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Back Pain and Arthritis of the Spine

Arthritis is inflammation of the joints. There are more than 100 rheumatic diseases and conditions that are types of arthritis. They affect joints, the tissues which surround the joints and other connective tissue. Arthritis is characterized by pain and stiffness in and around one or more joints. There are three main types of arthritis that affect the spine. They are osteoarthritis, rheumatoid arthritis and ankolyzing spondylitis.

Osteoarthritis is a disease in which the cartilage that cushions the ends of the bones at the joints wears away.

This causes the bones of the joint to rub together, causing pain, stiffness and bone spurs. The bone spurs can break off and float around in the joint, causing more damage and pain. The joint can become misshapen over time. Osteoarthritis is the most common form of arthritis. Osteoarthritis usually first strikes after the age of 40, and becomes more likely with age. People with osteoarthritis usually have joint pain and limited movement.

Rheumatoid arthritis occurs when the body’s immune system attacks the tissue that lines the joints, the synovial membrane. White blood cells, the agents of the immune system, travel to the synovium and cause inflammation (synovitis). During the inflammation process, the normally thin synovium becomes thick and makes the joint swollen and puffy to the touch, leading to joint pain and inflammation. The inflamed synovium leads to erosion of the cartilage and bone within the joint. The muscles, ligaments and tendons around the joint weaken, and provide less support to the joint.

Rheumatoid arthritis is usually accompanied by fatigue and fevers. It usually begins in middle age and is more common in women than men.

Ankylosing spondylitis is a chronic form of arthritis that affects the spine and the sacroiliac joint, where the spine meets the pelvis. It can also affect the hips and shoulders. In severe cases, bone spurs form on the vertebrae. These can fuse the vertebrae together, causing the spine to become rigid, resulting in a great loss of mobility. Ankolyzing spondylitis is most often first diagnosed in young men, usually under the age of 35.

Arthritis is typically treated with medication, either a pain reliever or an anti-inflammatory. Pain relievers include analgesic medications like aspirin and acetaminophen (Tylenol). Topical analgesics such as Zostrix, Icy Hot and Ben Gay can be effective in some cases where a pill-based medicine is not. NSAIDs, or non-steroidal anti-inflammatory drugs, are used to reduce swelling. These include such nonprescription medications as ibuprofen (Motrin, Advil), ketoprofen (Actron, Orudis) and naproxen sodium (Aleve).

Stronger prescription-based anti-inflammatories are available, including COX-2 inhibitors like celecoxib, which may be easier on the stomach than traditional NSAIDs.

Exercises will also be used to increase range of motion. These include various stretching and strengthening exercises to reduce the damage of the arthritis.