Back pain is a common experience, and arthritis can be a significant cause. This article explores how arthritis impacts the back, specific types affecting the spine, and strategies for managing associated pain.
How Arthritis Causes Back Pain
Arthritis causes back pain through inflammation and changes to spinal joint structures. The spine consists of vertebrae cushioned by discs and connected by facet joints. When arthritis develops, these components change, leading to pain.
Inflammation is a central feature of many types of arthritis; in the spine, it irritates nerves and surrounding tissues, causing discomfort. As arthritis progresses, protective cartilage in facet joints wears down. This breakdown causes bones to rub, generating friction and pain.
Bone spurs (osteophytes) can form on the vertebrae. These can press on nerves or narrow the spinal canal (spinal stenosis), causing radiating pain, numbness, or weakness in the arms or legs. Discs between vertebrae can also thin and dehydrate, increasing pressure on facet joints and contributing to pain and stiffness.
Types of Arthritis Affecting the Spine
Several forms of arthritis impact the spine, each contributing to back pain. These include degenerative conditions like osteoarthritis, and inflammatory types such as rheumatoid arthritis and spondyloarthropathies.
Osteoarthritis
Osteoarthritis of the spine (spondylosis) is the most common type of spinal arthritis. It results from gradual wear and tear on spinal joints, primarily affecting facet joints and discs. It is more prevalent with age; prior spinal injuries or obesity can accelerate its development.
Rheumatoid arthritis (RA)
Rheumatoid arthritis (RA) is an autoimmune disease where the immune system attacks the joint lining (synovium). While RA commonly affects peripheral joints, it can also involve the spine, particularly the cervical (neck) region. Spinal RA causes inflammation, pain, and stiffness, and can lead to instability or nerve compression.
Ankylosing spondylitis (AS)
Ankylosing spondylitis (AS) is an inflammatory disease that can cause spinal bones to fuse over time. It primarily affects the sacroiliac joints and lower back vertebrae. AS leads to stiffness and pain, especially in the morning or after inactivity. It may result in a hunched posture if the spine fuses.
Psoriatic arthritis (PsA)
Psoriatic arthritis (PsA) affects some individuals with psoriasis, causing joint pain, stiffness, and swelling, including in the spine. When PsA affects the spine, it is known as spondylitis or axial spondyloarthritis, leading to inflammation in spinal or sacroiliac joints. Back pain from PsA often worsens with rest and improves with activity.
Enteropathic arthritis
Enteropathic arthritis is associated with inflammatory bowel diseases like Crohn’s disease or ulcerative colitis. This condition can cause joint inflammation in the lower limbs and, in some cases, the spine. Joint symptom severity can sometimes coincide with flare-ups of the underlying bowel disease.
Identifying Arthritis-Related Back Pain
Recognizing specific characteristics helps differentiate arthritis-related back pain. It often presents as a dull, persistent ache. Pain might worsen with movement or after prolonged sitting or standing.
Morning stiffness is a common symptom, noticeable upon waking or after inactivity. For osteoarthritis, stiffness typically improves with activity. Inflammatory types, such as ankylosing spondylitis and psoriatic arthritis, often cause pain that improves with activity and worsens with rest.
Other symptoms include reduced range of motion in the spine, making bending or twisting difficult. Tenderness over affected joints and a grating or popping sensation during movement may also be present.
Approaches to Managing Back Pain from Arthritis
Managing arthritis-related back pain involves strategies to reduce discomfort and improve function. Lifestyle adjustments play an important role in alleviating symptoms. Maintaining a healthy weight helps reduce stress on spinal joints, as excess body weight places additional pressure on the spine.
Regular, low-impact exercise like swimming, walking, or cycling strengthens back muscles, improves flexibility, and supports spinal health. Gentle stretching, yoga, or tai chi can also enhance flexibility and balance. Consistent movement is generally more beneficial than prolonged inactivity for easing pain.
Physical therapy is often recommended to build strength in muscles supporting the spine and improve range of motion. Therapists teach proper body mechanics and posture to reduce strain on arthritic joints. Heat and cold therapy can provide temporary relief; warm applications relax muscles, while cold compresses reduce pain and swelling.