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Old 02-23-2013, 09:53 AM   #1
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Cervical arthritis - only 27

Hi,

I was diagnosed about a month ago with arthritis (I'm only 27). I have a bone spur and slight left foraminal stenosis at C5-C6, which I guess is what indicates arthritis to be the cause of my pain. It is all on the right side of my neck/upper back.

My doctor said the stenosis is not causing me a problem right now since I have no pain on my left side. I first started having a little problem with it about 3 years ago, but up until recently thought I was just continually pulling a muscle. It is not a constant terrible pain. I generally do something to aggravate it (weightlifting), then it goes away and am fine.

When I first had issues with it, I would aggravate it and a few days later would be fine (And would have 3-6 months of no problems). Over the last year, it has happened much more frequently and taken longer to go away, and in the last couple of months I have aggravated it somehow without any weightlifting or strenous activity. This past week I had gotten to the point of virtually no pain again, but last night woke up with a lot of pain. I don't think I slept on it wrong (I was on my back all night) and I did not do anything yesterday that should have aggravated it. So this is the frustrating part - having no idea why it is aggravated right now.

I have a follow-up appt with my ortho this week. He currently has me taking baclofen (a muscle relaxer). This has helped speed up the healing process when I do aggravate it, but it doesn't keep me from aggravating it. He said if it was bothering me when I see him next he may want me to try Cymbalta. I am hesitant to try this since it is also used as an anti-depressant and has side affects. I also do some neck stretches I learned from some PT sessions.

Has anyone else followed a similar progress of worsening neck arthritis as this? Has any medicine/treatment helped? I am normally very active, and this is very frustrating to be limited right now. I could live with it if it was an occassional thing, but right now I have not been pain free for four months (besides the few days earlier this week). Thanks!

 
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Old 02-25-2013, 12:44 PM   #2
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Re: Cervical arthritis - only 27

Did you have a MRI? If you have the report, you might want to copy some of it in case something else is mentioned that may be conbtributing to your pain. I am just leaving the house right now for an appointment, but when I return I will attempt to shed some light on your issues. I normally post on the back board and am familiar with your issues.

 
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Old 02-25-2013, 03:09 PM   #3
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Re: Cervical arthritis - only 27

I wanted to comment on the term "arthritis," and particularly the "only 27." We tend to think of arthritis as an ailment that is common among older people, but in reality, the spine begins its aging process in our 20s.

The discs are comprised of something like 95% "moisture" but do not have a good system to replenish the loss of moisture. Every day living results in a gradual deterioration of the discs, which can result in loss of disc height and in the formation of disc bulges and herniations. This is a natural process of aging, but it happens sooner in some people than others.

The body fights to maintain balance. When there is an issue that is resulting in a bit of instability, the body manufactures little bony overgrowths that serve to keep things from slipping. Unfortunately, these osteophytes result in the enlargement of a joint or bone, which when it occurs in the vertebral foramen or central canal, results in there being less space for the spinal nerves to function normally. This narrowing is called stenosis. This whole process is kind of lumped together and described as "spinal arthritis."

It is possible that the weightlifting is aggravating your neck...and the body is going into overdrive trying to keep everything working properly. Muscles tend to grip harder trying to hold the body in alignment...this can cause some muscle groups to contract and even shorten in length, which can pull the spine out of kilter. Ligaments can harden and lose their elasticity.

I'm a little confused by the description of your problems. You state there is an osteophyte and stenosis on the left side but that your pain is on the right side...what are the issues on the right side?

Are you seeing an orthopedic spine surgeon? You have to be a little careful with something like this as it can turn into a chronic pain situation. I would be beneficial to get an accurate diagnosis and a plan of treatment so that you get the issue resolved, rather than continually healing and reinjuring the same area over and over.

 
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Old 02-25-2013, 04:54 PM   #4
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Re: Cervical arthritis - only 27

Thank you for the reply! Here are my MRI results:

C5-C6: Posterior disc osteophyte complex. Moderate left foraminal stenosis.

Everything else in the MRI was fine. Sorry if my post was confusing. I could write 10 times as much as I did, but didn't want to overdo it. I am seeing an ortho spine surgeon (follow-up in two days, last appt was the initial diagnosis after the MRI) who said it was arthritis. He said the stenosis was not causing my problems as the pain from the stenosis would be on my left side. All of my pain is on the right side of my spine. Primarily right along my spine, but it can be bothersome out to the top of my right shoulder or around my right shoulder blade.

Up until the last month, each time it was aggravated by weightlifting. If it wasn't 100% better and I played tennis or some other sport, it may have irritated it, but did not aggravate it to the point of virtual immobility for a day or two like the weightlifting aggravations did.

However, twice since my diagnosis, it has become aggravated for no reason. A few weeks ago I was just walking around the house and something didn't feel right and within minutes it was tight and painful. A few days ago it had been feeling better than it had in months and then I woke up Saturday morning and it was very aggravated. I had not done anything the day before to aggravate it and had slept on my back all night, so I am now frustrated that I seem to not even be able to avoid the things I know aggravate it.

I will see what the ortho says in my follow-up, but his initial ideas were just to take muscle relaxers when I aggravate it, and take cymbalta if I was willing to take something long term (which I am hesitant to do). And I do stretching excercises I learned from going to a PT when I aggravated it once last summer.

 
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Old 02-26-2013, 06:34 AM   #5
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Re: Cervical arthritis - only 27

Disc osteophyte complex -- It helps to understand a bit about the disease process as I think it explains how a young person like you can begin to develop this at an early age.

We tend to think of arthritis as affecting the joints in the body, but we do not necessarily think about it involving ligaments and tendons...but it is usually through those ligaments and tendons that the disease process begins.

Osteophytes usually form when ligaments and tendons around the vertebrae and facet joints in the cervical spine are damaged or become inflamed. This damaged or inflamed tissue abnormally influences bone growth. New bone cells end up growing where they would not normally grow...and the result is osteophytes, which are little bone spurs.

This can be caused by a number of things including the natural aging process, poor nutruition, poor posture, abnormal stress or traumatic injury, obesity and a family history of osteoarthritis.

Once the inflammatory process gets going, it contributes to the formation of these osteophytes. Perhaps it is possible that the weightlifting was periodically stressing ligaments in the cervical area...and you would rest a couple days until it felt better and then start the activities again. So there was a cyclical pattern of stressing the ligaments and then stressing them again before they had healed completely. It is possible that the disc itself may have been slightly damaged -- maybe not enough to show up on MRI, but enough that it caused the inflammatory process to get going.

Obviously for whatever reason, that one disc segment is taking the brunt of the stress, as apparently the rest of the cervical area looks OK on the MRI.

Many times this process can happen without causing any pain. The result is that a natural fusion eventually occurs...over decades of time...and the person is not aware of it until a MRI is done for another reason and this fusion is a finding.

You cannot "undo" this disease process but you can do things to limit the consequences. Treatment usually consists of a course of physical therapy to strengthen the surrounding tissue, oral medications for pain and to control inflammation and sometimes a series of epidural steroid injections to help with swelling and to help with healing.

Last edited by teteri66; 02-26-2013 at 06:39 AM.

 
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Old 02-26-2013, 06:41 AM   #6
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Re: Cervical arthritis - only 27

Oh, I forgot to mention that there are two boards where people with spine issues hang out: the back board has most of the lumbar people and the spinal cord disorder has the most information about the cervical spine, including people with problems like yours. You may find some useful information there...and some people who can relate their problems to yours. I usually hang out on the back board but noticed your post and wanted to respond.

 
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Old 02-26-2013, 07:43 AM   #7
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Re: Cervical arthritis - only 27

The cervical spine is the only area where synovium exists (in the spine), and because of your young age, I would want to rule out rheumatoid arthritis, especially if you have any other joint issues like hands, feet, knees, hips, etc. You didn't mention being on any antiinflammatory med, which would be essential for this. They can be used along with a muscle relaxant. An OTC one would be Naproxen, but the Rx doses are higher than the OTC. If there are periods when you have obvious spasm, heat and massage can help, and even a soft cervical collar, like around the house, can support the head, limit motion of neck, and let muscles relax. Do a neck circumference measurement to buy right size (OTC at drug stores). Also, make sure you have a good supportive pillow that keeps neck in normal anatomical position while sleeping. Avoiding more trauma to neck structures is key in keeping this from getting worse.

 
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Old 02-26-2013, 04:54 PM   #8
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Re: Cervical arthritis - only 27

Isn't every facet joint in the spine a synovial joint?

 
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Old 03-05-2013, 12:12 AM   #9
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Re: Cervical arthritis - only 27

Posture plays a major role that develops Cervical Arthritis. This is commonly caused when the cervical vertebrae experiences the loss of cartilage. They affect the spinal disk of the neck. Itís highly important to maintain an erect posture so that this situation is not faced.

 
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Old 12-18-2013, 12:27 PM   #10
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Re: Cervical arthritis - only 27

I lost track of this thread after awhile, but wanted to follow-up as I'm continuing to struggle with some pain.

I never ended up taking cymbalta or anything else besides baclofen. I completely stopped any sort of weight (even body weight) excercises, and have concentrated on cardio excercises to keep in shape. Despite this, I still have flare-ups of pain. These have been a result of: ping-pong, tennis, running (the bouncing up and down?), throwing, leaning forward on my elbows, or for no reason at all (I am in more pain right now than I've been in awhile after bending down at the waist to grab something from a lower shelf at Target).

None of the flare-ups have been as bad as when I would have flare-ups following weightlifting, but they still will cause me to have to be inactive anywhere from a few days to a couple weeks. I still think the baclofen helps speed up recovery, but the two times I have been on baclofen for a long time (greater than a month), I seem to have residual depression when i get off of it. I assume the baclofen is at least partially responsible as I haven't had issues with depression otherwise.

I saw a second ortho spine specialist who has said essentially the same thing...there is a lot going on in a neck that won't be pinpointed in an MRI and so there is nothing they would recommend doing unless I was in constant severe pain. They say whatever it is gets irritated and inflamed for some reason and then the surrounding ligaments and muscles become rigid and painful and the pain spreads around the upper right side of my back and out to the top of my right shoulder.

They say I just need to manage it and avoid things that irritate it. So obviously I don't lift weights anymore, but given there seems to be no other specific trigger, I can't just avoid doing everything. I can go two months of playing tennis without much of any problem and then irritate it just reaching to grab something.

Any thoughts?

 
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