Back pain is one of the most common complaints for patients to seek medical care. And one of the most common causes for back pain is Degenerative Disease of The Spine, commonly known as “Arthritis of the spine.”
The spine has small joints (called Facet Joints) that connect each vertebra to the other, and like other joints in our body, inflammation could affect these joints and cause pain. There are many reasons for this inflammation, but the most common cause is Osteoarthritis (degenerative arthritis) which is the result of the normal “wear and tear” with advancing age. In some cases, degeneration of the spinal discs (degenerative disc disease) may contribute to facet joint arthritis. As discs between the vertebrae become thinner, more pressure is transferred to the facet joints, which leads to more friction and more damage to these joints.
Arthritis can occur anywhere along the spine but is more frequent in the lower back and neck. Some of the risk factors to develop this condition are age, excess weight/obesity and the presence of certain conditions such as diabetes and gout.
Signs and Symptoms
The symptoms of spinal arthritis may differ from person to person. In general, they may include neck and back pain, especially in the lower back. Stiffness and loss of flexibility in the spine, such as being unable to straighten your back or turn your neck, and the feeling of “grinding” when moving the spine.
If the inflammation is really bad, spinal arthritis may cause bone spurs (overgrowths on the edges of the bones), and although bone spurs on their own are not harmful, they may narrow the passages for the spinal cord inside the spinal canal causing spinal stenosis or pinching of the peripheral nerves as they exit the spine and cause radiculopathy (sciatica is one type of radiculopathy).
To diagnose spinal arthritis your doctor will listen to your medical history and perform a physical exam and may order some imaging like X-ray of the spine, CT-Scan or MRI.
The treatment for spinal arthritis depends on many factors. Usually starts with conservative measures like Nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy to improve back muscle strength and range of motion in the spine, lifestyle changes to reduce inflammation or stress on your spine: losing weight, quitting smoking, changing your posture, etc.
But if these measures failed your physician may recommend the Medial Branch Block procedure, in which the physician use fluoroscopy (x-ray guidance) to inject numbing medication near the facet joints in order to numb the nerves that innervate that facet joint. If the patient experiences significant pain relief immediately after this procedure, radiofrequency ablation (nerve burning) can be done at a later date to provide more long-lasting relief (typically six months to two years).
In very severe cases, surgery may be recommended for spinal arthritis if other treatments don’t sufficiently relieve pain.