From the Research
The recommended treatment for degenerative joint disease (DJD) of the neck typically involves a multimodal approach, with a focus on non-pharmacological interventions and pain management. Initial management includes physical therapy focusing on neck strengthening and range of motion exercises, performed 2-3 times weekly for 6-8 weeks, as supported by the study 1. Pain management often begins with acetaminophen (500-1000mg every 6 hours, not exceeding 4000mg daily) or NSAIDs like ibuprofen (400-800mg three times daily with food) or naproxen (250-500mg twice daily with food). For patients with contraindications to NSAIDs, such as kidney disease or gastrointestinal issues, topical analgesics like diclofenac gel 1% applied to the neck 3-4 times daily may help, as discussed in the study 2.
Some key points to consider in the treatment of DJD of the neck include:
- Activity modification to avoid neck strain and proper ergonomics at work stations are essential
- Heat therapy for 15-20 minutes several times daily can reduce stiffness, while ice packs for 15 minutes can help with acute pain flares
- Muscle relaxants such as cyclobenzaprine (5-10mg at bedtime) can address muscle spasms
- For persistent pain, referral for interventional procedures like cervical epidural steroid injections may be considered, as mentioned in the study 3
- Surgery is typically reserved for cases with neurological deficits, significant spinal cord compression, or failure of conservative measures after 3-6 months, as noted in the study 4
The most recent and highest quality study 3 provides evidence for the effectiveness of a multimodal approach in the treatment of DJD of the neck, and supports the use of exercise therapy, medications, and interventional procedures in the management of neck pain. Overall, the goal of treatment is to address both pain management and functional improvement while targeting the underlying inflammatory and mechanical aspects of cervical DJD.