What is Arthritis of the Spine?
Written by Neil Badlani, M.D., Chief Medical Officer, North American Spine

Although most people are familiar with the impact that osteoarthritis can have on joints, many are probably not familiar with how the degenerative joint disease can impact the spine. Osteoarthritis of the spine is denoted by the gradual deterioration of cartilage, joints, and discs that make up the neck as well as the lower back.

The impact that osteoarthritis can have on your joints is not too far removed from the damaging effects that it can cause to your spine. The chief difference, however, is that bone spurs caused by osteoarthritis can place an extraordinary amount of pressure on spinal nerves. If this occurs, those struggling with the degenerative disease may experience pain radiating in their arms and/or legs; additionally, they may suddenly feel unusually weak. In this article, we will focus on the etiology of osteoarthritis of the spine and also take a look at treatment options currently available.

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More About Arthritis of the Spine

lumbar foraminotomy

Osteoarthritis of the spine can occur at any age; however, the elderly are far more likely to be diagnosed with the disease. The biggest difference between older adults with osteoarthritis of the spine and younger adults with the disease is that for older adults the diagnosis is part and parcel of getting older.

Younger people, however, usually develop the disease following a traumatic event, or they have a genetic cartilage defect that predisposes them to the disease. As a corollary, it should be noted that age plays a tremendous factor when it comes to who is more likely to develop osteoarthritis of the spine.

Studies have shown that men under the age of 45 are more likely than women to be diagnosed; conversely, women over the age of 45 are more likely than men to be diagnosed.

What are the symptoms?

Unlike other diseases, the symptoms that delineate arthritis of the spine can be far-ranging in that it can significantly disrupt the lives of some people while causing minimal disruption in the lives of others. In addition to the physical problems brought on by osteoarthritis of the spine, there is also a mental component, namely depression.

A subset of people who have been diagnosed with the disease have stated this it has led to problems in the workplace, which, in turn, has contributed to feelings of uselessness, frustration and, worse yet, depression

How is Arthritis of the Spine Diagnosed?

Having provided an overview relative to the etiology, symptoms, and identifying who is at risk of developing osteoarthritis of the spine, let’s now turn our attention to how the disease is diagnosed. Although there are multiple options for confirming a diagnosis, your doctor will likely look at the totality of information gathered from varying tests before making a definitive diagnosis.

These tests may include:

•  MRI

Now that we have identified the three main osteoarthritis tests, let’s take a closer look at the information they can reveal to a physician, starting with an MRI. A Magnetic Resonance Imaging test can alert the physician to possible damaged discs or causes of spinal stenosis.

•  Blood Test

Obviously, because some diseases mimic others, your physician will more than likely recommend blood tests as a means to rule out other diseases.

•  X-Rays

Lastly, as part of your battery tests, your physician will perform of series of X-rays to confirm the presence of osteoarthritis and also the damage that the disease has caused to bones, cartilage, and discs if it is, in fact, present.

What are the Causes of Arthritis of the Spine?

low back pain

Several factors can contribute to the development of arthritis of the spine. In order of importance:

  • Wear-and-tear: Age and repetitive motion can cause discs to degenerate. In a sense, this is a natural process, but because it causes pain, it is considered a disease.
  • Genes: Researchers have discovered evidence that arthritis of the spine can disproportionately affect one family or another, making a genetic predisposition likely.
  • Injury: Car accidents and sports injuries may begin or accelerate the process of arthritis of the spine. Symptoms, however, may not be felt for many years.
  • Weight: Carrying extra pounds will add pressure to your back. This might contribute to arthritis of the spine.

How is Arthritis of the Spine treated?

Conservative Options

Conservative treatment options include nerve root blocks and steroid injections. These are designed to provide temporary relief (up to one year), and you may elect to have the procedure done multiple times. Other conservative strategies may include the placement of a spinal cord stimulator–or STIM–which is designed not to correct the underlying degeneration, but to lessen the pain the condition causes.

Decompression

Minimally invasive decompression surgery aims to relieve pressure on the nerves of the spine. This pressure is often caused by stenosis, bulging or herniated discs, and more. Relieving this pressure can be achieved by reducing or removing soft tissue (disc material or scar tissue) or bone (bone spurs, a section of the lamina or foramina) to decompress the affected nerve. When the compression is caused by soft tissue material, a surgical laser may be used to shrink the impinging material.

Fusion/Stabilization

Fusion surgeries are similar in goal–to remove damaged disc tissue and fuse the bones together–but differ in approach, including the use of specialized hardware to reinforce stability, and the location used to gain access to the spine. A related procedure is an artificial disc replacement, in which a damaged cervical disc is replaced with a synthetic disc, and the vertebrae are not fused.

How Much Does Treatment Cost?

Treatment cost depends on several factors, especially what insurance you have and how much of your deductible has been met. IN the last two years, 90% of our patients have paid less than $2000 out-of-pocket. Some have paid literally nothing, and other have paid much more than that. It depends. The good news is: our Patient Care Managers will handle as much as they can directly with your insurance company, and all your costs will be known up-front.

Important note: spine surgery often pays for itself within a year or two. Many people actually spend more money trying to live with the pain than they do getting the pain fixed. The following calculator is intended to give you a sense of what you spend on managing—rather than eradicating—your pain.

 

Equipment Used in Diagnosis and Treatment of Arthritis of the Spine

When diagnosing for this disease, the most commonly used equipment are X-rays and MRI scans.

X-rays. Even though these do not show cartilage loss directly, an x-ray can show the spacing between bones, which can be used to tell whether one has the condition. If one has osteoarthritis, their cartilages are eaten away thus causing the bones to move closer together.

MRI Scans. This allows the doctor to see soft tissue damage such as cartilages and ligaments.

Equipment used in treating this condition involves assistive devices that help with mobility and function. Thus, they include items such as canes, splints, walkers, scooters, and shoe orthotics.

How Does Arthritis of the Spine Compare to Similar Conditions?

Diseases that are compared with arthritis of the spine are often other forms of arthritis. These include:

  • Rheumatoid arthritis. This is an autoimmune disease which causes pain in the patient’s joints. It occurs when the immune system attacks joints, causing pain and stiffness. 

  • Lupus. This is also an autoimmune disease which causes inflammation in the joints, tendons, skins, and connective tissues.

  • Gout. This results from the buildup of uric acid crystals in joints, which causes tenderness, inflammation, and pain.

  • Bursitis. This results from the irritation of a fluid-filled sac in the joints, which is known as bursa, thereby resulting in pain. 

  • Tendinitis. This results from overuse of certain tendons which can cause swelling and pain in the nearby joints.

A physical examination can be used to differentiate these conditions.

Analogy: A Good Ladder

A good ladder must support your body weight at every step. The same is true of the spine. Arthritis disease can strip, rot, and ruin your vertebral discs, just as weather, age, and misuse can ruin a good ladder.

Surgery will focus on restoring the ladder to its previous glory.

Good Ladder

Bad Ladder

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