Arthritis of the Spine

The most common type of arthritis that affects the spine is Osteoarthritis. By itself, it rarely needs surgical intervention, but it can lead to other conditions that do. Osteoarthritis can lead to degenerative joint disease.

This occurs as the cartilage in the neck and low back wear down leading to a compression of the spinal cord and the spinal nerves (spinal stenosis). Spinal arthritis may also cause instability of the joint. The friction caused by the arthritic joint may also form bone spurs (osteophytes) which could intrude into space where the nerve roots leave the spinal cord (neuroforamen).

Symptoms of Arthritis of the Spine

Symptoms Include:

  • Pain, especially at the base of the skull or the low back; it is sometimes relieved when lying down
  • Headache
  • Crunching (crepitus) when the neck or low back joints are moved (more noticeable in the neck)
  • Weakness, tingling, numbness down your arms or legs
  • Stiffness
  • Loss of coordination or difficulty walking
  • Loss of bowel or bladder control (seek immediate medical attention)

How is Arthritis of the Spine Diagnosed?

After an examination and a review of your past medical history your spine surgeon or his physician assistant will order x-rays and an MRI to determine exactly which level of your spine in affected. After diagnostic testing is completed your physician will determine your treatment plan. Most arthritis can be managed without surgery.

Treatment Options for Arthritis of the Spine

Non-surgical treatment options for spinal arthritis include physical therapy, exercise, chiropractic therapy, massage therapy, acupuncture, and/or application of heat or cold compresses. Non-prescription medications such as acetaminophen, NSAIDs (nonsteroidal anti-inflammatory) such as aspirin, naproxen and ibuprofen may be tried if the patient does not have contraindications to them. Your physician may order prescription strength pain medications or steroids to reduce inflammation. Occasionally steroids are injected around the nerves in the spinal column (epidural steroid injections – ESI) easing the pain and reducing the inflammation.

The steroid injections are done by Orlando Orthopaedic Center’s Pain Management Physicians. This is done in an outpatient surgical suite under fluoroscopy (specialized x-ray machine), which allows the steroid medication to be injected around the spinal nerves that are being affected. This may relieve the pain completely. If the pain is not relieved surgery may be indicated.

When non-surgical treatment fails patients might be a candidate for spinal fusion to stop the motion of the spine alleviating the pain at this location. The other procedure used for bone spurs is called a laminectomy. This procedure allows the spine surgeon to remove the bone spurs and relive the compression on the spinal nerves. If a large portion of the bone is removed the patient may also need a fusion to stabilize the vertebra.

Who Should Consider Surgery?

Surgery should be considered for individuals who have failed conservative treatment with medications and injections, or those with symptoms that are so severe that they are starting to lose significant function and are at risk for permanent nerve damage.

All risks and benefits of spine surgery should be considered before making a decision. The spine surgeon will discuss all available options and treatments.

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