Frequently the result of degenerative changes in the spine, osteoarthritis is the most common form of arthritis, and can cause pain and stiffness in the neck and lower back.
What Is Spinal Osteoarthritis?
Arthritis occurs when joint cartilage degenerates as a result of wear and tear, aging, injury or misuse.
Osteoarthritis is the most common form of arthritis, and most frequently occurs in weight bearing joints. The spine consists of bones (vertebrae) and discs (spongy, cartilaginous pads located between each vertebra) that cushion the spine and allow it to move. Ligaments and muscles are attached to the back of the spine, and help facilitate movement of the joints of the spine.
Spinal osteoarthritis affects the vertebral facet joints that enable the body to bend and twist. As the facet joints deteriorate, cartilage may become inflamed and eventually start to break away from the joint surfaces. Vertebrae begin to rub together, and the surrounding nerves and tissues can become inflamed, making movement painful. Osteoarthritis also may trigger the formation of osteophytes (bone spurs), that in the spine can cause the disc space to narrow and the affected disc to collapse.
Osteoarthritis can cause stiffness and pain in the neck or in the lower back. Cervical arthritis (also called cervical spondylosis) affects the upper spine and neck. Lumbar or lumbosacral arthritis affects the lower back and pelvic area.
Ankylosing spondylitis (AS) is a type of arthritis that causes the sacroiliac joints and the joints of the lumbar spine to become inflamed. It also frequently affects the hips and other peripheral joints. AS usually develops between the teen years and age 40. Over time, chronic spinal inflammation can result in the bonding, or fusion, of vertebrae, a process referred to as ankylosis, which in turn can affect spinal mobility.
What Are The Symptoms Of Spinal Osteoarthritis?
In general, the symptoms of arthritis are inflammation, swelling, pain and stiffness in the joints that are affected. Symptoms of osteoarthritis in the spine also may include:
- Pain, tenderness or numbness in the neck
- Low back pain that extends into the buttocks, thighs or hips
- Pain or tenderness in the shoulders, hips, knees or heels
- A “crunching” sensation, or sound of bone against bone
- Weakness or numbness in the legs or arms
- Limited range of mobility, difficulty bending or walking
- Spinal deformity
How Is Spinal Osteoarthritis Diagnosed?
To determine whether you have spinal osteoarthritis, your doctor will examine your back and your medical history, and may order an x-ray, bone scan, myelogram, computed tomography (CT) scan and/or magnetic resonance imaging (MRI) to rule out another disorder as the cause of your symptoms.
How Is Spinal Osteoarthritis Treated?
There is no cure for arthritis, but if your doctor determines that you have the condition, there are a variety of treatment options that can help manage your symptoms so you can continue to do the things that you enjoy.
Non-surgical treatments your doctor may recommend include medication, physical therapy, exercise, heat/cold therapy and rest.
If conservative treatment fails to provide lasting relief, or if osteoarthritis is contributing to spinal instability or affecting the spinal nerves, your doctor may recommend spine surgery. Surgical therapies for treating osteoarthritis include:
- Laminectomy — A procedure in which the lamina of the affected vertebrae (the portion of the vertebral arch that forms the “roof” of the spinal canal) is removed or trimmed to widen the spinal canal and create more space for the spinal nerves.
- Spinal fusion — A surgical technique in which one or more of the vertebrae of the spine are joined together (fused) to stop them from moving against each other. This is done by placing bone grafts or bone graft substitutes between the affected vertebral bone. The graft material acts as a binding medium and also helps to maintain normal disc height – as the body heals, the vertebral bone and bone graft eventually grow together to join the vertebrae and stabilize the spine.
The decision to treat spinal osteoarthritis surgically requires careful consideration between you and your doctor. Factors to be considered include your specific condition and overall physical health. Discuss your condition thoroughly with your doctor, and rely on his or her judgment regarding which treatment option is most appropriate.