Spinal Osteoarthritis

Spinal osteoarthritis is a breakdown of cartilage in the joints of the spine that causes pain, stiffness, and reduced mobility. While the damage cannot be reversed, various treatments can help manage symptoms and improve quality of life.

Table of contents

• What Is Spinal Osteoarthritis?
• Who Gets Spinal Osteoarthritis?
• Symptoms of Spinal Osteoarthritis
• How Is Spinal Osteoarthritis Diagnosed?
• Treatment Options
• Lifestyle Changes That Help
• Living with Spinal Osteoarthritis

What Is Spinal Osteoarthritis?

Spinal osteoarthritis is also known as degenerative arthritis of the spine. It is a condition where the protective cartilage that cushions the ends of bones breaks down over time^[1]. This breakdown occurs in the joints between the vertebrae, the 33 bones that make up your spinal column^[4].

In the spine, this condition specifically affects the facet joints, which are small joints located between and behind the vertebrae^[3]. As the cartilage wears away, the bones can rub together painfully. This can also cause swelling and may lead to the development of bone spurs, which are bony growths that can form in the joints^[1].

Spinal osteoarthritis can occur anywhere along the spine, but it most commonly affects the cervical spine (neck) and the lumbar spine (lower back)^[4][3]. Sometimes, these bone spurs put pressure on nerves leaving the spinal column, which can cause weakness and pain in the arms or legs^[1].

Who Gets Spinal Osteoarthritis?

Spinal osteoarthritis is very common, especially as people age. Experts estimate that around 95% of males and 70% of females older than 60 have some amount of spinal arthritis^[4]. In fact, an estimated 80% of Americans have an episode of low back pain during their lifetime^[2].

In general, osteoarthritis happens as people get older^[1]. However, younger people may develop it due to injury or trauma to a joint, or from a genetic defect involving cartilage^[1].

For people younger than age 45, osteoarthritis is more common among men. After age 45, it becomes more common among women^[1].

Certain factors can increase your risk of developing spinal osteoarthritis. You might have a higher risk if you:

• Are overweight or have obesity, which puts extra pressure on your joints^[1][4]
• Have a job or hobbies that put repetitive stress on your spine, such as physical work or contact sports^[1][4]
• Have a family history of arthritis^[4][3]
• Use tobacco products, as smoking increases arthritis risk^[4]
• Have certain autoimmune disorders, including Crohn’s disease, ulcerative colitis, or psoriasis^[4]

Symptoms of Spinal Osteoarthritis

The most common symptoms of spinal osteoarthritis include back pain, especially in the neck or lower back, and stiffness or feeling less flexible^[4]. Pain and stiffness are often worst when you first wake up or after sitting for a long time. Pain can also worsen after being very active^[3].

Other symptoms you may experience include:

• A loss of flexibility, making it difficult to turn your neck or straighten your back^[3]
• Arm or leg pain, particularly if the condition is severe enough to affect spinal nerves^[4]
• Weakness or numbness in the legs or arms^[1]
• Not being able to walk as far as you used to^[4]
• Fatigue or feeling tired all the time^[4]
• A grinding feeling or crepitus when moving. Some people say the joints in their spine feel creaky^[3][4]
• Tenderness and swelling along the affected joints^[3]

Usually, back discomfort is relieved when lying down^[1]. Depending on where you have spinal arthritis, you might also have pain in other areas, including your head, ribs, hips, buttocks, or knees^[4].

Some people experience little interference with their daily activities, while others become more severely disabled^[1]. In addition to physical effects, a person with osteoarthritis might also experience social and emotional problems. For instance, someone with osteoarthritis that hinders daily activities and job performance might feel depressed or helpless^[1].

How Is Spinal Osteoarthritis Diagnosed?

To diagnose spinal osteoarthritis, your doctor will take a medical history and perform a physical exam to check for pain, tenderness, and loss of motion in your neck or lower back. They will also look for signs of nerve involvement, such as weakness, reflex changes, or loss of sensation^[1].

The best way to confirm a diagnosis of osteoarthritis is through imaging tests^[1]. Your doctor may order several tests, including:

• X-rays to look for bone damage, bone spurs, and loss of cartilage. However, X-rays cannot show early damage to cartilage^[1][3]
• Magnetic resonance imaging (MRI) to show possible damage to discs or narrowing of areas where spinal nerves exit^[1]
• Blood tests to exclude other diseases^[1][3]

It’s important to understand that radiographic imaging of spine osteoarthritis does not necessarily correlate with the amount of pain you experience^[2]. This means that the images may show significant changes in your spine, but you might have little pain, or the opposite could be true.

Treatment Options

The damage caused by osteoarthritis cannot be reversed^[3]. Treatment focuses on relieving symptoms of pain and increasing your ability to function. The goal is to help you maintain a healthy lifestyle^[1].

Non-Drug Treatments

Several non-drug approaches can help manage spinal osteoarthritis:

• Physical therapy to improve muscle strength and your ability to move your spine^[3]
• Exercise, including swimming, walking, and water aerobics. Besides helping with weight management, exercise can increase flexibility, improve your mood, strengthen your heart, improve blood flow, and make daily tasks easier^[1]
• Heat and cold therapy. Applying heat can help relax muscles and reduce stiffness. Cold packs can reduce pain and swelling^[16]
• Acupuncture or massage for pain relief^[3]
• Braces or corsets to support the lower back and abdomen, reducing pressure on the discs^[16]

Medication

Your doctor may prescribe medication to help control pain and inflammation:

• Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) or naproxen (Aleve), and acetaminophen (Tylenol) can control pain^[3]
• Steroid injections (glucocorticoids) may be injected into the back for short-term relief^[3]

It’s important to take your medicine as prescribed, even if you start to feel better^[17]. Check with your healthcare team if you plan to take any over-the-counter remedies or nutritional supplements, as these can sometimes interfere with your prescribed medicine^[17].

Surgical Treatments

If nothing else helps your pain, your doctor may recommend surgery^[3]. Surgery might be used to:

• Take pressure off the spinal cord and free nerve roots from bone spurs that are pressing on them^[3]
• Fuse several segments of the spine together to stabilize it^[3]

Lifestyle Changes That Help

Making certain lifestyle changes can play a key role in managing spinal osteoarthritis pain and preventing further damage:

Weight Management

Losing weight if needed and maintaining a healthy weight can take pressure off your back^[3][1]. Being overweight adds pressure to the joints, including the facet joints of the spine. Carrying excess weight increases the chances of discs becoming herniated, particularly in the low back. Studies have linked excess fat to the release of chemicals that trigger inflammation in the body^[12].

Regular Exercise

Living a sedentary lifestyle may worsen inflammation. Inactivity leads to stiffness and decreased flexibility^[12]. Regular exercise improves joint movement, balance, muscle strength, and helps prevent obesity. Low-impact exercise, swimming, water aerobics, gentle stretches, tai chi, and walking can benefit people with spinal arthritis^[12].

Improve Your Posture

Poor posture puts strain on the discs, vertebrae, and facet joints. Slouching or slumping creates friction that may damage cartilage^[12]. A physical therapist can teach you proper ways to sit, stand, and move^[4].

Modify Activities

Change activities to ones that don’t put as much stress on your back^[3]. You may need to adjust your home and workplace to make them more accessible and comfortable^[16].

Living with Spinal Osteoarthritis

With the right support, you can lead a healthy, active life with osteoarthritis^[17]. The condition does not necessarily get worse over time^[17].

Managing Your Health

Because osteoarthritis is a long-term condition, you’ll be in regular contact with your healthcare team^[17]. Having a good relationship with your team means you can easily discuss your symptoms or concerns. The more they know, the more they can help you^[17].

A good diet and regular exercise will help keep muscles strong and control your weight, which is good for osteoarthritis and also has other health benefits^[17].

Finding Support

Many people find it helpful to talk to other people who are in a similar position. You may find support from a group or by talking individually to someone who has osteoarthritis^[17]. It is important to seek emotional support from people who understand what you are going through. You can talk to your family members, friends, or healthcare providers about your feelings and concerns^[13].

Work and Financial Considerations

If you have severe osteoarthritis and are still working, your symptoms may interfere with your working life and affect your ability to do your job. If you have to stop work or work part time because of your arthritis, you may find it hard to cope financially. You may be entitled to various types of financial support or disability benefits^[17].

Possible Complications

Spinal arthritis complications can include:

• Spinal stenosis, which is narrowing of the spinal canal^[4]
• Radiculopathy and other types of pinched nerves^[4]
• Broken vertebrae (spinal fractures), especially compression fractures^[4]

If back pain persists after several weeks of at-home treatment with no improvement, it’s time to see a physician for a diagnosis of the cause^[12]. Visit a healthcare provider if you’re experiencing arthritis symptoms like pain and stiffness. They’ll suggest treatments to relieve your symptoms and prevent more damage to your spine^[4].