Back pain can take many forms and can have many causes, but one of the most frustrating is arthritis. When people think of arthritis they tend to think of pain in the fingers or knees, but it is just as likely to impact the joints, muscles and bones in the back, and especially the lower back. The discomfort can be debilitating.
There are several different forms of arthritis that impact the spine, including:
- Osteoarthritis, which is a chronic form of arthritis. It is the most common type of arthritis and is caused by cartilage breaking down where the bones meet the joints. When the spine is affected by osteoarthritis, the breakdown is of the cartilage between the facet joints. This makes movement hurt. The inflammation that occurs can lead to bony growths that can cause even greater irritation when they press on the nerves.
- Rheumatoid arthritis, which is an inflammatory autoimmune disease that can attack the joints in the spine. If left untreated, rheumatoid arthritis can destroy the joints and the vertebra can slide forward and put pressure on the spinal cord and the nerve root.
- Ankylosing spondylitis, which is caused by inflammation where the ligaments and muscles attach to the bone. It is characterized by stiffness and pain, and if left untreated it can eventually lead to the joints fusing.
- Reactive arthritis, which generally follows an infection in the urinary tract, gastrointestinal system, or genitals. It is experienced as inflammation in several areas of the body, including the eyes, the bladder, and the joints.
- Psoriatic arthritis, which is a symptom of the autoimmune disease psoriasis, which causes scales and lesions on the skin. Roughly one in five people who suffer from psoriasis also have psoriatic arthritis, which can cause the vertebrae to grow together.
Arthritis has no cure and its progression cannot be stopped, but relief is available. The treatment of arthritis in the spine depends on the type of arthritis that you have and how it presents itself. In many cases, a conservative approach or medication can help, while for other patients the only solution is surgery. The first step is always getting an accurate diagnosis so that you can identify the actual cause of the pain. Options include:
- An active exercise program – by stretching the muscles and joints, motion can be restored and the spine’s health can be improved. In many cases, physical therapy can provide relief.
- Rest – in many cases, arthritis is exacerbated by specific activities, so knowing what those activities are and learning to limit the amount of time that you are engaged in those activities can prevent further pain.
- Heat or cold – many people find relief from the use of heating pads, warm towels or a hot shower directed on their back. Cold can also numb the area that is causing pain.
- Medications – there are several over-the-counter medications that can provide relief, including nonsteroidal anti-inflammatories, creams and gels that provide a sensation of heat or cold, and supplements containing chondroitin and glucosamine to strengthen the cartilage.
- Cortisone Injections – these are administered by a physician directly to the point of pain in order to ease inflammation and swelling.
- Massage therapy and manipulation – These can provide greater mobility and relief.
- Electrical nerve stimulation – this can redirect the sensations that the nerves send to the brain.
- Acupuncture – this ancient technique has been shown to help osteoarthritis pain.
When non-invasive treatments don’t work, surgery may help. This is generally reserved for those whose arthritis has created instability of the joint or constant pain.