Osteoarthritis

Spinal osteoarthritis is a disease in the joints of the spine. Each vertebra has joints that connect them. A lubricating connective tissue, called cartilage, helps the joints bend and move fluidly. As cartilage breaks down, the vertebrae are unable to smoothly glide, so the bones of the spine or the facet joints (the joints where the vertebrae are connected) begin to rub together. This degeneration of the cartilage is called osteoarthritis, spondylosis, or degenerative joint disease.

Osteoarthritis can occur in the neck and upper back from, say, slouching and poor posture, but is most common in the lower back (lumbar region) that carries the weight load of the body and all of the stresses that come with it. Osteoarthritis can be painful and cause inflammation in the area and eventually a loss of mobility in the spine. However, with proper care, most people who have osteoarthritis can lead normal, functioning lives.

Osteoarthritis is mostly an age-related disease that affects people over 45 and a higher percentage of women over men. People who are overweight have a higher chance of having osteoarthritis. Heredity can also play a part if the person already has joint irregularities or defective cartilage. Pain and inflammation is a common symptom, but the damage doesn’t always cause pain, or the pain may be intermittent. This intermittent pain sometimes makes it difficult for doctors to determine if the osteoarthritis is causing the symptoms. Other symptoms are bone spurs (osteophytes), which form in the areas where the bones are rubbing together, and/or a crunching sound when the joints are moved. Getting out of bed may be a longer process as the joints become stiff after a night of inactivity. In advanced cases, numbness or tingling might occur. Numbness, muscle weakness or a loss in bladder or bowel control can be a serious problem and a health care provider should be consulted immediately.

Osteoarthritis is a degenerative disease, but if taken care of, a person can still function normally, though they might have to alter their lifestyle somewhat, e.g. reduction of heavy lifting, weight loss. The disease most often can be treated without surgery. Non-invasive methods health care professionals use to treat the pain and stiffness is highly effective.

To determine what the cause of the pain or loss in mobility is, a physician will ask for medical and family history, conduct a physical exam and possibly take x-rays or in some cases an MRI.

Reducing pain and inflammation is the first step that is taken. Doctors will usually prescribe rest until the pain goes away, icing the area (never put ice directly on the skin, which can cause frost bite), anti-inflammatories and possibly muscle relaxants if there is a muscle spasm. Some people experience relief by using topical analgesics. Other common treatments are acupuncture; chiropractic care; massage; TENS (electrical impulses send through the skin); supplements (glucosamine and chondroitin, omega-3 fatty acids and MSM are three of the most commonly recommended); and herbal remedies. Your health care professional can help you decide what is best for you.

Occasionally invasive treatments are required. Some possible treatments in severe cases are:

  • Spinal or facet joint injections where a hormone steroid is injected into the spine or facet joints
  • Epidural Steroid Injection (ESI) where a steroid injection travels through the epidural area and coats the facet joints and nerves to reduce inflammation and pressure on the soft tissues in the area
  • Surgery – to remove floating cartilage, bone spurs, or other things that are causing irritation or putting pressure on the nerves in the spine

Relief from invasive treatments is often temporary. As people find it more difficult to move and experience pain, they think that they need to stop moving, however strengthening the muscles of the back and stomach is a necessary step in keeping the spine protected and in line. Once pain and inflammation is under control, regular movement and a routine of stretching and low impact aerobics is often prescribed. Staying at an ideal weight, exercising regularly (and smartly) and stretching can help the person lead an active and normal lifestyle.

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