Help for Spinal Arthritis – Back Pain Center – Everyday Health

Osteoarthritis, the “wear and tear” form of arthritis, typically emerges in people over age 40, and while there are many potential causes for back pain, the spine is a common target for osteoarthritis.

"Arthritis can affect any joint in the body, including the joints in the back," says S. Christine Kovacs, MD, a rheumatologist at the Lahey Clinic in Burlington, Massachusetts. "Although any part of the back can have arthritis, the lower back is the most common area." According to the Arthritis Foundation, the lower back tends to be more susceptible to osteoarthritis because it bears more of the body's weight than other areas of the back.

Symptoms of spinal arthritis occur when the bones or other structures of the back put pressure on or pinch the spinal cord or the nerve roots that emerge from the spinal cord.

In some cases, spinal arthritis can significantly narrow the spinal canal, the bony canal in which the spinal cord is located, resulting in a condition called spinal stenosis. Spinal stenosis — which is most commonly caused by the degenerative process of aging, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) — typically causes back pain accompanied by pain or numbness in the legs.

Although the majority of spinal arthritis is caused by wear-and-tear arthritis, it can also be from inflammatory types of arthritis, such as rheumatoid arthritis or ankylosing spondylitis. However, these forms of arthritis usually affect people at a younger age than osteoarthritis and are not a common cause of back pain.

Causes of and Risk Factors for Spinal Osteoarthritis

The spinal column is made up of 33 bones, or vertebrae, stacked on top of each other and separated by disk "cushions." These back bones allow you to stand up, and they also protect your spinal cord and spinal nerves.

Osteoarthritis predominately affects cartilage, a type of tissue that covers the ends of bones and helps them glide past one another, according to NIAMS. Spinal osteoarthritis occurs when cartilage of the vertebrae wears down, allowing the bones to rub against each other, resulting in inflammation and loss of joint motion. The joint may also eventually lose shape. Over time, small bony growths called osteophytes, or bone spurs, form on the vertebral joints and around vertebrae.

Risk factors for osteoarthritis back pain include:

  • Age. Because osteoarthritis is caused by age-related wear and tear, it most commonly affects older adults. For instance, one study showed that while 36 percent of adults younger than 45 had moderate to severe osteoarthritis in the lower back (as shown by imaging scans), 67 percent of adults between 45 and 64 years old and 89 percent of those older than 65 had it, according to a report published in 2013 in Nature Reviews Rheumatology.
  • Weight. "Carrying around excess weight increases the wear and tear on your spine," notes Dr. Kovacs.
  • Back injury. A history of trauma to your spine or a history of spinal surgery can increase your risk of developing spinal arthritis. Additionally, joint injury is a common cause of osteoarthritis in younger populations, according to NIAMS.
  • Stress and strain. Repetitive strain on the neck and back from leaning, twisting, and lifting can also increase the risk of osteoarthritis. This may be from athletic activities like hockey, football, gymnastics, or weightlifting, as well as from certain occupations.
  • Spinal misalignment. Scoliosis, a sideways curvature of the spine, or other forms of spinal misalignment can put stress on the joints and increase the risk of spinal osteoarthritis.
  • Family history. Osteoarthritis tends to run in families, according to the University of Maryland Medical Center in Baltimore. And specific genes are associated with a higher risk of other types of arthritis, including rheumatoid arthritis and ankylosing spondylitis, according to the Centers for Disease Control and Prevention.

Symptoms of Arthritis in the Back

Arthritis symptoms can occur anywhere along the spine. They usually come on slowly and get worse over time.

Other symptoms of spinal arthritis may include:

  • Neck pain that radiates into the shoulders and arms
  • Back pain that radiates into the buttocks and legs
  • Numbness, cramping, or weakness in the arms or legs
  • Loss of bladder or bowel control (in severe cases) from pressure on the nerves in the lower back

"Symptoms that might indicate something other than osteoarthritis as a cause of back pain would include back pain that starts suddenly or starts at a younger age," explains Kovacs. Sharp pain in your back that comes on suddenly is often related to a muscle spasm, herniated disk, or fracture. Back pain that begins at a younger age may be related to a chronic inflammatory disorder, such as rheumatoid arthritis. "Spinal arthritis caused by rheumatoid disease is more common in young men and typically causes morning stiffness that gets better with movement," adds Kovacs.

Diagnosis and Treatment of Arthritis of the Spine

Doctors can usually diagnose spinal arthritis by taking your medical history and doing a physical exam, Kovacs says. “An X-ray is sometimes the only other diagnostic exam needed. If symptoms persist over time, the next step is usually an MRI,” she explains.

Treatment of arthritis back pain usually starts with rest, but may require medications, physical therapy, and sometimes surgery.

"We used to advise rest for a longer period, but now we know that returning to activity sooner is usually better," says Kovacs. People who resume normal activities after experiencing back pain may have better back flexibility and less pain than those who rest in bed for a week, according to the National Institute of Neurological Disorders and Stroke.

Common approaches to ease arthritis back pain may include:

  • Physical therapy to strengthen the muscles that support the back
  • Medications to relieve pain and reduce inflammation
  • Weight loss and regular exercise, which can increase the strength and flexibility of back muscles
  • Alternative treatments such as chiropractic manipulation or acupuncture
  • Surgical treatment to relieve pressure on the spine or the spinal nerves

If you have arthritis and experience back pain or neck pain that radiates into your arms or legs, work with your doctor to find the best treatment. You should always tell your doctor about spinal arthritis symptoms of numbness and weakness. Loss of bladder or bowel control is an emergency symptom that requires immediate attention.

Arthritis back pain is very common, especially if you are older than 45. Although there is no cure for arthritis, related back pain can be relieved in most cases by conservative treatment and lifestyle changes.

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