Friday, June 14, 2024

Gout In Neck And Shoulder

Arthritis In The Neck

Physical Therapy Treatments : Stretching to Relieve Neck & Shoulder Pain

Arthritis in the Neck is a degenerative joint disease that affects the neck at the top of the cervical spine and spinal column. The muscles, discs and spinal nerves affect your ability turn your head as well as lower and raise your head. When you have neck arthritis you may have limited range of motion, and you may not be able to move your neck around to see to the side of you without turning your whole body.

It is a condition that affects people during their midlife years and beyond . More men are affected with arthritis in the neck than women and they also seem to develop it at an earlier age as well. With the use of electronic devices for long periods of time, now younger women and men are experiencing neck pain and symptoms of degenerative neck arthritis. Im sure youve seen the posture that matches the Facebook symbol

What Causes Neck Pain?

What Causes Neck Pain in arthritis? Poor posture, injury, not using an ergonomic chair or pillow. It can be from Osteoarthritis in the neck or Rheumatoid arthritis in the neck Neck arthritis pain has a burning type of pain that frequently radiates into your facial area as well as your shoulder area. It can be aggravated by a neck injury or strain that will cause swelling and sometimes you will hear a popping sound when you move your head.

Diseases That Mimic Gout

Gout is a disorder in which uric acid crystals accumulate in the joints. The sharp edges of these crystals irritate the soft tissue of the joints, and cause inflammation and pain. Uric acid crystals are the waste products formed when purines, which are part of the nucleic acids that make up the genes, break down. A number of other conditions can cause symptoms similar to those of gout.

If you are experiencing serious medical symptoms, seek emergency treatment immediately.

What Is Calcium Pyrophosphate Dihydrate Crystal Deposition Disease

Calcium pyrophosphate dihydrate crystal deposition disease is a form of arthritis that causes pain, stiffness, tenderness, redness, warmth and swelling in some joints. It usually affects one joint at a time, but sometimes it may affect several joints at once.

The symptoms are similar to the symptoms of other diseases, especially gout . Some symptoms of CPPD may appear to be symptoms of rheumatoid arthritis or osteoarthritis.

CPPD commonly affects the knee or wrist. Less often, it can involve the hips, shoulders, elbows, knuckles, toes or ankles. Rarely it affects the neck and causes neck, shoulder pains, headaches and in some cases fevers. This occurs when the calcium crystals deposit around the dens part of the second cervical vertebra. The condition is called crowned dens syndrome.

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What Are The Types Of Shoulder Bursitis

The different types of shoulder bursitis include:

  • Chronic: Repeat injuries or repeated incidents of acute bursitis can cause chronic shoulder bursitis. Its the most common type of shoulder bursitis. You may have periods without symptoms and then have symptom flare-ups that last several months. Over time, this ongoing inflammation can cause arm and shoulder weakness. Many people learn how to adapt to the pain . This may lead to other regional pain .
  • Acute: This type comes on suddenly, often from an accident or injury. Touching or moving the shoulder causes pain.
  • Infectious : In rare cases, bacterial infections like staph infections cause infectious shoulder bursitis. The shoulder may look red or purple and feel warm to the touch. In this rare case, you may have a fever and feel sick. You may have severe shoulder pain.

What Are The Symptoms Of Shoulder Bursitis

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Shoulder pain from bursitis can come on suddenly or gradually. You may experience a dull ache, sharp pain or mild tenderness.

Other signs of shoulder bursitis include:

  • Shoulder stiffness or a feeling of swelling.
  • Painful range of motion.
  • Nighttime pain when lying on the affected side.
  • Sharp or pinching pain with overhead shoulder motions.

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How Neck Arthritis Is Diagnosed

Your doctor will start by taking a history and doing a physical exam. Theyll check the range of motion in your neck and test your strength, sensation, and reflexes to find out if there is pressure on your nerves or spinal cord. Theyll ask when your symptoms started, when the pain happens, and what makes the pain better and worse.

Your doctor may order an X-ray to assess alignment and look for arthritic changes, says Dr. Shah. If there is a concern of compression of spinal nerves or the spinal cord, you may need an MRI to look at the neutral structure and discs, says Dr. Shah.

A CT scan may be ordered to look at the bone more closely, especially to see if any bony outgrowths are causing compression. However, X-rays and MRIs are the tests that are usually ordered, says Dr. Shah. A CT scan with a myelogram may be used if an MRI cant be done.

An electromyography, or EMG, may be ordered to assess for nerve compression, says Dr. Shah. An EMG tests the electrical conduction of the nerves in the arms. This test would be helpful if you have multiple nerves being compressed or compression of nerves at the neck and in the arm, he says.

Your doctor may order blood tests to see if you have any antibodies or systemic inflammation that would reveal inflammatory arthritis, such as rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis.

How Is Bursitis Of The Shoulder Diagnosed

In addition to a complete medical history and physical exam, diagnostic tests for bursitis may include:

  • X-ray. A diagnostic test that uses invisible electromagnetic energy beams to make pictures of internal tissues, bones and organs on film.
  • Magnetic resonance imaging. An imaging test that uses a combination of large magnets, radiofrequencies and a computer to make detailed pictures of organs and structures within the body.
  • Ultrasound. An imaging test that uses high-frequency sound waves to look at the internal organs and tissues.
  • Aspiration. A procedure that involves using a thin needle to remove fluid from the swollen bursa to check for infection or gout as causes of bursitis.
  • Blood tests. Lab tests may be done to confirm or rule out other conditions.

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Rheumatoid Arthritis In The Neck

Rheumatoid arthritis is a chronic inflammatory disease where the bodys immune system mistakenly attacks the lining of the joints. It often starts in the smaller joints of your hands and feet and can spread to other parts of the body like the neck as the disease progresses. This typically doesnt happen until years after the onset of arthritis symptoms.

Neck pain is the primary symptom of rheumatoid arthritis in the neck, with the severity varying from person to person. You may feel a dull or throbbing ache in the back of your neck around the base of the skull. Joint swelling and stiffness can make it hard to move from side to side.

The difference between rheumatoid arthritis neck pain and a neck injury is that stiffness and pain from an injury can gradually improve over days or weeks. Rheumatoid arthritis in the neck may not get better it can worsen if left untreated. Even if symptoms improve, inflammation, swelling, and stiffness can return with rheumatoid arthritis in the neck.

Lifestyle Modifications Can Prevent Gout Attacks

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The good news about gout is that lifestyle changes can help prevent attacks or at least lessen the severity. A few suggestions from Dr. Weisman:

  • Hydrate water helps remove uric acid from the body and lubricates your joints
  • Maintain a healthy weight this can lower uric acid levels and significantly reduce the risk of gout attacks
  • Include nonfat and low-fat dairy foods in your diet
  • Eat lots of vegetables
  • Get regular exercise if you are not exercising now, ask your doctor about a plan that is right for you

Dr. Weisman added that one study showed cherries might reduce the risk of gout attacks. Another suggested that high doses of regular or decaf coffee four cups a day or more can be helpful. Ask your about lifestyle changes that might be helpful.

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Get An Accurate Diagnosis And Treatment

While gout attack symptoms do resolve on their own, people are advised to seek medical treatment. If left untreated, gout can become chronic and cause lasting joint damage.

Diagnosis begins with a clinical exam and interview. Patients are encouraged to be honest with their health care providers about their eating, drinking, and other lifestyle habits. This honesty can be helpful both for diagnosing gout and creating a treatment plan. Diagnosis may also involve blood tests, urine tests, and medical imaging, such as x-rays and ultrasound.

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Treatment typically involves advice to avoid alcohol and certain foods known to trigger gout, such as foods and drink high in sugar, seafood, red meat, and organ meats.19 Medications to lower urate levels in the bloodâwhich can lead to gout attacksâare often recommended. Losing excess weight is another effective way to reduce the risk of a gout attack and chronic gout.20

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How Does Shoulder Arthritis Develop

Shoulder arthritis usually results from gradual wear and tear of the cartilage. Cartilage is present in every joint in the body it covers the surface of the bones inside the joints similar to Teflon on a ball bearing. Cartilage is a living tissue 2 millimeters to 3 millimeters thick about the thickness of one or two layers of cardboard. This makes the contact between bones softer. If the cartilage is intact, it can take multiple rotations with no wear of the surface because its smooth.

Shoulder arthritis typically develops in stages. First, the cartilage gets soft , then it develops cracks in the surface , then it begins to fibrillate , and finally, it wears away to expose the surface of the bone . As a result, it loses its ability to act as a smooth, gliding surface.

The cartilage doesnt wear away all at once over the entire surface of the bone in a joint. Instead, it wears at different rates in different parts. So if you consider the surface of a ball bearing that was covered with Teflon, this type of wear would be as if the Teflon had pits and the surface would now be irregular .

Once the surface becomes irregular, the cartilage may undergo further damage. It may begin to thin out, eventually leading to the bones of the shoulder rubbing against each other . Many people think that arthritis is bone-on-bone traction in the joint, but in reality, arthritis is the process that can lead to the bone-on-bone traction.

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Rotator Cuff Tear Arthropathy

Rotator cuff tear arthropathy is a type of shoulder arthritis that can develop after a massive and prolonged rotator cuff tear. The four rotator cuff tendons in your shoulder wrap around the ball portion of the shoulder joint, holding it in place. If one or more of these tendons is heavily torn, this may cause the humeral head to rub against other bones and develop arthritis.

When Is Surgery Indicated For Bursitis

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Surgery is rarely needed to treat bursitis and is usually done only in the chronic cases that have not improved with traditional therapy. The most common surgical treatment, if needed, is an incision and drainage and is used only in cases of infected bursa. The surgeon first numbs the skin with an anesthetic and then opens the bursa with a scalpel. Finally, he or she drains the fluid present in the inflamed bursa. Sometimes it is necessary to excise the entire bursa surgically. This is indicated only if the bursal swelling causes problems.

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Surgery For Neck Arthritis

Surgery is usually a last resort for neck arthritis, says Dr. Milani. Your doctor may recommend it if you have severe pain that isnt relieved with nonsurgical treatment or if you have signs of neurologic injury. Surgery may be needed if the arthritis causes instability, or more importantly, impingement of nerves and/or the spinal cord, says Dr. Shah.

What You Need To Know

  • Arthritis is damage to the cartilage in joints. Shoulder arthritis occurs when the cartilage starts wearing down on the ball and/or socket sides of the shoulder joint.
  • Symptoms of shoulder arthritis may include pain in the shoulder joint, stiffness and reduced range of motion.
  • There are many nonoperative treatments for shoulder arthritis, including stretches, lifestyle modifications, application of ice or heat, and medication to control the pain.
  • Surgical options, such as shoulder replacement, are available to treat shoulder arthritis if nonoperative treatments dont offer the desired relief.

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Is My Shoulder Pain From Arthritis Or Bursitis

Your shoulders are packed with bones, muscles, tendons, and ligaments. Shoulder pain can develop from a variety of conditions that affect oneif not manyof these structures. While this can make it difficult to pinpoint the exact source of your shoulder pain, an accurate diagnosis and proper treatment are the key to recovery.

Arthritis and bursitis are two of the most common causes of shoulder pain however, they can be difficult to differentiate. The following article will help you determine if your shoulder pain is caused by arthritis or bursitis.

Injections For Shoulder Arthritis

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There are currently two types of injections that can provide pain relief for shoulder arthritis. The first type is cortisone shots. Typically, cortisone is mixed with a numbing agent that provides immediate pain relief and helps your doctor know if the injection is in the right place. Once the numbing medicine wears off, the joint may be sore until the cortisone kicks in. Its important to ice the shoulder for a day or so after the shot.

Cortisone shots dont damage the shoulder, but most surgeons limit them to no more than a few a year in most cases of arthritis. Cortisone shots may increase the risk of infection if you undergo a total shoulder replacement soon after the shot. If you are considering the surgery, consider avoiding cortisone shots a few months prior.

The other medicine that can help with shoulder arthritis is synthetically manufactured hyaluronic acid. Its a naturally occurring lubricant in the human body. This liquid substance has been injected into arthritic knees for many years. This injection sometimes helps with the pain for up to two years, but it is unusual for it to take all the pain away for an extended period of time.

The current recommendation is not to have shoulder replacement surgery within three months of having a cortisone shot in the shoulder. If you are considering surgery, it is best to avoid cortisone shots until you have discussed it with your doctor.

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How Gout Can Affect The Spine

A study published in 2016 in the World Journal of Orthopedics reviewed 68 published case reports of people diagnosed with spinal gout from 2010 to 2014. Some 69% of patients experienced back or neck pain and 66% of patients had elevated uric acid levels. Dr. Fields says, In addition to back pain, people describe classic neuropathy, including pinched nerve pain down the arm.

More than half of these patients had a surgical procedure called a laminectomy to relieve the pressure on their spinal cord or nerve roots. Another 29% responded to non-invasive treatments like uric acid-lowering medications.

But Brian F. Mandell, MD, rheumatologist at the Cleveland Clinic in Ohio and board member of The Gout & Uric Acid Education Society, cautions that most people with spinal gout dont have any symptoms .

Historically, he says, doctors have thought of spinal gout as affecting transplant patients taking organ-rejection drugs like cyclosporine which are known to send uric acid levels through the roof. Then researchers began looking at pictures of the spine with advanced imaging known as dual energy CT scans and found gout in places they never expected.

With the new dual energy CT scans we have today, you will actually be able to see clumps of uric acid colored green along the spine. You can see a definitive collection in the area where the symptoms are and predict which nerves would be involved, explains Dr. Fields.

Symptoms Of Neck Arthritis

What are the most common Symptoms of Neck Arthritis? Since the neck and shoulder are connected they are sometimes tied together in a neck ache. Here are the most common symptoms of Neck Arthritis:

  • Headache or Fever
  • Facial Pain
  • Feeling Tired or Lethargic

If you are experiencing any of the above cervical arthritis symptoms along with neck pain, then you will want to treat it immediately by using exercises for neck pain, neck arthritis remedies and a natural neck arthritis treatment which are all shown below.

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How Is Calcium Pyrophosphate Dihydrate Crystal Deposition Disease Diagnosed

CPPD can’t be diagnosed simply from a blood test. It’s diagnosed by the study of the synovial fluid from the inflamed joint, which is observed under a microscope for CPPD crystals.

Fluid is aspirated through a needle from the inflamed joint. This procedure is called arthrocentesis. Removing the fluid may also help reduce the pressure within the joint, and this can help reduce the pain.

Since different types of crystals in the joint can be the cause of other forms of arthritis, it’s important that an accurate diagnosis be made. Then your doctor can prescribe the appropriate treatment.

The diagnosis of CPPD can be suspected by certain X-rays and imaging studies or computed tomography , but the findings of CPPD crystals on synovial fluid analysis leads to a more definite diagnosis.

What Can I Do If The Symptoms Of Bursitis Do Not Improve


Symptoms should improve if treated as described above. If you do not see an improvement, you may want to talk to your doctor. It is especially important to seek medical care if you think you may have an infection. You should also seek attention if you notice swelling in more than one area or if the swelling increases despite the treatment above.

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