Arthritis can develop in the back, affecting the joints and structures within the spinal column. This condition involves inflammation and degeneration within the spinal joints, leading to various symptoms. Understanding the types of arthritis that affect the spine is important, as each has distinct characteristics. This article explores the forms of back arthritis, their symptoms, contributing factors, and typical diagnosis and management.
Common Forms of Back Arthritis
Several types of arthritis can affect the spine. Osteoarthritis of the spine, often called spondylosis, is the most prevalent form. It results from gradual wear and tear on the cartilage and discs that cushion spinal joints, leading to inflammation and pain. This degenerative process can cause bone spurs and disc height loss, increasing pressure on facet joints.
Spondyloarthritis is a group of inflammatory conditions that also affect the spine. These autoimmune diseases cause the immune system to attack healthy tissues, especially joints and where ligaments and tendons attach to bone. Ankylosing spondylitis, a specific spondyloarthritis type, primarily inflames vertebrae and sacroiliac joints at the base of the spine. Severe cases can lead to vertebrae fusing, causing stiffness and a hunched posture.
Other spondyloarthritis forms involving the spine include psoriatic arthritis, associated with the skin condition psoriasis, and reactive arthritis, triggered by an infection elsewhere in the body. Enteropathic arthritis is another type linked to inflammatory bowel diseases like Crohn’s disease or ulcerative colitis. Rheumatoid arthritis, another autoimmune disorder that attacks the joint lining, can also affect the spinal column, particularly the neck, though it is less common in the spine.
Signs You Might Have Back Arthritis
Individuals with back arthritis report persistent ache or deep discomfort in the affected area, worsening with movement or after inactivity. This pain is described as a dull ache, but can also be sharp. Pain commonly includes the neck or lower back, though any part of the spine can be affected.
Stiffness is a common indicator, noticeable in the morning or after rest. This stiffness improves as the day progresses and with increased activity, reflecting the mechanical nature of some spinal arthritis forms. Reduced range of motion and flexibility accompany this stiffness, making it difficult to bend, twist, or move freely.
A grinding or creaking sensation may also occur when moving the spine, indicating bone-on-bone contact due to cartilage degeneration. In advanced cases, if arthritic changes pressure spinal nerves, symptoms like numbness, tingling, or weakness may develop in the arms or legs. These nerve-related symptoms occur because the spinal column houses nerves extending to the limbs.
What Leads to Back Arthritis
Several factors contribute to back arthritis. Aging is a primary influence for degenerative types like osteoarthritis. As people age, natural wear and tear on spinal discs and cartilage leads to their breakdown, a common pathway for spondylosis. Most individuals show signs of spinal osteoarthritis by age 50 or 60, even without symptoms.
Genetic predisposition plays a significant role in inflammatory forms of back arthritis, such as spondyloarthritis. For instance, the HLA-B27 gene substantially increases the likelihood of developing ankylosing spondylitis. While genetics contribute, not everyone with these markers develops the condition, suggesting other factors are involved.
Previous back injuries or trauma can accelerate degenerative changes in the spine, potentially leading to arthritis years later. Excess body weight, or obesity, places additional stress on spinal joints, increasing osteoarthritis risk in the lower back. Lifestyle factors, including occupations with repetitive spinal stress or tobacco use, also contribute to back arthritis risk.
Diagnosing and Addressing Back Arthritis
Diagnosing back arthritis begins with a thorough medical history and physical examination. A healthcare professional inquires about symptom nature, duration, and factors that worsen or improve them. During the physical exam, the doctor assesses the spine’s range of motion, checks for tenderness, and performs neurological tests to evaluate limb strength and sensation.
Imaging tests are often used to visualize spinal structures and confirm diagnosis. X-rays reveal degenerative changes such as joint space narrowing, bone spurs, and spinal alignment. Magnetic resonance imaging (MRI) details soft tissues like intervertebral discs, ligaments, and nerves, which can show signs of inflammation or nerve compression. Computed tomography (CT) scans provide cross-sectional views of bone structures and the spinal canal, identifying bony overgrowth. For inflammatory arthritis, blood tests check for specific markers or antibodies.
Managing back arthritis involves a range of strategies tailored to the individual’s condition and symptoms. Medications include nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation. For inflammatory arthritis, disease-modifying antirheumatic drugs (DMARDs) or biologic therapies target the immune system. Corticosteroid injections directly into affected spinal joints provide localized relief.
Physical therapy is frequently recommended to improve spinal strength, flexibility, and posture. Therapists guide exercises designed to support the spine and reduce joint stress. Lifestyle modifications, such as maintaining a healthy weight and avoiding tobacco, can also help manage symptoms and prevent progression. If conservative measures are insufficient or nerve compression is significant, surgical options like laminectomy or spinal fusion may be considered to alleviate symptoms and stabilize the spine.