When people think of arthritis, they often think of rheumatoid arthritis, the autoimmune disease where the body’s own immune system attacks the joints. But more common is osteoarthritis, which is caused by mechanical wear and tear on the joints. At the DFW Center for Spinal Disorders, we diagnose and treat spinal osteoarthritis.
What is Spinal Arthritis?
Spinal arthritis involves inflammation of the spinal facet joints. The spinal facet joints in the lower back are prone to developing osteoarthritis. This often produces bone spurs that put pressure on the nerves exiting the spinal column. This leads to weakness and pain in the arms and legs.
What causes spinal osteoarthritis?
Osteoarthritis is a degenerative joint disease, where the protective cartilage that cushions the tops of the bones wears down. In the spine, this usually involves the facet joints. The surfaces of the facet joints are lined with smooth cartilage that allows the two sides of the joint to rub against one another. The condition is usually tied to simple aging so it affects mainly older people. In can occur in younger patients after a traumatic injury to a joint or due to a genetic defect involving the cartilage.
When the joint has osteoarthritis, this is the process that leads to pain:
- The cartilage on one side is chipped, torn, or damaged and it then gouges the neighboring healthy cartilage, damaging it.
- This damage results in friction between the vertebrae, leading to inflammation.
- The swollen facet joint now transmits a pain signal through the nerve in the joint.
- This nerve message causes the back muscles to spasm.
- Those spasms, along with the joint inflammation, lead to lower back pain.
What are the symptoms of spinal osteoarthritis?
Spinal arthritis has a full range of symptoms. There will usually be a combination of some of these symptoms:
- Back and/or neck stiffness and pain that is usually the worst when first waking up
- Pain that subsides during day, but tends to return in the evening
- Pain that disrupts sleep
- Weakness or numbness in the legs or arms if a nerve impinges
- Difficulty moving either the arms or legs
- Swelling and warmth in one or more joints, particularly during weather changes
- Loss of flexibility of a joint
- Steady, aching pain in a joint that is aggravated by motion
Diagnosing spinal osteoarthritis
At the DFW Center for Spinal Disorders, we diagnose spinal arthritis with imaging x-rays, computerized tomography (CT scans), or magnetic resonance imaging(MRI). X-rays can show bone damage, bone spurs, and loss of cartilage or discs. But x-rays are limited in their ability to show early cartilage damage. CT scans can include myelography, where a contrast dye is injected into the spinal column to show issues such as a bulging disc or bone spur possibly pressing on a nerve. MRIs can show disc damage and areas where discs have become narrow at the locations where spinal nerves exit.
How is spinal osteoarthritis treated?
The goal of our treatment for spinal arthritis is for the patient to return to a healthy
lifestyle. Often the disease can greatly impact the patient’s activity and his or her mental state along with it.We begin with conservative treatments such as better postural support and training.Overweight people are more prone to spinal osteoarthritis, weight loss plan is often a treatment goal. Exercise helps in a variety of ways. We break it down into strengthening exercises to make the muscles that support the joints stronger, aerobic exercises to strengthen the heart and circulatory systems, and range-of-motion exercises to increase flexibility. Exercise:
- Increases flexibility
- Improves mood and outlook
- Strengthens the heart
- Improves blood flow
- Allows the patient to perform everyday tasks
Some of the exercises included in our treatment include swimming, walking, and water aerobics. Pain medications come into play, as well. Over-the-counter pain medications and non-steroidal anti-inflammatory drugs are used. But these only address the pain and do nothing to solve the condition. We also utilize physical therapy, massage, and chiropractic treatment when appropriate.
Most cases of spinal osteoarthritis can be treated without surgery, but sometimes it is necessary. Spinal osteoarthritis is one of the causes of spinal stenosis or a narrowing of the spinal canal that puts pressure on the surrounding nerves. If this compression increases to the point of impacting bladder or bowel function or damaging the nerves, surgery may be necessary. In those cases, we have a variety of surgical methods to decrease the pressure on the spinal cord.