Arthritis in Back - Spinal Arthritis Overview

Arthritis in the back can occur anywhere along the spine. It can leave you feeling stiff, sore, and unable to do your normal daily activities. As many as 85% of Americans over the age of 65 suffer from some form of spine arthritis; which places a major burden on the healthcare system and leaves those suffering with a lower quality of life. Keep scrolling to learn more about spinal arthritis.

What is Spinal Arthritis?

Spinal arthritis is the inflammation in the facet joints (there are two of these joints above and below each joint) on the spine or sacroiliac joints that connect the pelvis and spine together. The degenerative changes in the spine affect normal joint mechanics and can lead to a plethora of symptoms (see below). 

Most commonly affects the lumbar spine (lower back) and cervical spine (neck) due to wear and tear with activity.

Types of Arthritis of the Spine

There are several different types of arthritis that can affect the spine. The most common form of arthritis are degenerative or inflammatory in nature. We will review some of the most common types below. 

Osteoarthritis of the Spine

The most common type of arthritis in the spine is osteoarthritis (OA). It most often occurs in the lower back and is degenerative in nature rather than inflammatory. Thus, factors like age, activity level, and past injuries are the biggest contributors. WIth time, the cartilage within the spine gradually wears (most often in the facet joints), most often leading to low back pain and stiffness with everyday moves like bending and twisting. Additionally, the degeneration of the discs between each vertebrae (spondylosis) can also affect or exacerbate spine arthritis.

Rheumatoid Arthritis

Rheumatoid Arthritis (RA) is not caused by degeneration. This form of arthritis is an auto-immune disease, meaning that the body attacks its own tissues for unknown reasons. While it is more common in other joints like the knees and hands, it can affect the spine- particularly the neck. The pain, stiffness, and joint deformation that can occur from RA are due to breakdown of the synovium, or connective tissues surrounding the spine joints.

Spondyloarthritis

There are many different forms of spondyloarthritis. This form of arthritis includes ankylosing spondylitis, psoriatic arthritis, reactive arthritis (due to infection), and enteropathic arthritis (due to irritable bowel syndrome). These conditions are inflammatory in nature but affect more than just the joints and are not related specifically to auto-immunity like RA. Surrounding ligaments and tendons are also affected and become stiff.  

Symptoms of Spinal Arthritis

Regardless of the type of arthritis you have, the most common symptoms are low back pain, neck pain, and stiffness. While symptoms can vary between different arthritic conditions and people, here are some general descriptors to look out for.

• Back pain- particularly of the lower back or cervical spine
• Loss of spine range of motion with normal activities- such as bending or twisting
• Loss of spine flexibility that results in extreme stiffness or an inability to obtain an upright posture
• Swelling in the affected area
• Tenderness to touch
• A grinding sensation within the spine itself with movement
• Stiffness that is worst in the morning and improves with movement (OA)
• Pain and inflammation in other areas of the body (especially with RA) 
• Generalized weakness and fatigue (more common with inflammatory conditions)
• Pain, numbness, or tingling along the affected nerve levels
• Headaches

Manage Pain Relief of These Symptoms

Causes & Risk Factors

Unfortunately, the mechanisms behind both degenerative disease and autoimmune disease are not well understood. Thus, it can be hard to pinpoint a cause and what risk factors contributed to spine disease. However, there are some general factors that are most common with the onset of spine arthritis, these include:

• Autoimmune disease (RA and others diseases)
• Infection
• Wear and tear
• Aging
• Poor stress management
• Past injury to the spine
• Obesity or being overweight
• Inflammatory conditions such as,

• Diabetes
• Gout
• Psoriasis
• Tuberculosis
• Irritable bowel syndrome
• Lyme disease

Diagnosing Lumbar Arthritis

Arthritis is a tricky diagnosis and is very dependent on the person. In fact, it has been found that the severity of arthritis found on an x-ray has little to no correlation to symptoms. This means that some people have very little arthritis with severe symptoms, while some people have severe arthritis with little to no symptoms. Thus, each case must be treated very individually for the best results.

The first step to diagnosis is scheduling a physical exam with your doctor. They will ask you about your history and symptoms and assess your general health, strength, flexibility and more. They can then decide what diagnostic tests you need, if any. These may include:

• Blood tests to screen for RA antibodies and other inflammatory markers.
• X-rays to assess vertebral bone health and alignment.
• Tests like an MRI, CT scan, myelography, or ultrasound can be done to see what muscles, nerves, ligaments, tendons and other soft tissues are affected.
• Fluid assessment of the affected spine joints via aspiration to rule out infection

Treating Spinal Arthritis

If you ignore arthritis pain, it can quickly become a chronic issue and can cause further damage. It can  trigger other health related issues such as spinal stenosis (pressure on the nerve roots or spinal cord from bone spurs and Osteoarthritis), radiculopathy (nerve damage and irritation), and more.

With proper diagnosis, you can move forward with appropriate treatment for cervical and back pain; such as over-the-counter pain medications, nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, and lifestyle changes for arthritis pain.

Continue through our guide to learn more about treatment options and pain management.

Sources:

https://www.hopkinsmedicine.org/health/conditions-and-diseases/spinal-arthritis

https://swfna.com/5-common-types-arthritis-spine/

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