Uncovertebral joint hypertrophy is a condition in which the uncovertebral joints (sometimes referred to as Luschka joints) in the neck become enlarged. Hypertrophy (enlargement) of these joints often degenerates (breaks down) over time from wear and tear or bone spurs (bony growths) in the joints. This condition commonly occurs with age and can lead to other problems, including pinched nerves.
This article discusses uncovertebral joint hypertrophy, including symptoms, causes, and treatment options.
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Role of Uncovertebral Joints in Neck
The neck contains seven stacked bones called vertebrae, named C1 through C7. Uncovertebral joints are found on each side of the vertebrae, from C3 through C7.
The primary function of the uncovertebral joints is to move the cervical spine forward and backward and limit excess lateral flexion, which is sideways bending of the neck. These joints also provide stability during other neck movements.
Symptoms: How Uncovertebral Joint Hypertrophy Pain Feels
The primary symptom of uncovertebral joint hypertrophy is neck pain, which often increases with movement.
Other symptoms can include:
- Headaches
- Muscle spasms
- Popping or grinding with movement
- Swelling
- Tenderness to the touch
As uncovertebral joint hypertrophy progresses, it can lead to compression of nerves that exit each side of the spinal cord between each vertebra, a condition called cervical radiculopathy.
Symptoms of nerve compression from uncovertebral hypertrophy can include:
- Numbness
- Pain that shoots down the arm on the affected side
- Tingling
However, healthcare providers must do imaging to confirm that uncovertebral joint hypertrophy is present.
Diagnosis and Radiology Findings
Healthcare providers typically turn to X-ray imaging to help diagnose the causes of neck pain. However, this type of test is not always enough to show bone spurs and degeneration present with uncovertebral joint hypertrophy.
A computed tomography (CT) scan provides a three-dimensional (3D) image of the uncovertebral joints, which provides more detail about their breakdown.
Sometimes, healthcare providers order additional imaging, such as magnetic resonance imaging (MRI), to determine whether your condition affects other structures. MRIs can help providers assess damage to the spinal cord, spinal nerves, or intervertebral discs.
What Causes Hypertrophy in Uncovertebral Joints
Uncovertebral joint hypertrophy is usually a wear-and-tear condition, meaning it develops from use over time. Osteoarthritis causes bone spurs to develop, leading to hypertrophy in the uncovertebral joints.
Healthcare providers can observe joint changes in CT scans of people in their 20s, which progressively worsen with age. Uncovertebral joint hypertrophy usually affects the joints between C4-C5 and C5-C6.
Other risk factors can contribute to uncovertebral joint hypertrophy, such as:
- Activities that require repetitive neck movements for long periods
- Excess strain on the neck muscles for extended periods
- Family history of neck arthritis
- Obesity
- Poor posture
- Previous neck injury
- Smoking
- Working overhead
Overview of Neck Osteoarthritis
Treatment Options
Healthcare providers can treat mild uncovertebral joint symptoms conservatively. However, severe cases might require surgery.
Conservative Management for Mild Flares
Mild symptoms of uncovertebral joint hypertrophy can be treated with medications, home remedies, and physical therapy, as follows:
- Heat or ice can temporarily help reduce neck pain. Ice can decrease inflammation and pain during a flare-up, while heat can increase blood flow to help decrease stiffness.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Aleve (naproxen), Bayer (aspirin), and Motrin or Advil (ibuprofen) can help reduce pain and inflammation.
- Prescription medications, such as oral steroids or muscle relaxants, are sometimes used to treat pain and muscle spasms.
- Wearing a soft neck collar to support sore muscles can temporarily relieve neck pain. However, wearing it for more than a few days can weaken your muscles. Use it for brief periods when your symptoms are severe.
- Gentle range-of-motion exercises can also reduce stiffness and pain with neck movements. Perform these movements two to three times each, one to two times per day, and avoid any movements that cause pain.
Range-of-Motion Neck Exercise
Talk to a healthcare provider about implementing gentle, range-of-motion exercises to ease neck pain. Here's an example:
- Sit up straight. Squeeze your shoulder blades together and downward.
- Tip your right ear toward your right shoulder, then return to the center.
- Tip your left ear toward your right shoulder, then return to the center.
- Turn your neck and look over your right shoulder.
- Turn your neck and look over your left shoulder.
- Return to center.
In addition to at-home treatment and medications, a healthcare provider may recommend physical therapy for neck pain. Physical therapy is commonly used to treat neck pain caused by degenerative joint changes. This can include a variety of interventions, such as:
- Cervical traction (a specific technique to gently stretch the neck)
- Massage
- Range-of-motion exercises
- Stretches
- Modalities (therapeutic tools, such as ultrasound and electrical stimulation)
- Joint mobilization (moving the joint under a healthcare provider's supervision)
Severe Pain and Complications
If conservative treatment doesn't help treat your uncovertebral joint hypertrophy symptoms, your healthcare provider may consider injections or surgery.
Healthcare providers inject steroid medications into the affected joint to help decrease pain and inflammation. You may require repeat injections after a certain amount of time (typically several months) as symptoms often return.
If your condition has caused complications such as nerve compression, you may need surgery to find relief. Surgery can include decompression through the removal of the uncovertebral joint or other procedures such as a cervical fusion.
Many people benefit from physical therapy after surgery. It can help you regain your range of motion and strength and improve your functioning with daily tasks. If you have a desk job, you might be able to return to work within a few weeks of surgery. However, you'll have restrictions on your activities for four to six weeks.
How to Ease Uncovertebral Joint Hypertrophy Pain
While you can't prevent uncovertebral joint hypertrophy, there are things you can do to help reduce your risk of developing more severe symptoms—particularly if you have neck pain or have been diagnosed with neck arthritis. These include:
- Use proper posture: Maintain a straight neck whenever possible. If you sit at a computer, position your screen at eye level. If you spend a lot of time on the phone, consider using a headset rather than bending your neck to hold the phone in place.
- Stay active: If you spend a lot of time sitting, take several breaks during the day to move around. Incorporate gentle neck stretches into your day.
Long-Term Effects and Risks
Left untreated, uncovertebral joint hypertrophy pain can significantly interfere with daily functioning and negatively impact your quality of life. Additionally, for those who experience nerve compression, it can lead to permanent numbness and weakness in the arm muscles.
Summary
Uncovertebral joint hypertrophy is a condition that affects the lower part of the spine in the neck, causing pain, stiffness, and grinding with neck movements. As the condition progresses, it can lead to pinched nerves, numbness, tingling, and weakness in the arms.
Uncovertebral joint hypertrophy usually develops over time from wear and tear. Symptoms often improve with conservative treatment, including medications, stretches, and physical therapy. In more severe cases, you may need steroid injections or even surgery for relief.
