In fact, a recent study from Japan has reported a link between wrist and finger rheumatoid arthritic changes and the neck leading to neck instability. Orthopedic surgeons from the Kobe University School of Medicine explored the natural history of rheumatoid arthritis (RA) affecting the cervical spine (neck).
They followed a group of patients (267 total) over a period of five years to see what happens over time. They hoped to see if it’s possible to predict who will develop cervical spine instability from RA.
By performing serial (repeated) X-rays, the authors were able to observe progression of disease over time. They compared erosive joint destruction of the fingers with changes in the cervical spine.
Analysis of the data showed that early signs of cervical instabilities and worsening of hand involvement were two predictive factors for progression of cervical spine instability. As the hands got worse, the neck got worse.
This study showed that by observing early changes (as seen on X-rays) in the neck and hands, it is possible to target patients most likely to develop cervical spine degeneration. Preventing the risks associated with this problem is a more attainable goal now with the new disease modifying antirheumatic drugs (DMARDs) and biologic agents currently available.
Cervical instabilities are considered by some experts the most serious problem associated with rheumatoid arthritis (RA). Understanding and preventing cervical instabilities in this patient population is extremely important. A sudden shift of the vertebra putting pressure on the spinal cord can cause difficulty breathing that could be life-threatening.
Have your primary care physician or rheumatologist take a look at you. An X-ray may be all that’s needed to answer the question of whether or not you are experiencing some early changes in the cervical spine. A change in medication and/or a couple of visits with your physical therapist may be all that’s needed to maintain alignment, mobility, and function.