Your Spine: Introduction
Millions of people suffer from arthritis. In fact, arthritis
affects approximately 80% of people over the age of 55 in the United
States. It is estimated that by the year 2020, over 60 million
people will suffer from this often-disabling problem.
Arthritis is actually a term for over 100 rheumatoid disorders.
Common forms include :
Quick Anatomy Lesson - The Spine
- Rheumatoid Arthritis
- Ankylosing Spondylitis
- Juvenile Arthritis
- Psoriatic Arthritis
- Systemic Lupus Erythematosus
The spine is made up of individual bones called vertebrae, which
provide support for the spine. These vertebrae are connected in the
front of the spine by intervertebral discs that help support the
spine and also allow it to move. The many ligaments and muscles that
are attached to the back of the spine provide the power for
Arthritis occurs when the cartilage in the joints is worn down as a
result of wear and tear, aging, injury or misuse. Osteoarthritis
the most common form of arthritis, also includes loss of cartilage,
overgrowth of bone and the formation of bone spurs. This causes the
bones under the cartilage to rub together, causing pain, swelling
and loss of motion of the joint. Osteoarthritis can occur in any
joint but most often occurs in the hips, knees, hands or the spine.
In medical terms, the bone spurs are called osteophytes. Osteophytes
may be found in areas affected by arthritis such as the disc or
joint spaces where cartilage has deteriorated. The body's production
of osteophytes is a futile attempt to stop the motion of the
arthritic joint and deal with the degenerative process. It never
completely works. The evidence of bony deposits can be found on an
x-ray. A bone spur may cause nerve impingement at the neuroforamen.
The neuroforamen are passageways through which the nerve roots exit
the spinal canal. Sensory symptoms include pain, numbness, burning
and pins and needles in the extremities below the affected spinal
nerve root. Motor symptoms include muscle spasm, cramping, weakness,
or loss of muscular control in a part of the body
Osteoarthritis and the Spine
In the spine, osteoarthritis can cause stiffness and pain in the
neck or in the lower back. Cervical arthritis (also called cervical
spondylosis) affects the upper spine and neck. Lumbar or lumbosacral
arthritis affects the lower back and pelvic area. Ankylosing
Spondylitis is another type of spinal arthritis.
Who Gets Arthritis and Why?
Some people are more at risk for developing arthritis than others.
The following are some factors that contribute to a person's risk of
developing arthritis :
Spinal Arthritis : Symptoms
How Do I Know if I Have Arthritis in My Spine?
- Age: arthritis is more common in people over the age of 50
- Overused joints from work or sports related activities
- Injury or trauma to the bones (like fractures)
- Obesity: excessive weight places stress on joints
- Family history
- Gender: women are twice as likely to get arthritis
- Chronic illness such as diabetes, cancer or liver disease
- Weakened immune system
- Infections such as Lyme disease.
Generally, the signs and symptoms of arthritis include
inflammation, stiffness and pain in the joints. In the spine,
symptoms may also include one or more of the following :
- Back pain that comes and goes
- Spinal stiffness in the morning such as after getting out of
bed or after activity. Often this pain decreases with rest or,
for some, after exercise
- Pain, tenderness or numbness in the neck
- Lower back pain that runs down into the buttocks, thighs, or
pelvic area, sciatica
- Pain or tenderness in the shoulders, hips, knees or heels
- A crunching feeling or sound of bone rubbing on bone
- Weakness or numbness in legs or arms
- Limited range of motion, difficulty bending or walking
- Spinal deformity
If your back pain is severe, it is a good idea to visit your
doctor. He or she will ask you about the history of your pain. Be
sure to talk to your doctor about when the pain started, when it
feels better or worse, how long it lasts and what you have done to
relieve the pain. Also, make sure you inform your doctor about any
other health problems you are experiencing or have had in the past.
Your doctor will then examine your back. You may be asked to do a
few simple exercises so your doctor can see if your range of motion
has been affected. These exercises may include bending forward,
side-to-side or backwards. You may also be asked to lie down and
raise your legs. Be sure to tell your doctor when or if any of these
exercises causes pain.
The symptoms of arthritis, especially in the spine, are similar to
other spinal conditions. Therefore, it is important for your doctor
to rule out other, possibly more serious problems. To do this, you
may need to undergo a variety of tests such as :
Do I Do Now?
- Blood Tests :
These will help determine the type of arthritis.
- X-rays :
These tests can show the structure of the vertebrae and the
outlines of joints and can help determine if there has been any
deterioration of cartilage.
- MRI (Magnetic Resonance Imaging) :
This test gives a three-dimensional view of parts of the back
and can show the spinal cord, nerve roots and surrounding
- Computerized Axial Tomography (CAT Scan) :
This test shows the shape and size of the spinal canal, its
contents and structures surrounding it. It shows bone better
than nerve tissue.
- Bone Scan :
This test uses injected radioactive material that attaches
itself to bone. A bone scan can detect arthritis, but may not be
able to differentiate it from other disorders. Therefore, bone
scans are usually performed along with other tests.
- Myelogram :
A liquid dye is injected into the spinal column and appears
white against bone on an x-ray film. A myelogram can show
pressure on the spinal cord or nerves from herniated discs, bone
spurs or tumours.
If your doctor determines that you have arthritis in your spine,
there are a number of treatment options. Keep in mind, there is no
cure for arthritis, but you can treat the pain and discomfort using
medications, physical therapy, exercise, heat/cold therapy and rest.
Your doctor will talk to you about these options and together you
can develop a treatment plan that works for you.
Arthritis is not a death sentence. In fact, many people who have
arthritis continue to live active and productive lives. Educating
yourself about your condition and managing your symptoms are the
keys to not letting arthritis slow you down.
The chronic pain associated with arthritis can very seriously
affect your quality of life. If left untreated, it can also lead to
physiological problems such as muscle breakdown or weakness as well
as psychological difficulties such as anxiety and depression.
Arthritis is a common cause of back pain.
But you don't have to live with pain. Today, there are a wide
variety of treatments that can help relieve the pain and discomfort
of arthritis. This article discusses some of the most common
non-surgical treatments for arthritis, particularly for arthritis of
the spine. Remember to talk to your doctor before starting any
People with arthritis today have numerous pain medications that can
be used to relieve their pain. Some require a doctor's prescription,
some do not. However, do not assume that just because a drug is
available without a prescription or "over the counter", it
is safe for everyone.
Talk to your doctor about which pain medications are best for you.
Be sure to let your doctor know what other medications you are
taking, even for other health problems.
Acetaminophen (ie, Tylenol) - this is the drug of choice for mild
to moderate arthritis pain because it has very few side effects and
is relatively inexpensive. It is used to help relieve pain but does
not reduce inflammation. Acetaminophen may cause liver problems in
people who consume large amounts of alcohol.
Non-steriodal anti-inflammatory drugs, or NSAIDs (aspirin,
ibuprofen, naproxen) - these medications are often used for moderate
to severe arthritis pain. They treat pain as well as inflammation.
Like acetaminophen, they are relatively inexpensive. However, many
patients report stomach upset from NSAIDs. These drugs may also
interfere with other medications or cause serious side effects. Talk
to your doctor before taking any NSAIDs.
COX-2 Inhibitors (Celebrex®, Bextra®) - a new type of NSAID
that may not cause stomach irritation. Works well for moderate to
severe arthritis pain. These drugs are often more expensive than
- Opioids (oxycodone, morphine, codeine, meperidine) :
May be used to for short-term treatment of severe or sudden
onset of arthritis pain, however, they are rarely prescribed due
to their addictive nature.
- Narcotic Analgesics :
While acetaminophen is an analgesic, sometimes arthritis
sufferers need additional pain relief. There are a number of
narcotic analgesics available by prescription that may help.
These include propoxyphene hydrochloride (Darvon®) and
acetaminophen with codeine. Narcotic analgesics may cause
serious side effects when used over long periods of time.
- Topical analgesics, ointments or creams :
these are medications that are rubbed into the skin. They
usually have fewer side effects since they only affect the area
of the body where they are applied.
- Corticosteroids :
These are not used for pain but are strong medications used for
types of arthritis that include inflammation, such as rheumatoid