Osteoarthritis of the Spine

What is osteoarthritis?

Osteoarthritis is the most common form of arthritis. It is also known as degenerative joint disease (DJD). For many people it develops slowly as we age. Inflammation and injury to the joint cause bony changes, deterioration of tendons and ligaments and a breakdown of cartilage, resulting in pain, swelling, and deformity of the joint.

How does it affect the spine?

Osteoarthritis of the spine usually affects the facet joints between the vertebrae. It is also known as facet joint arthritis, facet joint syndrome and facet disease. The discs between your vertebrae get thinner and the cartilage at the rear of your spine may wear away. Cartilage is a firm, rubbery, tissue made up of water and protein, which covers the ends of bones in your joints. Its purpose is to reduce friction in the joints and act as a shock absorber. It has no blood vessels so healing is a very slow process, and the body does not grow new cartilage after injury. When cartilage wears away, bone rubs against bone creating spurs (little growths of additional bone, and your nerves may become pinched. It usually affects your lower back. When these degenerative changes occur in the neck, this condition is called cervical spondylosis. 

What are the symptoms of osteoarthritis of the spine?

You may feel pain or stiffness, usually in your lower back. You may lose some of your range of motion and flexibility, and your symptoms may be worse in the morning and on rainy days. Symptoms tend to worsen when you are active. 

What causes osteoarthritis of the spine?

Osteoarthritis doesn’t have a specific cause – the normal wear and tear of aging brings it on so your risk of developing it increases as you get older. You are also more at risk if there is one in your family, if you are overweight or if you have ever injured your spine.  

How is osteoarthritis diagnosed?

Your doctor will usually discuss your medical history with you and then carry out a physical examination. Your doctor may also decide to send you for further investigation which may include: 

• X-rays of the spine to locate the arthritic joint
• MRI, CT scan, bone scan and/or ultrasound may be used to locate the damage or rule out other causes

How is osteoarthritis treated?

The treatment for spinal osteoarthritis depends on a number of factors including your age, level of pain, the severity of your arthritis and your health goals. Because the joint damage caused by osteoarthritis is irreversible, treatment generally focuses on managing pain and avoiding further damage.

Conservative treatment options include medications to reduce pain and inflammation, physiotherapy to improve your back muscle strength and flexibility, and measures to reduce the stress on your spine such as losing weight, stopping smoking and improving your posture. 

If these treatments don’t help you may need surgery.