grasping movements. Pain accompanies these changes but it burns out leaving the unsightly swellings.

ELBOWS rarely show OA except after trauma.

SHOULDERS are mostly affected by soft tissue problems but again trauma will predispose it to OA.

Physiotherapy in all cases is to reduce the inflammation and maintain movement where possible.

THE NECK
OA in the neck is commonly referred to as cervical spondylitis, or spondylosis cervical being the name of the vertebrae of the neck and spondylitis being inflammation on the bony growths called spondylus, osteophytes or spurs.


This is an age-related condition. It’s the wear and tear of everyday life.
The severity depends on occupation, sport, posture. The list is never ending. However, carrying heavy weights or having strain on the neck for long periods of time are two of the main factors causing this problem.

Men and women suffer equally. House work can prove just as much strain as bricklaying.!!
As the discs wear down the bones come closer together and react by forming more bone.
Depending where these spurs form determines the symptoms. Symptoms vary in severity. A general aching is produced by pressure on the small pain sensitive nerves which grow around the worn-out area. However, if a main nerve is pinched the pain is sharp electric shock like. So, symptoms can be an aching of the neck spreading down into the shoulders and between the shoulder blades or it could be a sharp pain going all the way down the arm to the fingers. Pins and needles in the hand and also numbness occurs.
The pain also varies enormously. Some people complain of constant pain while others have it from time to time. Problems occur by a sudden jolt or twist, or carrying a heavy object.

TREATMENT AND MANAGEMENT

Physiotherapy is helpful in the acute phase. Improvement may take several weeks depending on the severity. It is important to seek help during this phase as it is the inflammation which causes the initial damage. Over enthusiastic manipulation on the neck is not advised and can even be dangerous causing further nerve and spinal damage.
Cervical spondylosis often produces recurrent episodes of pain. Self management is very important:

1 Avoid sudden movement and prolonged stressful positions.
2 Correction of posture is important.
3 Sensible use of collar.
4 Gentle mobility exercises in pain free range.
5 When acute see your physiotherapist for help.
6 Use anti inflammatory drugs prescribed by your family doctor.