Arthritis of the Spine

WHAT IS ARTHRITIS OF THE SPINE?

Spinal arthritis describes joint pain and inflammation that affect the facet joints in the spine or the sacroiliac joints that connect the spine and pelvis.

While arthritis can occur anywhere along the spine, it more commonly develops in the neck (cervical spine) and low back (lumbar spine). There are over 100 different types of arthritis, but some forms are more likely to affect the spine than others. These include:

• Osteoarthritis. “Wear and tear” arthritis is the most common form that develops in the spine. It typically affects the facet joints between vertebrae in the low back and neck. Osteoarthritis occurs when the cartilage that cushions the ends of bones begins to wear away, causing pain, stiffness, inflammation and swelling in the joint. Over time, the cartilage may wear away completely, leading to painful bone-on-bone friction. 
• Rheumatoid arthritis. Rheumatoid arthritis is an autoimmune disorder that develops when the body’s immune system begins attacking its own tissues and joints. It attacks the cartilage and lining of the joint, leading to pain, swelling and stiffness. 
• Ankylosing spondylitis. Ankylosing spondylitis is a form of inflammatory arthritis that affects the spinal joints and the connective soft tissues. It causes painful inflammation of the vertebrae, joints and attached ligaments and tendons. It commonly develops in the low back vertebrae and sacroiliac joints. Over time, ankylosing spondylitis can cause vertebrae to fuse.

Arthritis of the spine is a chronic condition that causes progressive joint damage and degeneration. While arthritis can be managed and treated, there is no cure and the joint damage is irreversible.

CAUSES AND RISK FACTORS

The causes of spinal arthritis vary depending on the type of arthritis. Osteoarthritis is the most common and well-studied form of arthritis of the spine. Age-related wear and tear on the spine, past joint injuries, repetitive movements from a job or sports, obesity and genetics are common causes of osteoarthritis. The disease typically occurs in adults over the age of 40 and is more common in women.

The causes of inflammatory forms of arthritis like rheumatoid arthritis and ankylosing spondylitis are less well-known. Scientists believe genetics play a large role. Inflammatory arthritis can develop at any age. Rheumatoid arthritis is more likely to develop in middle-aged adults and is more common in women. Ankylosing spondylitis is more likely to develop in youngadulthood and is more common in men. 

SPINAL ARTHRITIS SYMPTOMS

Common symptoms of arthritis include:

• Back or neck pain
• Swelling, tenderness and warmth over affected joints
• Stiffness, especially first thing in the morning and at night
• Loss of flexibility and range of motion in the spine
• A grinding or crunching sound with movement of the spine
• Arm or leg numbness, tingling and weakness if arthritic changes affect nearby nerves

Osteoarthritis is a degenerative disease that causes progressive joint damage, so symptoms typically start slowly and worsen over time. Damage and degeneration may begin in one joint and spread to several joints as the disease progresses. In advanced stages, joint pain and stiffness from osteoarthritis can cause difficulty walking, climbing stairs or sitting up straight.

In addition to the symptoms listed above, inflammatory forms of arthritis like rheumatoid arthritis and ankylosing spondylosis can cause fever, fatigue, loss of appetite and weakness. Additionally, pain and inflammation might affect other organs and soft tissues of the body. 

COMPLICATIONS

Spinal arthritis can affect surrounding structures and cause additional problems in the spine. Osteoarthritis may contribute to the development of:

• Bone spurs
• Spinal stenosis
• Nerve root compression

Ankylosing spondylitis may contribute to the development of:

• Kyphosis
• Vertebral compression fractures

TREATMENT AND PREVENTION

There is no cure for arthritis, and joint damage and degeneration caused by arthritis cannot be reversed. However, arthritis is manageable using a combination of medications, exercises and lifestyle changes. With early and aggressive treatment, patients with spinal arthritis can experience less pain, maintain good mobility, slow the progression of joint damage and remain active for as long as possible. Treatment plans usually include the following: 

• Medications. Over-the-counter analgesics (pain relievers) like acetaminophen can ease mild to moderate joint pain. Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen and naproxen can relieve mild to moderate pain, inflammation and swelling. If you have risk factors for bleeding, talk to your doctor before taking NSAIDs. If you have severe pain or flare-ups, your doctor may prescribe a stronger pain medication or muscle relaxants.
• Disease modifying anti-rheumatic drugs (DMARDs). If you have inflammatory arthritis (rheumatoid arthritis, ankylosing spondylitis), your doctor may prescribe DMARDs, a category of drugs that block or destroy inflammatory markers in the body. DMARDs can help slow down the progression of joint damage and degeneration. 
• Topical solutions. Topical creams, gels and patches containing ingredients like capsaicin, methyl salicylate, salicin and menthol can help relieve pain when applied directly over the achy joint.
• Activity modifications. It’s important to stay active when you have arthritis. Regular exercise strengthens your back and joints, relieves pain and reduces inflammation. But it’s beneficial to switch from high-impact activities like running that place a lot of stress on the joints, to joint-friendly, low-impact activities like walking, swimming, ellipticals and yoga.
• Physical therapy. Your doctor may prescribe a course of physical therapy. A therapist will work with you to strengthen your back and core muscles and improve your flexibility, range of motion, balance and endurance. Your therapist can also help you practice good posture and proper body positioning to protect your spine and joints. 
• Injections. Corticosteroid injections directly into the painful joint can help reduce inflammation, pain and swelling. The effects of an injection are temporary, but may offer pain relief that lasts up to a few months to a year. Hyaluronic acid injections can help lubricate arthritic joints, relieving pain and increasing joint range of motion.
• Weight loss. Excess body weight places more stress on the spine and joints, speeding up the process of joint damage and degeneration. Talk to your doctor about steps you can take for healthy weight management.

SURGICAL OPTIONS

Surgery is not a common treatment for spinal arthritis, but it may be an option if arthritis has caused a complicating condition like bone spurs, spinal stenosis or nerve compression. Surgery is only recommended if conservative treatments have been ineffective for pain and symptom relief. The type of surgery you need will depend on what’s causing your pain and symptoms. The two most common procedures for arthritis of the spine include:

• Spinal decompression. A decompression procedure may be performed to treat bone spurs, stenosis and nerve compression. The goal of decompression is to create more space in the spine for the spinal cord and nerves to move freely. 
• Spinal fusion. A spinal fusion may be performed to reduce pain and symptoms by limiting facet joint mobility and instability.

CONTACT INTEGRITY SPINE AND ORTHOPEDICS TO LEARN MORE ABOUT THE CONDITIONS WE TREAT

At Integrity Spine and Orthopedics, we specialize in identifying, diagnosing and treating a wide range of acute and chronic back, spine and joint conditions. Our board-certified orthopedic surgeons specialize in performing minimally invasive spine surgeries to reduce pain and improve mobility for patients diagnosed with spinal arthritis, degenerative disc disease, bulging or herniated discs, a pinched nerve, spinal stenosis and more. 

Some of the primary benefits of minimally invasive surgery include:

• Smaller incisions
• Fewer complications and bloss loss during surgery
• Less damage to surrounding muscle and soft tissues
• Lower risk of infection
• Less post-op pain and less reliance on strong pain medications during recovery
• Faster recovery and rehabilitation
• Better cosmetic results with minimal scarring 

If you’re experiencing back or joint pain, weakness, or a loss of mobility, reach out to us today to schedule a consultation with our team. We provide compassionate and comprehensive care to help you find relief from pain and get back to doing the activities you love.

Call us at 904-456-0017 or contact us online to request an appointment.