Arthritis in the Spine
The spine is one of the body's areas that is most affected by arthritis. Inflammation from spinal arthritis can force you to change much of your daily routine to accommodate the pain and swelling.
What Is Spinal Arthritis?
Spinal arthritis occurs when there is friction in the spinal joints, leading to pain and discomfort anywhere from your pelvis up to your neck. The spine is composed of 33 bones called vertebrae, the majority of which are connected by facet joints.
Since arthritis takes place in the joints, any of the connection points along the spine may be affected. Spinal arthritis can also affect the sacroiliac joints between the spine and the pelvis.
Two Major Types of Spinal Arthritis
There are more than 100 types of arthritis, many of which can affect the back. The two main types of arthritis are non-inflammatory and inflammatory arthritis.
Non-inflammatory arthritis, better known as osteoarthritis, is the most common form of spinal arthritis (wear and tear). The spine is quite vulnerable to osteoarthritis as a result of daily activities, aging, and other factors that break down the cartilage between joints over time. Movements such as bending or twisting make spinal arthritis more noticeable. When the cartilage is worn away, the bone ends grind together, which leads to the typical arthritis symptoms of inflammation and pain.
Inflammatory arthritis, or rheumatoid arthritis, of the spine is an autoimmune disorder. Unlike the gradual breakdown of osteoarthritis, rheumatoid arthritis occurs when the immune system essentially attacks itself by targeting the synovium (joint lining) between vertebrae. This type of arthritis is less common in the spine than other joints of the body.
What Causes Spinal Arthritis?
Causes of spinal arthritis vary depending on the type of arthritis you have. In many cases, the exact cause cannot be identified.
With osteoarthritis, the lower region of the spine (aka the lumbar) produces a constant loading on the spine. At the same time as the cartilage wears away, the disks in the spine narrow due to water loss. This causes an issue because it increases the pressure on facet joints, and as a result, the joints can develop inflammation.
Other factors that may cause spinal arthritis include:
- Trauma to the spine, which increases the chance of having spinal osteoarthritis.
- Autoimmune disorders may lead to rheumatoid arthritis.
- Genetics may be involved as well. Your chances of getting spinal arthritis increase if one or both of your parents have spinal arthritis.
- Ankylosing spondylitis is an inflammatory disease that may cause some of your vertebrae to fuse together and also cause spinal arthritis.
- Other risk factors include age, excess weight, presence of certain conditions like diabetes, gout, psoriasis, and tuberculosis, to name a few.
Symptoms of Spinal Arthritis
Symptoms will also vary depending on the type of spinal arthritis you may have.
- Back pain in the lower back is a common symptom, but surprisingly, not everyone with spinal arthritis gets back pain. Since vertebrae go up to your neck as well as your back, you may also experience neck pain.
- The affected vertebrae will experience swelling or tenderness in the joints.
- Spinal arthritis may come with stiffness and lack of flexibility in the spine, which tended to be worse in the morning and referred to as "first movement pain," which lasts around 30 minutes.
- With non-inflammatory arthritis, there can be a feeling of grinding in the spine during movement.
- Bone spurs can form; these growths are also called osteophytes, which can cause the spine to stiffen.
- As osteoarthritis gets worse over time, the bone spurs can narrow the areas where nerves exit the spinal cord. This provides an opportunity for nerves in the spine to be pinched and cause numbness/weakness in the legs.
- With inflammatory arthritis, weakness, or overall fatigue is common.
If you've tried other treatment options for arthritis that haven't worked, then clinical trials for arthritis may be an option for you. Learn more here.
Treatment for Spinal Arthritis
There is no cure-all treatment that works for everyone, but options are ranging from medication, lifestyle adjustments, to surgery. As with any treatment regimen, make sure you consult a medical professional before prescribing a solution for yourself.
Over-the-counter pain relievers, like ibuprofen and nonsteroidal anti-inflammatory drugs (NSAIDs), are available to help with pain and discomfort. Other medications are available to target specific symptoms of inflammatory arthritis.
If you experience higher levels of pain due to severe inflammation, you may be prescribed cortisone injections to offer temporary relief.
It is very important to make sure you're staying active. Activity increases the strength and flexibility of the muscles supporting the spine; you want to keep them strong.
If you avoid movement and activities out of fear of hurting your back further, you're doing yourself a disservice. By avoiding activities, you're making your muscles weak and tight, which is a combination that makes you more sensitive to pain.
Movement also increases blood flow, which provides nutrients and removes inflammatory waste from the joints and muscles of the back.
Physical therapy is an excellent way to improve muscle strength and increase range of motion in the spine under the guidance of a professional. Other lifestyle changes like losing weight, quitting smoking, or improving your posture also add relief to your back.
Surgery may be a viable option for other treatment methods prove to be ineffective. This is only recommended if you're not finding relief and spinal arthritis dramatically impacts your quality of life. There are two main types of surgery for spinal arthritis:
Decompressing the spinal cord to free the nerve roots from bones spurs and other tissues that may be pressing on them.
A spinal fusion whereby the surgeon fuses several segments to stabilize the spine.
Can Spinal Arthritis be Prevented?
While there is no way to prevent spinal arthritis, you can make some lifestyle changes to reduce your risk.
Be mindful of your spine, maintain a healthy weight, so your lumbar isn't put under as much pressure, practice good posture, and make sure that you're exercising the muscles that support the spine.
Being mindful and aware of your arthritis and what you can do about it will help improve your day-to-day life.