How does Rheumatoid arthritis affect the cervical spine (neck joints)?

Rheumatoid disease can affect the cervical spine (neck vertebrae) joints as any other joint. What makes the cervical spine joints different is the fact that the spinal cord is in close vicinity & any pressure on the same by the rheumatoid synovium or the bone can lead to paralysis.

To understand this, we should understand the anatomy of these vertebrae. The 1 st vertebra is called Atlas & the 2 nd vertebra is called the Axis. These are ring shaped circular bones. The axis has a vertical structure called the odontoid process (Dens). The atlas sits on top of the Axis & the odontoid process.

Cervical vetebrae anatomy

The space enclosed by the atlas has the odontoid process & the spinal cord within. The swollen rheumatoid synovium destroys the ligament (Transverse Ligament) that holds the odontoid process in its position. Once this ligament is damaged, the odontoid starts pressing against the spinal cord. The cord in turn has nerve fibres that control the movements of the limbs.

Rheumatoid affection of the cervical vetebrae

Early symptoms would include weakness in the limbs, neckache, electric current like sensation when one bends the neck. This generally happens with chronic deformed Rheumatoid Arhtirits.

Prevention with tight control of Rheumatoid activity remains the best way to avoid this serious problem. However, once the dislocation occurs, surgery remains the best option to avoid damage to the spinal cord.

Rheumatoid Atlantoaxial dislocation surgery


10 Responses to How does Rheumatoid arthritis affect the cervical spine (neck joints)?

  1. Thanks Doctor !
    does RA affects all the joints of all the patients sooner or later ?


  2. Elona Wagner says:

    I’m having my first flare. I have OsetoArthritis of the spine with bulging disks of L1 thru L5 plus Spondylothisthesis of L4 to L5. I noticed immediately tightness and stiffness of my sacroiliac joins with pain. I started Methotrexate and it helped moderately well. The methotrexate also helped with the pain from the OsteoArthritis. I was surprised at the improvement. I do daily Tai Chi and Qui Gong exercises. They also help with the stiffness and pain.


    • Dear Elona,

      If you have osteoarthritis & spondylolisthesis, the SI pain must be referred pain.
      Pl see a Rheumatologist before starting mehtotrexate.


      • Elona Wagner says:

        Thanks for your response. I see a Rheumotologist. I’ve been on methotrexate for four months and embrel for two months.. I was just noting tin my previous post the methotrexate had an affect on my back pain. I know back pain with Rheumatoid Arthritis is not considered part of R.A., but I think it is under reported. The spine has joints therefore of course it would be affected. There’s no question in my mind there is a rheumatoid process in my back. Thankfully, the methotrexate is helping it.


  3. Thank u sir, it is new information for me


  4. miamirn says:

    I just had an appointment with my Rheumatologist. I asked him if there was any literature he could give me on Rheumatoid Arthritis and lumbar vertebral involvement. He said he has many patient’s that have bone erosion of the vertebral column related to R.A. but there is not any literature on it that he can remember. I’m curious whether you have come across any research literature on this. Thanks.


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  6. baryjazz says:

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