Psoriatic arthritis (PsA) is a chronic inflammatory condition that develops in some people with psoriasis. Patches of scaly skin and sore joints are among the most common symptoms of PsA.
Neck pain can also affect people with a type a specific type of PsA called psoriatic spondylitis. Research also suggests that some people with PsA may experience a significant reduction in the range of motion of their neck.
If PsA is causing stiffness and pain in your neck, work with your doctor to determine an appropriate treatment plan. These treatments and exercises may help relieve PsA neck pain.
PsA is an inflammatory disease that affects the joints and the spots where bones connect with tendons and ligaments. Inflammation in these areas causes swelling, pain, and stiffness.
Spondylitis is one of five PsA subtypes. It’s associated with inflammation in the discs between your spinal vertebrae.
Spondylitis can make it difficult and painful to move your neck. It can also cause pain and stiffness in the lower back or pelvis, and even fusion in the sacroiliac joints of the pelvis.
Spondylitis occurs in up to 20 percent of people who have PsA. Symptoms of spondylitis may include:
- lower back pain
- back and neck pain that worsens when you’re sedentary
- back and neck pain that disrupts your sleep
- back and neck pain that improves with exercise
- hip and buttock pain from inflammation in the sacroiliac joints
- morning stiffness in the back that lasts for a half hour or more, and improves with warm shower
People with PsA may experience these symptoms for up to 10 years before receiving a spondylitis diagnosis. The diagnosis is especially delayed in women.
Doctors have several ways to diagnose psoriatic spondylitis:
- Blood tests. Your doctor can check your blood to rule out other diseases that can cause neck pain, such as rheumatoid arthritis.
- Imaging tests. X-rays, MRI scans, and CT scans can give doctors a look at the bones and joints of your spine.
- Medical history. Your doctor may ask detailed questions about your symptoms, family history, and medical history to help determine if you have spondylitis.
- Physical exam. Your doctor can perform a physical exam to look for signs related to spondylitis, such as a rash or nail pitting.
PsA is a lifelong condition with no known cure. A number of treatments can help improve the neck pain associated with spondylitis by reducing inflammation or targeting an over-reactive immune system.
Medications your doctor may recommend include:
- nonsteroidal anti-inflammatory drugs (NSAIDs)
- disease-modifying antirheumatic drugs (DMARDs), such as sulfasalazine, methotrexate, and JAK inhibitors
- biologic drugs, such as TNF blockers, IL-17 inhibitors, or IL-12/23 inhibitors
Lifestyle changes can also help you to manage PsA neck pain. Here are some things you can try:
- Exercise. Maintaining an active lifestyle can help ease PsA symptoms. Doctors usually recommend low-impact exercise, such as yoga, swimming, or tai chi.
- Use hot or cold therapy. A hot shower, bath, or heating pad right after waking up and just before bedtime can soothe pain and stiffness. Using an ice pack for 10 minutes at a time can also help calm inflammation and decrease nerve pain.
- Quit cigarettes. Smoking increases your risk of PsA and can make the condition more severe. Quitting may help improve your symptoms and decrease other inflammatory risk factors like cardiovascular disease.
- Maintain a healthy weight. Being overweight can place additional burden on your joints and potentially increase your pain, as well as body inflammation. Work with your doctor to determine if losing weight should be part of your treatment for PsA neck pain.
- Make your bed more comfortable. The right mattress and a pillow with good neck support can help keep your body in a comfortable position throughout the night. Look for a mattress that’s firm and supportive but not too hard.
- Switch to an ergonomic chair. A high-backed chair with a firm seat, armrests, and adjustable recline can help you to maintain good posture and relieve weight on the spine. It’s still a good idea to get up and stretch frequently during the workday.
Regular exercise can be a key to managing PsA neck pain. Before starting any exercise program, check with your doctor to make sure it’s safe for you.
The following exercises can help with PsA neck pain:
- Stand with your back, shoulders, buttocks, and heels against or close to a wall.
- Tuck in your chin and push your head back. Stretch your body tall without lifting your heels.
- Slowly lift your arms out toward the sides and up over your head. Touch the wall with the back of your hands the whole time.
- Slowly lower your arms.
- Repeat the exercise five times.
Trunk side stretch
- Stand against a wall.
- Lean to the side and slide your right arm along the outside of your right leg as far down as possible until you feel a stretch. Keep your buttocks and shoulders touching the surface.
- Gently release.
- Do the same thing on the opposite side.
- Repeat the exercise five times on each side.
- Sit up tall in a chair. Keep good posture, with your feet flat on the floor.
- Grip the edges of your chair seat and turn your head to look to one side as far as possible. Make sure to keep your shoulders facing forward.
- Do the same exercise on the other side.
- Repeat three times.
- Lie on your back with your head in a neutral position.
- Use your fingers to gently press your chin downward and your head into your resting surface until you feel a stretch in the back of your neck.
- Repeat up to 10 times.
Prone head lift
- Lie face down with your forearms flat on the ground and your elbows bent at 90-degree angles beneath your shoulders. If you do yoga, this position is similar to the sphinx pose.
- Release all tension from your neck. Let your head hang down so your chin is near your chest.
- Raise your head as your chin tucks in and try to look toward the ceiling. Hold for 5 seconds. Slowly release.
Neck pain is a common symptom of psoriatic spondylitis. Staying active and making lifestyle changes can help you manage PsA neck pain. Your doctor may also recommend additional treatments including medication for your PsA.