24 Aug Osteoarthritis of the Spine
The term arthritis comes from the Greek word “arthros” which means the joint and its attachments. The -it is at the end of the word is used medically to signify inflammation. The term “osteo” means bone and osteoarthritis typically affects weight-bearing joints. In the United States, approximately 30 million Americans have been diagnosed with arthritis. It is a condition that mostly affects women and those who are 45 years old and above. It is also a common cause of lower back pain, especially in individuals who are 50 years old or older.
The human spine is made up of 33 spinal vertebrae: 7 cervical (neck), 12 thoracic (upper back), 5 lumbar (lower back), 5 sacral (sacrum), and 4 coccygeal (tail bone). In between these vertebrae are intervertebral discs that function to absorb shock and impact whilst allowing the spine to move without the vertebrae rubbing on each other. Just like any other part of the human body, the spine is susceptible to wear and tear.
Arthritis of the spine usually occurs when there is damage to the facet joints in the spine. The facet joints are lined with cartilage that allows movement but can cause pain when the cartilage is chipped or torn. This leads to friction which causes inflammation and pain. The facet joints in the lower back are the most susceptible to osteoarthritis as the lower back has the most stress and strain. It can also occur when there is a torn or damaged disc.
Patients with c of the spine usually complain of pain and stiffness that is worst in the morning, decreases with activity but worsens at the end of the day. The pain can be severe enough that sleep is disrupted. Most patients are affected in the lower back and usually present with pain that radiates into their buttocks and hip. Swelling and warmth are also noticed along with the loss of flexibility and function. There may also be tingling and numbness.
The diagnosis can be achieved via the patient’s history, physical examination, and tests. Tests may include imaging such as X-rays to see if there are any fractures and bone spurs associated with arthritis. A computed tomography (CT) scan can also be used to look at the surrounding structures of the spine. A magnetic resonance imaging (MRI) scan can also be used to show detailed images of the spinal cord, nerve roots, discs, and ligaments surrounding the spine. Other tests such as blood tests may be done to exclude the possibility of other conditions.
The goal of treatment is to improve the symptoms and quality of life. Treatment methods include conservative methods such as oral medication (pain killers), physical therapy, massage therapy, spinal manipulation by a chiropractor, and lifestyle changes to encourage weight loss and exercise. Injections for pain relief is also an option. If conservative therapy does not improve the symptoms, surgery is the next option. With modern technology, minimally invasive spinal surgery can be performed as an outpatient procedure and offers many benefits such as smaller incisions, smaller scars, less blood loss, lower infection rates, shorter hospital stay, and faster recovery rates.