Spinal Arthritis

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is spinal arthritis?

Arthritis of the spine develops in the joints of the back—the facet joints—that link one bony vertebra to the next. Your spinal column is made up of vertebrae and intervertebral discs, with cartilage lining the vertebral joints. The column protects the spinal cord at its center. The discs contain a gel-like material that buoys the spine, and cartilage lines the facet joints. When spinal discs begin to dry out and cartilage begins to break down due to wear and tear and other causes, the vertebrae and joints don’t have as much cushion when they move. The result is bone rubbing on bone. This is osteoarthritis of the spine—the most common form of arthritis in the back. Older people are more at risk for osteoarthritis of the spine because the risk increases with age.

Inflammation in the spinal joints is known as spondyloarthritis, which is the umbrella term for several kinds of inflammatory spinal diseases that cause arthritis. The type that most often affects the spine is ankylosing spondyloarthritis, more commonly known as ankylosing spondylitis. Young men have the highest risk of developing it. Family history of spondyloarthritis also raises the risk of developing inflammatory arthritis in the spine.

Low back pain is the most common symptom of spinal arthritis, which typically develops slowly over time. People also may experience stiffness and limited range of motion.

Treatment for spinal arthritis focuses on pain management and joint mobility. To keep pain under control, doctors often recommend nonsteroidal anti-inflammatory drugs for both types of spinal arthritis. This and other types of conservative spinal arthritis treatments, including physical therapy and low-impact exercise, help maintain your range of motion. Surgery usually isn’t necessary.

Without treatment, the disease will progress and make it more difficult to perform your daily activities due to excessive pain or limited mobility. If you have inflammatory spinal arthritis, it could even begin to destroy your bones, which can cause deformities in your spine.

What are the symptoms of spinal arthritis?

Pain is a common complaint among people with either spinal osteoarthritis or inflammatory arthritis of the spine, but it’s not the only symptom of spinal arthritis.

Inflammatory spinal arthritis symptoms

The most common spondyloarthritis symptoms include:

  • Stiffness

  • Fatigue

  • Limited mobility in the spine

  • Sometimes, swelling of the arms and legs

Spinal osteoarthritis symptoms

Symptoms of osteoarthritis in the spine depend on how far the disease has progressed. These symptoms can include:

·       Pain in the lower back after a period of inactivity, such as first thing in the morning. In later stages, pain worsens with physical activity.

  • Stiffness

  • Limited mobility in the spine

  • Abnormal curvature of the spine—kyphosis—which can look like a humpback

  • Bone spurs that sometimes press on nerves or compress the spinal canal leading to spinal stenosis

Without treatment, spinal arthritis usually gets worse with time and can eventually cause enough pain and difficulties with mobility that it affects your ability to carry on your daily activities. If you notice symptoms of spinal arthritis, such as low back pain that doesn’t go away, talk with your doctor about diagnostic tests for spinal arthritis.

What causes spinal arthritis?

Osteoarthritis in the back is often caused by degenerative disc disease. This condition occurs when the supportive intervertebral discs between each bony vertebra in the spine begin to wear down and lose their cushioning ability. Spinal joints run along the back, or posterior side of the spinal column connecting one vertebra to another. They allow you to move and bend your entire upper body. Less space between vertebrae due to disc disease increases pressure on the spinal joints. When the bones rub together, it causes pain and stiffness—typically in the lower back.

Scientists aren’t certain about the cause of inflammatory spinal arthritis, but they believe it may be inherited. More than two dozen genes have been linked to the development of ankylosing spondylitis.

What are the risk factors for spinal arthritis?

The risk factors differ for spinal osteoarthritis and inflammatory spinal arthritis.

Risk factors for spinal osteoarthritis

Confirmed risk factors for osteoarthritis include:

Risk factors for inflammatory spinal arthritis

Inflammatory arthritis of the spine includes ankylosing spondylitis, psoriatic arthritis, and reactive arthritis. Risk factors for the most common form, ankylosing spondylitis, include:

  • Male gender younger than 30 years of age

  • Family history of inflammatory spinal arthritis

  • Presence of the gene HLA-B27

  • Asian/Pacific Islander, Hispanic American, and White American race

Reducing your risk of spinal arthritis

You can’t change your gender, race or genes, but there are other ways you may be able to lower your risk of spinal arthritis. These include:

  • Getting regular low-impact exercise to strengthen back and core muscles

  • Getting enough calcium and vitamin D to prevent or slow osteoporosis

  • Maintaining a healthy weight

  • Sleeping on a firm mattress and using a supportive chair at work

If you have a family history of inflammatory spinal arthritis or if you have osteoporosis, talk with your doctor about additional ways you can manage your risk of developing arthritis of the back.

How is spinal arthritis treated?

Treatment for spinal arthritis is designed to reduce pain, maintain mobility of the spine, prevent deformities, and slow progression of the disease. Most of the time, nonsurgical treatments can achieve these goals.

Doctors usually recommend using a combination of conservative treatments to manage spinal arthritis. These treatment options include:

  • Pain relievers such as nonsteroidal anti-inflammatory drugs

  • Disease-modifying anti-rheumatic drugs and biologics for inflammatory arthritis

  • Applications of heat or ice to reduce inflammation

  • Rest when arthritis flares

  • Physical therapy exercises to improve spinal extension and mobility

  • Acupuncture or massage

Back surgery is necessary for spinal arthritis when there are broken bones in the spine or if the person is unable to straighten the neck (the cervical spine). Spine surgery options may include laminectomy and spinal fusion

What are the potential complications of spinal arthritis?

The purpose of treatment for spinal arthritis is to prevent as many complications as possible from the disease, including spinal nerve compression. Complications also can include spreading of the arthritic pain and stiffness up the spine from the lower back, sometimes all the way to the neck and into the ribs. As inflammatory spinal arthritis progresses, it can cause fusion of the vertebral bones, which results in rigidity and limited mobility. In some cases, spinal arthritis can cause curvature of the spine.

If you are facing spinal arthritis, learn as much as you can about your type and stage of disease and how best to treat it. It can be challenging to maintain a positive outlook when facing a progressive condition, but take heart in the fact that treatment has advanced along with a continued focus on understanding the causes of spinal arthritis. Work with your doctor to fine-tune the treatment(s) most likely to be effective for you.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Aug 23
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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