Lower back pain is becoming increasingly common in most individuals to report to a healthcare setup. Some of the factors that have been found responsible for this include the increasing epidemic of obesity which causes an increased load on the lower back and spine, leading to back pain. In addition, a majority of individuals with these symptoms are found to have arthritis of the spine.
What Are The Forms Of Arthritis Affecting The Spine?
The common types of arthritis that may affect the spine include Osteoarthritis, rheumatoid arthritis of the spine, and spondyloarthritis.
Osteoarthritis Of The Spine
Spinal Osteoarthritis, which may also be referred to as a degenerative joint disease, is a condition affecting the articular surfaces of the spinal canal. Osteoarthritis, in general, is most commonly found in the body’s load-bearing areas, including the joints found in the spinal column. (1)
The spinal cords are made up of three joints, including one intervertebral disc joint and two facet joints. (2) (3) Degeneration can lead to back pain in any of these joints. Other factors that may promote back pain include vertebral osteophyte formation, facet joint osteoarthritis, and disc space narrowing. (4) (5)
Osteoarthritis is reported to occur in humans’ four stages in humans, which include minor, mild, moderate, and severe. While the minor stages are characterized by wear and tear of the joint with no pain, the mild phase is characterized by the presence of bone spurs and a feeling of stiffness after rest periods. The moderate phase involves erosion of the cartilage, while the severe phase includes high levels of inflammation in the joint and complete degeneration of the cartilage. Individuals with severe Osteoarthritis present with high levels of pain due to the overgrowth of bony spurs over time.
Rheumatoid Arthritis Of The Spine
Rheumatoid arthritis is a unique form of arthritis where the body’s immune system turns against its own cells. While rheumatoid arthritis is comparatively less common in the spine, it may affect it in cases where inflammation is involved. This is why it may also be referred to as inflammatory arthritis of the spine.
Even though rheumatoid arthritis and spondyloarthritis are both inflammatory in nature, they are not the same condition. This form of arthritis attacks the joints and the surrounding ligaments and tendons at the locations where they get attached to the bones. Cervical spondylosis is the general term used to define the wear and tear changes taking place in the body as an individual age. Spondyloarthritis may be further divided into different types, which include Ankylosing spondylitis and Psoriatic arthritis. While ankylosing spondylitis is a form of spinal arthritis affecting the sacroiliac joints, psoriatic arthritis is characterized by the development of psoriasis with itchy and scaly rashes.
Inflammatory Bowel Disease Associated With Arthritis
Inflammatory bowel disease may also lead to arthritis, which is inflammatory in nature. The forms of arthritis which may be promoted by inflammatory bowel disease include psoriatic arthritis, ankylosing spondylitis, and reactive arthritis.
What Causes Arthritis of the Spine?
There are numerous factors that play a role in causing arthritis of the spine. These include the individual’s lifestyle, diet, gender, ethnicity, and genetic differences. (6) (7) (8) The genetic factors which play a role in causing arthritis include over 80 gene mutations, which may be inherited in the form of Osteoarthritis of the cervical and lumbar region. The lifestyle factors may include sitting in an unhealthy posture for long periods of time and eating foods that may promote inflammatory activity in the body.  However, the factor that may play the greatest role is the increasing age of the individual. This is because as individuals age, they experience deterioration of their spines. In a healthy individual, the facet joins carry the maximum load of the body. The increasing load can lead to an increase in bone density and bone spurs. This can also lead to spinal stenosis.
What Are The Symptoms Of Osteoarthritis Of the Spine?
Osteoarthritis of the spine may present with certain symptoms like mid-shoulder pain, which may be caused by degeneration of cervical and lower cervical pain facet joints. Certain individuals may also experience thigh and buttocks joint pain due to the involvement of the lumbar spine. Pain below the knee may be caused by nerve root compression. Neck pain is also commonly reported. The painful joints also lead to a limited range of motion and loss of grip strength.
Evaluation And Diagnosis
Evaluation and diagnosis of arthritis of the spine include a detailed medical history and physical examination to assess the joint damage. During the physical examination, the doctor may also test the range of motion. Blood tests, Magnetic Resonance Imaging, and X-rays may also be performed.
Treatment Plan For Spinal Arthritis
Treatment options for Osteoarthritis include both conservative and aggressive methods. Healthcare professionals recommend superficial heating, massage, and acupuncture as the first line of treatment. In contrast, acute back pain may last for four weeks. On the other hand, the subacute may last for 12 weeks, and chronic arthritis, the chronic pain may last for even more than 12 weeks. (9) Health experts may also recommend physical therapy, spinal manipulation, and low-level laser therapy for mild to moderate cases of low back pain. Physical therapy may work by promoting lumbar stabilization and improving the symptoms of spinal stenosis. They may also be encouraged to undergo lifestyle changes for an overall improvement in health.
The pain relief medications that are commonly recommended include over-the-counter non-steroidal anti-inflammatory drugs. The NSAIDs like ibuprofen, acetaminophen, and Naproxen are recommended, which work by reducing the inflammatory activity in the body. In the cases where anti-inflammatory medications prove to be ineffective, corticosteroids may be used. Even though steroid injections are very effective at pain relieving the affected joints, they may lead to several side effects, which is why they should be avoided. Surgical processes like spinal fusion and new bone implantation are kept as a last resort. (10)
Arthritis is a condition characterized by a disease of joint and joint pain. There are many forms of arthritis; however, most of these affected areas with a higher load. However, not only the environmental factors but genetic factors are also found to play a role. Osteoarthritis of the spine can be a source of pain not only limited to the spine itself but may also radiate to the shoulders and buttocks. Individuals with spinal arthritis are recommended to consume drugs like over-the-counter NSAIDs and undergo physical therapy. Lifestyle changes and diet alterations may also be found to be effective. This may include quitting smoking, doing daily exercise, and losing weight.
Frequently Asked Questions
Is Arthritis In Spine A Disability?
Having arthritis in the spine can cause pain to the individual, in turn limiting their mobility. This is why it may interfere with their everyday activities. Individuals who cannot perform their daily tasks due to arthritis of the spine are eligible for getting disability benefits from the Social Security Administration.
What Are The 4 Stages Of Osteoarthritis In The Spine?
The four stages of Osteoarthritis of the spine include Stage 1, Stage 2, Stage 3, and Stage 4. While Stage one is also known as the early stage, stage 2 is referred to as the mild stage. Stage 3 is called the moderate stage, and stage 4 is the severe stage.
What Is End Stage Arthritis?
End-stage arthritis is characterized by a progressively worsening case of arthritis, which involves the continuous damage of the cartilage until the bones come directly into contact with each other. This rubbing of the bones of a joint as the individual moves can be a source of pain. This pain leads to their loss of movement and function as well.
Does Osteoarthritis Hurt All The Time?
Early and Mild stages of Osteoarthritis are not associated with a significant amount of pain as compared to the later stages. However, as Osteoarthritis worsens over time, this can lead to chronic debilitating pain. The joint stiffness and limited range of movement can interfere with the individual’s everyday activities and affect their quality of life as well. This may lead to depression and disturbances of sleep due to the disability caused by arthritis.
What Activities Should Be Avoided With Arthritis?
While it is highly recommended to get treatment for arthritis before it gets worse and becomes a source of pain and disability, there are certain activities that an individual should avoid after their diagnosis. These include activities like jumping rope, running, jogging, and high-impact aerobics. This is because both the feet are off the ground and may trigger arthritis pain.
What Is The Most Painful Type Of Arthritis?
Also, the later stages of all types of arthritis can prove to be highly painful for the patient; rheumatoid arthritis is generally considered the most painful form of arthritis. This is because it does not only involve the joint but also involves the surrounding tissues and organs.
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- Weinberg, D. S., Liu, R. W., Xie, K. K., Morris, W. Z., Gebhart, J. J., & Gordon, Z. L. (2017). Increased and decreased pelvic incidence, sagittal facet joint orientations are associated with lumbar spine osteoarthritis in a large cadaveric collection. International orthopaedics, 41(8), 1593–1600. https://doi.org/10.1007/s00264-017-3426-1
- Wenger, H. C., & Cifu, A. S. (2017). Treatment of Low Back Pain. JAMA, 318(8), 743–744. https://doi.org/10.1001/jama.2017.9386
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