Pain And Other Symptoms Of Spinal Osteoarthritis
The intensity and type of pain people experience as a result of arthritis in the spine varies from mild to severe, and occasional to episodic to chronic. Each type of pain is treated differently. Of course, it is not uncommon for arthritic neck or back pain to be accompanied by other symptoms, such as tingling sensations, numbness, or muscle spasms. Learn more about the range of osteoarthritis symptoms.
Diagnosis Of Back Pain
Regardless of what type of doctor you see, there are some things you can expect your doctor to do during your visit. Your doctor first will ask you a number of questions, the most common of which are listed as follows:
- What are your symptoms–that is, what aches or pains do you have?
- Exactly where is the pain?
- Where is the pain the most severe?
- When did the pain begin?
- How long have you had it?
- Did something specific cause your back pain, such as an accident or injury?
- What home treatments have you used?
- Were you under any additional stress when the pain began?
- Do you have any other health problems?
- What kind of work do you do?
- In what types of recreational activities do you participate?
Think about these ahead of time so you can answer them easily. You also may have questions you’d like to ask the doctor. As you think of questions at home, jot them down and take them to the appointment.
Next, your doctor will give you a physical exam. During the exam, the doctor may perform any of the following: observe your muscles and joints ask you to sit and lie down ask you to move your back in different positions observe and feel the area of most pain and/or check to see if other areas of your body are tender or painful If the doctor can identify the likely cause of your back pain at this point, no further tests will be needed.
Symptoms Of Arthritis Of The Spine
Spinal arthritis causes stiffness and low back pain. The stiffness is worst upon waking up in the morning, tends to ease with activity, then worsens toward the end of the day. Presumably, this is because fluid has built up in the joint due to inactivity overnight, which causes more swelling.
The low back pain due to facet joint arthritis has a typical pattern:
- The pain is mostly more than 80% in the back, runs into the buttocks, and often really feels like its in the hip.
- As it gets even worse people often report burning on the outer aspect of the thigh, and sometimes pain down the leg.
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How Is Ankylosing Spondylitis Managed Or Treated
Ankylosing spondylitis is a lifelong condition. While theres no cure, treatments can prevent long-term complications, reduce joint damage and ease pain. Treatments include:
- Exercise: Regular physical activity can slow or stop disease progression. Many people experience worse pain when theyre inactive. Movement seems to lessen pain. Your healthcare provider can recommend safe exercises.
- Nonsteroidal anti-inflammatory drugs :NSAIDs, including ibuprofen and naproxen , ease pain and inflammation.
- Disease-modifying anti-rheumatic drugs : Medications such as sulfasalazine reduce pain and joint swelling. The drugs also treat lesions caused by inflammatory bowel disease. Newer DMARDs called biologics help control inflammation by changing the immune system. Biologics include tumor necrosis factor and interleukin inhibitors .
- Corticosteroids: Injectable corticosteroids temporarily ease joint pain and inflammation.
- Surgery: A small number of people with ankylosing spondylitis may need surgery. Joint replacement surgery implants an artificial joint. Kyphoplasty corrects a curved spine.
Who Should I See For Lower Back Pain
Your primary care physician knows you best and should be your first contact for lower back pain. If he or she is unable to diagnose or treat the issue, you may get referred to a specialist, such as a rehabilitation physician . These specialists practice a comprehensive approach to lower back pain, and can diagnose and treat a variety of conditions that have lower back pain as a symptom.
Later, you may get referred to a physical therapist, a chiropractor or another practitioner depending on the nature of your back pain. The good news is that surgery is rarely needed for lower back pain. Only about one in ten patients needs lower back surgery, Chhatre says.
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Rheumatoid Arthritis Of The Spine
Rheumatoid arthritis is an autoimmune disorder, meaning that the immune system turns on itself. It attacks synovium the lining of the joints. Although rheumatoid arthritis is more common in other joints, it can also affect the spine, specifically the cervical region . Rheumatoid arthritis of the spine is not caused by wear and tear, so its considered an inflammatory arthritis. It may cause back pain even when these joints are not in use. It tends to affect women more than men.
Degenerative Disc Disease Treatment Goals
The vast majority of people with degenerative disc disease experience low back pain symptoms that flare up periodically, but do not get worse over time. For those people, the main goals for managing lower back pain caused by degenerative disc disease are usually:
- Achieving enough pain relief to be able to engage in lower back pain exercises and a rehabilitation program
- Trying to manage the low back pain and maintaining an ability to function at home and at work.
Once a disc has degenerated, the degenerative process cannot be reversed. Instead of trying to rehabilitate the disc itself, treatment focuses on improving the health of surrounding structures, such as the spinal nerves, vertebral bones and joints, and supporting muscles and ligaments.
The main goals of the rehabilitation program include a therapist-guided and individual approach, which aim to2:
- Increase, restore, and/or maintain the range of motion in the affected spinal segment
- Build physical strength, flexibility, coordination, balance, and endurance in the lower back and legs
- Guide patients to make ergonomic changes in their workspace and home to support the spine and prevent recurrence of pain
- Teach the correct use of posture while sitting, walking, sleeping, and lifting to promote maximum function with lesser pain
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Prescription Medications For Spinal Osteoarthritis
- Prescription strength NSAIDs are stronger doses of a chosen non-steroidal anti-inflammatory drug that helps block certain pain-producing chemicals in your body.
- Muscle relaxants have a sedating effect and are prescribed to ease muscle tension.
- Opioids may be prescribed to manage severe pain.
- Lidocaine in an adhesive patch form may be prescribed for placement on the skin over the painful area.
What Does It Mean If Lower Back Pain Is Shooting Into Legs
Lower back pain can radiate to other parts of the body: up or down from its place of origin. Sometimes lower back pain can be on one side of the back, which is also normal.
If the pain is shooting from the lower back into one or both legs, it could be sciatica , but its not always the case. There are many parts in the lower back that may cause the pain to radiate into the legs, such as facet joints, sacroiliac joints, muscles or inflammation of the bursa.
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Half Crunch On The Ball
Do 2 sets of 5 to 10 repetitions.
Repeat 10 times.
The number of repetitions and sets recommended here are just thatrecommendations. You may do more or less depending on your ability. Remember that keeping good form is more important than doing multiple sets or repetitions. If you have questions about form, a doctor or physical therapist can help guide you.
What Otc And Prescription Drugs Treat Spinal Osteoarthritis
Over-the-counter and prescription medications for spinal arthritis are usually the same as those taken to treat joint-related arthritic pain in the hips and kneesunless the diagnosis is rheumatoid or another type of inflammatory arthritis. For patients with symptoms of pain or numbness affecting the arms or legs, a may be considered.
Today, people with spinal arthritis have access to different types of pain medications that can be taken or applied to relieve pain. Some require a doctor’s prescription, some do not. However, do not assume that just because a drug is available without a prescription, or over the counter, that it is safe for everyone.
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How Is Osteoarthritis Of The Spine Treated
In most cases, treatment of spinal osteoarthritis is geared toward relieving the symptoms of pain and increasing a person’s ability to function. The goal is to have a healthy lifestyle.
Initial treatment may include losing weight if needed and then, for everyone, maintaining a healthy weight. It may also include exercise. Besides helping with weight management, exercise can also help:
- increase flexibility
- improve blood flow
- make it easier to do daily tasks
Some of the exercises associated with osteoarthritis treatment include swimming, walking, and water aerobics. Exercise may be broken down into the following categories:
- Strengthening exercises. These exercises seek to make muscles that support the joints stronger. They work through resistance with the use of weights or rubber bands.
- Aerobic exercises. These are exercises that make the heart and circulatory system stronger.
- Range-of-motion exercises. These exercises increase the bodyâs flexibility.
Including rest periods in the overall treatment plan is necessary. But bed rest, splints, bracing, or traction for long periods of time is not recommended.
There are non-drug treatments available for osteoarthritis, including:
- heat or cold compresses, which refers to placing ice or heated compresses onto the affected joint
- transcutaneous electrical nerve stimulation using a small device that emits electrical pulses onto the affected area
- nutritional supplements
What Are The Most Common Spinal Arthritis Treatment Options
One common treatment option that your doctor may recommend is bracing or a cervical collar to restrict your movement.
If theres no improvement after a period of time, your doctor may recommend spine surgery.
He or she will probably also prescribe a painkiller, like acetaminophen , nonsteroidal anti-inflammatory drugs such as ibuprofen , or prescription opioids such as codeine and morphine.
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Deterrence And Patient Education
Low back pain is a widespread condition that affects the majority of patients in their lifetime. Providers need to educate patients on this condition and the various treatment measures to prevent developing chronic back pain. Shared decision-making is a crucial part of an active educative effort between a physician and patient and should be individualized based on patient needs. All education efforts should include key components regarding disease information and emotional support as it pertains to social influences and self-management. Specifically, the diagnosis, prognosis, and management are components of discussion in patients with spondyloarthritis of the spine.
Surgery For Back Arthritis
Surgery is a last resort when it comes to arthritis in the back. Know that 95 percent of people with back pain will not need surgery, and 75 percent will fully recover within three months, says Dr. Tiso.
Doctors recommend that you try medications, physical therapy, and weight loss before considering surgery, says Dr. Kilian. The best surgical outcomes often occur in patients who are actively involved in physical therapy and have a healthy body weight, he says.
The type of surgery depends on the type of arthritis and region of the back that is affected. Depending on the procedure performed, surgery aims to decompress any pinched nerves and free up the nerve roots from bone spurs and other tissues that may be pressing on them.
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Who Gets Osteoarthritis Of The Spine
In general, osteoarthritis happens as people get older. Younger people may get it from one of several different causes:
- injury or trauma to a joint
- a genetic defect involving cartilage
For people younger than age 45, osteoarthritis is more common among men. After age 45, osteoarthritis is more common among women. Osteoarthritis occurs more often among people who are overweight. It also occurs more frequently in those who have jobs or do sports that put repetitive stress on certain joints.
What Are The Symptoms Of Osteoarthritis Of The Spine
Osteoarthritis of the spine may cause stiffness or pain in the neck or back. It may also cause weakness or numbness in the legs or arms if it is severe enough to affect spinal nerves or the spinal cord itself. Usually, the back discomfort is relieved when the person is lying down.
Some people experience little interference with the activities of their lives. Others become more severely disabled.
In addition to the physical effects, a person with osteoarthritis might also experience social and emotional problems. For instance, a person with osteoarthritis that hinders daily activities and job performance might feel depressed or helpless.
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Exercise For Arthritis In The Neck
If youre experiencing neck pain due to arthritis, your doctor may recommend physical therapy. Physical therapy for neck arthritis entails doing specific exercises to help strengthen and stretch weak or strained muscles. Physical therapy can improve range of motion. Sessions and programs vary in length and frequency and are tailored to your condition.
The foundation of what were trying to do in physical therapy for the neck is often to help improve posture and the way people move, says Dr. Milani. Exercises in physical therapy tend to be focused on strengthening muscles of the back and neck, which puts less strain on structures of the cervical spine.
Youll do exercises during physical therapy and get instructions on ones to do at home.
Regular Physical Activity at Home
You may feel like you dont want to move when your neck hurts. But being inactive may increase stiffness, which can cause you to lose even more mobility. Aches and pains tend to respond better to continued movement than rest, says Dr. Milani. Exercise is often the foundation of treatment.
Exercises that involve stretching, strengthening, and improving range of motion can help reduce pain and keep your neck limber. You want to move gently and smoothly when doing neck exercises, not jerk your neck or make sudden movements. You may feel discomfort at first. Stop if any exercise increases your neck pain.
Managing Arthritis Pain And Fatigue
Several approaches can be used to manage the pain associated with osteoarthritis of the hip including:
- Activity modification appropriate kinds of exercise and weight loss when necessary may alleviate some hip arthritis symptoms
- Nutritional supplementation are helpful to some patients, although the literature on these supplements is not consistently in favor of their use
- Non-narcotic pain tablets , or over-the-counter non-steroidal anti-inflammatory drugs, if medically appropriate, sometimes are helpful
- Prescription strength, non-steroidal, anti-inflammatory drugs are useful for some patients, though, in general, long-term use of these drugs is discouraged
- Arthritis unloader braces or hip sleeves are helpful for some patterns of arthritis
- Joint injections might help
- Total hip replacement surgery may be used if non-operative interventions dont suffice.
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Degenerative Disc Disease Treatment For Low Back Pain
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Most people with degenerative disc disease respond well to nonsurgical treatments.
- Research indicates that 90% of patients report improvement in back pain and radicular leg pain within 3 months of nonsurgical treatments.1
- Surgical intervention may be extensive, so most people are well-served making a concerted effort with nonsurgical treatment regimens.
The long-term outlook for this condition is usually favorable, especially when coupled with lifestyle modifications and the correct use of ergonomics.1
This article describes the various treatments available to manage the symptoms of degenerative disc disease, including addressing both painful flare-ups as well as longer-term pain management and rehabilitation.
When Does Spinal Arthritis Become Spinal Stenosis
As a part of normal aging, the spine can develop arthritis. The discs lose their water content and begin to collapse, bone spurs form, and the ligaments around the joints of the spine begin to thicken. After age 50, these slowly growing bone spurs and thickened ligaments may begin to narrow the spinal canal and compress nerves. The result is slowly worsening pain into the buttocks, hips, thighs, and legs. Walking and standing are often worse than sitting. Feet or legs can become numb or tingle. Walking distances becomes more difficult as the legs begin to “feel heavy.” Often, patients find themselves standing or walking in a stooped forward position in order to ease the pain. This process of spinal nerve compression is called spinal stenosis. Back pain may or may not be present. Over time, if signs and symptoms of spinal stenosis are ignored, bowel and bladder control can be lost.
Nonoperative Treatment of Spinal Stenosis
Surgery for Spinal Stenosis
Spinal stenosis most often requires surgery to decompress nerve roots and alleviate the pressure caused by the overly narrowed spinal canal. The surgery is called Laminectomy and is commonly done by spine surgeons all over the country.
Risks of Surgery: The risk of infection is 1-2%. If the incision becomes infected, an additional trip to the operating room is usually required to wash out the infection. Antibiotics are required, sometimes through a vein.
Surgical Procedure for correcting spinal stenosis
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