Osteoarthritis of the Spine

What is Osteoarthritis?

osteoarthritisArthritis literally means inflammation of the joints – osteoarthritis describes a form of arthritis which refers to the degeneration of joints and underlying bone. It is one of the most common forms of arthritis and can affect any joint, although it often manifests in the knees, hips, joints of the hand and the spinal joints.

The main symptoms of osteoarthritis are pain felt in the joint itself and the surrounding area, as well as stiffness, swelling and tenderness. It may also be difficult and painful to move the affected joint – when the knee is affected, it may be painful to bend or walk. Osteoarthritis in the hip joint can make carrying out daily activities such as getting dressed and moving around extremely painful and osteoarthritis in the hand may affect manual tasks such as writing, typing, opening bottle tops, etc. Joints may also develop a knobbly appearance and become slightly bigger, when the hand is affected fingers often bend sideways and painful cysts can develop on the backs of fingers.

Osteoarthritis of the Spine

When osteoarthritis develops in the spinal facet joints, it is referred to as spinal osteoarthritis or Spondylosis – a blanket term used to describe a range of degenerative disorders affecting the spinal structure. Although degeneration of the facet joints can occur at any point along the spine, osteoarthritis is predominantly found in the lower back (lumbar spine) and the neck region (cervical spine).

Symptoms

Osteoarthritis of the spine can cause a range of painful symptoms – in the lower back it generally causes pain and stiffness which may radiate to the buttocks and in some more extreme cases, as far as the legs. There is typically tenderness upon palpation and symptoms may be more noticeable first thing in the morning, gradually improving during the course of the day, before deteriorating in the evening - in some cases, the condition may disrupt sleep.

Cervical osteoarthritis may provoke symptoms ranging from mild discomfort to severe and debilitating pain – as with the lower back, pain and stiffness is generally worse first thing in the morning and late evening. Other symptoms may include disrupted sleep, headaches, pain upon palpation and referred pain to the shoulders.

Causes of Osteoarthritis of the Spine

Spondylotic Age Related Wear and Tear

Osteoarthritis is a relatively common cause of lower back pain in people over the age of 50, the facet joints of the lower back are comparatively small to the weight they have to bear and over time, everyday wear and tear takes its toll.

Each spinal vertebra has two sets of facet joints, these serve to cushion the vertebrae and facilitate movement, degenerative changes due to the ageing process can cause the facet joints to break down and waste away, allowing the bones to come in contact with one another during movement – this can result in inflammation, swelling and painful symptoms. In an attempt to repair the damage and stabilize the joint, the body produces more bone – osteophytes or bone spurs, which grow irregularly at the edge of the bone. In some cases, this excess bone may go unnoticed, if however an osteophyte encroaches upon any nearby structures, complications can arise. An osteophyte which forms at the edge of a vertebra may compress a nearby nerve root exiting the spinal column, resulting in a wide range of possible neurological symptom, depending on where the compression occurs.

Degenerative Disc Disease

The cervical discs in the spinal column act as shock absorbers - soaking up any knocks and jolts during everyday movement, as well as preventing the vertebrae from coming into contact with one another. Degenerative changes may cause the discs to shrink and lose elasticity and in some cases collapse altogether – this can result in changes to the way the facet joints work, causing swelling, stiffness and inflammation and in some cases, provoking the formation of osteophytes.

Repetitive Strain

Habitually poor posture over long periods of time can put a considerable strain on muscles and soft tissue including the joints. Postural problems involving the lower back are very common in a modern society where many of us have desk bound occupations.

Injury

Following a direct injury, if the affected joint hasn’t been allowed sufficient time to heal and is over used, further injury may be caused as the joint is strained and the cartilage damaged.

Gender

Some studies suggest the prevalence of osteoarthritis of the spine is more common in post-menopausal women, than in men. This is thought to be due to hormonal alterations which occur during the menopause.

Obesity

Excess weight puts a considerable strain on the entire body, including the weight bearing spinal facet joint, leading to an increased chance of developing osteoarthritis.

Genetics

The risk of developing spinal osteoarthritis may be increased if there is a family history of the condition.

Diagnosing Osteoarthritis of the Spine

A physical examination will assess pain and tenderness, movement and reflexes, and any muscle weakness. Other tests necessary for an accurate diagnosis typically include X-Ray to examine the bones and joints, MRI scans to highlight any changes to the discs and spinal neural structures, and to exclude the possibility of other diseases or infections, a blood test or a sample of synovial fluid may be taken for analysis.

Treatment

Osteoarthritis of the spine is a long-term condition, and although there is currently no cure for any form of arthritis, there are a number of available treatments to relieve symptoms and slow down the progression of the disease.

Conservative Treatment Methods

Symptoms are usually managed initially through a conservative treatment plan, which typically includes a combination of non-surgical treatment methods.

Pain Relief Medication

Over the counter medication such as analgesics (paracetamol) and NSAIDS (ibuprofen) may be prescribed initially for pain relief, if this doesn’t suffice, stronger prescription medication may be administered for short term use.

Lifestyle/Weight Management

Lifestyle changes can be highly beneficial in the management of osteoarthritis, this may include losing weight (if weight is an issue), postural correction, regular exercise, healthy eating, giving up smoking and limiting alcohol intake. Some individuals find heat packs beneficial, or regular use of a sauna or steam room.

Physiotherapy and Exercise

Exercise is good for general fitness, it also increases flexibility, and builds and strengthens muscles to support and stabilize the joints, which can help to relieve pain. Low impact exercise, such as power walking, cycling, swimming, etc. often form part of spinal osteoarthritis treatment plans. High impact exercise such as running or load bearing activities can put a severe strain on the joints and are not recommended. It is important to ensure that any exercises are suitable and performed correctly, Physiotherapy sessions often involve manipulation and specific strengthening exercises to aid in pain relief, a physiotherapist can also help teach correct exercise techniques to avoid accidental injury and put together a specific plan based on individual needs.

Facet Joint Injections

An injection of anaesthetic and steroid medication into the facet joint can reduce inflammation and provide effective pain relief lasting up to several months.

Read More: https://www.painmanagement.org.uk/facet-joint-injections

Surgery

When there is a clear evidence of nerve compression or spinal cord compression as a result of spinal osteoarthritis, surgery may be recommended in order to avoid more serious neurological consequences.

Pain Management Clinic

The multi-disciplinary approach of the pain management clinic can be highly beneficial in the treatment of osteoarthritis of the spine. The pain management clinic is formed of a team of pain management consultants, surgeons, physiotherapists, psychologists and other health professionals all working together to provide an optimum treatment plan, specifically tailored to suit individual needs. This provides a complete all round treatment, helping not only to relieve painful symptoms but also to assist patients in the management of their symptoms and supporting them in any necessary lifestyle adaptations.

Nerve Pain

nerve pain

Back Pain

back pain

Treatments

pain treatment