To help you better understand back pain caused by arthritis, we sat down with Steven Levin, M.D., a Johns Hopkins Pain Management specialist on staff at HCGH, for a Q&A session.
Q: What is spinal arthritis?
Spinal arthritis is the breakdown of cartilage in the facet joints—the joints that connect the vertebrae together and enable the spine to move. As the joints deteriorate, the vertebrae impact each other, creating friction during movement. This can result in mild to severe pain and potentially lead to the development of other degenerative spine conditions including osteoarthritis—an abnormal bone formation in the joints.
Q: What causes spinal arthritis?
It is most commonly caused by the natural aging process, but other factors, such as lifestyle, obesity, gender, heredity and injury, can increase a person’s risk.
Q: How do I know if my back pain is from arthritis?
If you are experiencing recurring pain that does not subside with conservative treatment after two to three weeks, visit your family doctor for an evaluation. Sometimes arthritis can be seen on an X-ray and often is strongly inferred by palpating your spine during a physical exam. While any part of the back can be affected, the lower back is the most common site of arthritis back pain. Typically we see back pain caused by arthritis in patients over the age of 50.
Q: How can spinal arthritis be prevented?
While spinal arthritis is not always avoidable, it might be possible to delay its development by avoiding some of the controllable risk factors. Good posture and body mechanics as well as maintaining a healthy weight and diet, having strong core muscles, and being flexible are important to back health. Exercise is in many ways like medicine— you should do the right exercise in the right amounts at the right time.
Q: How is spinal arthritis treated?
Many patients find relief through conservative, nonsurgical treatment that lengthens the spine and removes pressure from the compressed nerve that is causing pain. Physical therapy can improve motion and teach you proper body mechanics which will lessen the strain on your spine. Other conservative treatments include heat, over-the-counter pain medication, exercises and stretching.
Q: What if spinal arthritis does not respond to conservative treatment?
When conservative treatment doesn’t work, many patients benefit from specialized interventional techniques such as facet nerve blocks which involves the injection of an anesthetic to the area surrounding a nerve to help identify the pain and possibly to treat it and, sometimes, minimally invasive procedures such as radiofrequency ablation – a specialized technique that decreases pain signals from a specific area of nerve tissue and can reduce the severity of pain that arthritis can cause.
Q: Is there a cure?
While there is no cure for arthritis, a comprehensive treatment plan can be very helpful at managing symptoms and maintaining function. Effective treatments are available to enable a healthy quality of life.