The spine in the neck, called the cervical spine, is made of a stack of seven block-like bones called vertebrae. These bones are separated by oval cushions called discs. The top vertebra connects to the base of the skull, and the seventh attaches to the middle (thoracic) spine. Ankylosing spondylitis is an arthritic disease which causes inflammation in the spine and joints. This leads to stiffness and in severe cases the spinal bones fuse together. Ankylosing spondylitis is more common in men. The entire spine and sometimes other joints in the arms and legs are involved. Rheumatoid arthritis may involve the neck, but does not cause the bones to fuse.
If the disease occurs mainly in the spine, it is called ankylosing spondylitis. Occasionally, other types of inflammation affect the neck. If there is psoriasis present, then it may be called psoriatic arthritis. In many cases a blood test for a gene named HLA-B27 is positive, especially in ankylosing spondylitis.
The symptoms of common neck pain and neck stiffness due to ankylosing spondylitis are different in several important ways, but especially in how long the stiffness lasts - several hours to all day. This is different than other more common causes of neck pain where the extra morning stiffness is usually no more than thirty to sixty minutes. The neck stiffness due to ankylosing spondylitis tends to worsen after a period of rest or sleep. The worst stiffness is usually in the morning. It may be difficult to expand the chest when taking a deep breath, as the rib joints to the spine may be involved.
A physical examination and x-rays by an arthritis specialist may confirm the disease is present.
Very successful treatment now is available for patients with inflammatory types of arthritic diseases like ankylosing spondylitis. Arthritis specialists called rheumatologists usually provide care for this form of arthritis. Newer medications reduce inflammation and improve pain, stiffness, function and quality of life when ankylosing spondylitis is treated. The FDA has approved several medications called “TNF inhibitors” for the treatment of ankylosing spondylitis (Enbrel, Humira, Remicade and Simponi).