Why Neck Arthritis Might Start in Your Joints—Not Your Discs

Neck arthritis doesn't always develop the way doctors used to think. A 2021 study found that isolated facet joint arthritis—damage to the small joints between vertebrae—is actually quite common and may occur before disc degeneration happens, challenging the traditional belief that disc breakdown always comes first. This discovery matters because understanding where your neck pain originates can change how it's treated and managed.

What's Actually Happening in Your Neck?

When arthritis develops in the neck, it's called cervical spondylosis. The condition involves wear and tear of cartilage in the facet joints—the small joints that connect your vertebrae together. For decades, doctors assumed that when discs between vertebrae degenerated, the pressure would eventually damage these facet joints. But recent research shows the opposite can happen too: facet joint arthritis can develop on its own, sometimes even before disc problems appear.

The good news? Many people with cervical spondylosis don't experience any symptoms at all. Pain isn't always a guaranteed part of having neck arthritis, which means you could have some joint wear and tear without even knowing it.

How Common Is Neck Arthritis Really?

Spinal arthritis is remarkably widespread. Research shows that 89% of adults aged 65 and over have moderate to severe lumbar facet joint arthropathy—that's arthritis in the lower back facet joints. While this statistic focuses on the lower back, the prevalence increases with age across the entire spine, including the neck. The condition becomes more common and more severe as people get older, making it one of the most frequent age-related changes in the human body.

What's driving this increase? A 2025 study found that the global burden of osteoarthritis continues to rise, with a notable increase in early-onset osteoarthritis driven in part by obesity and joint injuries. This means younger people are developing arthritis earlier than previous generations, likely due to weight-related stress on joints and accumulated damage from injuries.

What Causes Neck Arthritis Beyond Normal Aging?

While wear and tear is the most obvious culprit, multiple factors can contribute to neck arthritis developing. Understanding these risk factors helps explain why some people develop problems earlier than others:

• Age and genetics: Getting older increases risk, and some types of arthritis have genetic components, suggesting it may run in families.
• Weight and metabolic factors: Being overweight or obese puts extra stress on your spine, and systemic inflammation throughout the body can accelerate joint damage.
• Previous injuries: Old neck injuries or trauma can trigger arthritis development years later, even if the initial injury seemed minor.
• Underlying diseases: Conditions including Lyme disease, diabetes, gout, psoriasis, tuberculosis, and inflammatory bowel disease can all contribute to spine arthritis.

Osteoarthritis is by far the most common type of spine arthritis, accounting for the majority of cases. It develops gradually over time as cartilage breaks down, and bending or twisting your neck typically makes the pain more noticeable because the discomfort comes from mechanical damage rather than inflammation.

Why This Discovery Changes Treatment Thinking

The finding that facet joint arthritis can develop independently from disc degeneration has important implications for how doctors approach neck pain. "Spinal degeneration can begin either in the disc or in the facet joints depending upon various etiological factors," according to research reviewed in the medical literature. This means your doctor needs to look carefully at imaging to understand exactly where your problem originates, not just assume the typical progression pattern.

Treatment options for neck arthritis are multimodal, meaning doctors typically combine several approaches rather than relying on a single solution. These can range from physical therapy and pain medications to steroid injections and, in some cases, minimally invasive procedures or surgery when conservative treatments fail. Early intervention focused on pain management and damage control is key, since joint destruction is often irreversible once it progresses.

Recent genetic research offers hope for future treatments. A large-scale genetic study from 2025 identified 700 genes involved in osteoarthritis, with 10% of those genes already targeted by approved drugs. This suggests that as research continues, more targeted treatment options may become available for people dealing with neck arthritis.

The bottom line: if you're experiencing neck pain or stiffness, getting a proper diagnosis that identifies exactly where the problem is located—whether in the discs, facet joints, or both—can help your doctor create a more effective treatment plan tailored to your specific situation.