Neck Problems for Patients with Rheumatoid Arthritis

If you suffer from RA, you may have joint pain in your neck. The first two vertebrae in the neck are called the atlantoaxial joint. Laxity of the ligaments in this area can cause two disorders. The first is atlantoaxial subluxation (AAS), a forward sliding of one vertebra over the other. The second is AA impaction, erosion of vertebral bone causing one vertebra to press down on the other. The worst-case scenario of the AA impaction is the atlas falling around the axis, followed by the skull.  

In a 2005 study done at a Finnish Hospital, the authors studied neck pain on 124 patients. They were studied with neck X-rays, X-rays of the hands and feet, a neck strength testing system, and self-assessment.  Pain was evaluated during the neck strength testing.

AA disorders coexist with the erosion of joints in other areas of the body. If a patient has rheumatoid changes in hands and wrists, they may also have changes of the AA joint. Because the ligaments in the neck may become lax with RA, the possibility of AAS is great.

The researchers found that AAS alone does not cause problems with range of motion. The AA joints have little rotation when compared with vertebrae in the middle of the neck (C4-5 and C5-6). Gaining greater muscle strength in the neck may help to relieve pain symptoms and slow the progression of instability.

For further information: “Decreased muscle strength and mobility of the neck in patients with rheumatoid arthritis and atlantoaxial disorders,” A Hakkinen,  PhD; M. Neva, MD, PhD; M. Kauppi, MD, PhD; P. Hannonen, MD, PhD; J. Ylinen, PHD; H. Makinen, MD; I. Jappinen, PT; T. Sokka, MD, PhD; Archives of Physical Medicine and Rehabilitation, journal 86, issue 8, p. 1603-1608, August 2005.