ARTHRITIS OF THE SPINE

There are different types of juvenile arthritis, which is the most common chronic rheumatic disease of childhood. This condition along with Juvenile Spondyloarthritis affects the spine and the places where the muscles, tendons, and ligaments are attached to the bone.

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Arthritis of the Spine

Arthritis of the Spine Spinal arthritis is inflammation in the facet joints of the spine. Also, it occurs in the sacroiliac joints between the spine and the pelvis. It is often the result of wear and tear, infections, or various conditions such as autoimmune disorders, etc.

Sometimes, inflammation also affects the areas where tendons and ligaments attach to the bones of the spine. However, no matter the location, arthritis in the spine (back or neck) can be painful. And in children, if not treated earlier, it often becomes a chronic problem.

What You Need to Know

Osteoarthritis is the most common type of arthritis that affects the spine. Arthritis can develop in any section of the spine. However, it is more common in the lower back and neck. And the most common symptoms of spinal arthritis are pain and stiffness.

The causes of this spinal issue are not properly known except those of osteoarthritis. Osteoarthritis is generally a result of wear and tear. Treating spinal arthritis in children may include pain medications, steroid injections, physical therapy, etc. Also, spine doctors may recommend surgeries in severe cases.

Cause

The causes of spine arthritis whether in the back or neck vary depending on the type of arthritis. Apart from normal wear and tear as well as autoimmune triggers, the exact cause remains unknown in many cases. Genetics is often associated with some forms of spinal arthritis which means it may be hereditary.

Other risk factors of spinal arthritis are age, excess weight/obesity, and certain other conditions including psoriasis, tuberculosis, diabetes, gout, Lyme disease, irritable bowel syndrome, etc.

QUESTIONS AND ANSWERS

What is Arthritis of the Spine?

Spinal arthritis, also known as facet joint osteoarthritis or degenerative joint disease, is a condition characterized by the gradual breakdown of the cartilage in the facet joints of the spine. This degeneration leads to inflammation, pain, and stiffness in the affected area of the spine.

What are the symptoms of Arthritis of the Spine?

Symptoms of spinal arthritis can vary, but they often include persistent back pain, stiffness, and reduced flexibility in the spine. Pain may worsen with movement or activity and may improve with rest. Some individuals may experience radiating pain in the arms or legs if nerves become compressed due to joint changes. In severe cases, spinal arthritis can lead to spinal instability or compression fractures.

How is Arthritis of the Spine Diagnosed and Treated?

Diagnosis of spinal arthritis involves a thorough medical history, physical examination, and imaging studies such as X-rays, MRI, or CT scans to visualize the affected joints and rule out other conditions. Treatment approaches aim to manage pain, improve mobility, and prevent further degeneration. Non-surgical options include pain medications, physical therapy, chiropractic care, lifestyle modifications, and corticosteroid injections. In cases where conservative treatments do not work, doctors may suggest surgical interventions like spinal fusion or minimally invasive procedures to stabilize and alleviate pain in the affected joints. Doctors will devise a personalized treatment plan based on the severity of symptoms, the patient’s overall health, and the specific characteristics of spinal arthritis.

Schedule an Appointment for your child to be seen by one of the doctors at the Medical City Children’s Orthopedic and Spine Specialists for Arthritis of the Spine

Types of Arthritis of the Spine

There are different types of arthritis that might be seen in both children and adults. Almost every type of them may impact the back or neck. Even though every arthritis leads to inflammation, depending on the origin, arthritis can be both inflammatory and noninflammatory (degenerative).

Osteoarthritis of the Spine

Osteoarthritis is a noninflammatory or degenerative arthritis. It is the most common form of spinal arthritis and usually affects the lower back. It develops because of wear and tear. The gradual deterioration of the cartilage between the joints causes pain and inflammation. Since the pain comes from mechanical damage, it is usually more noticeable while bending or twisting your back. If your child had back injuries in the past, it may also develop into degenerative arthritis of the spine. Osteoarthritis of the spine generally affects the facet joints lying between the vertebrae. And it is called facet joint arthritis, facet joint syndrome, facet disease, etc. Sometimes, degenerating spinal discs (degenerative disc disease) may cause facet joint arthritis. When discs between the vertebrae become thinner, it transfers more pressure to the facet joints causing more cartilage friction and damage.

When there are degenerative changes in the neck, it is called cervical spondylosis. Spinal arthritis doesn’t always cause pain. Many people have no noticeable symptoms at all.

Rheumatoid Arthritis of the Spine

Rheumatoid arthritis (RA) is an autoimmune disorder. And that means the immune system collapses and attacks the synovium (the lining of the joints). RA is more common in other joints. But it can also affect the spine. And it commonly affects the cervical region which is the neck area. Rheumatoid arthritis of the spine is inflammatory arthritis and is not the result of wear and tear. It may cause back pain as well as pain in other joints even when these are not in use. It affects women more than men.

Spondyloarthritis

Spondyloarthritis is a group of inflammatory diseases. It affects the joints along with the locations where the ligaments and tendons connect to the bones. Spondyloarthritis is inflammatory but is not similar to rheumatoid arthritis.

There are different types of spondyloarthritis and some of these are more common in the spine than in other places –

Ankylosing spondylitis is spinal arthritis that causes inflammation in the vertebrae and the sacroiliac joints at the bottom of the spine.
Psoriatic arthritis is a condition related to psoriasis. People usually develop psoriasis before arthritis and sometimes after. It is more common in smaller joints, but sometimes also affects the spine.
Reactive arthritis is joint inflammation caused by an infection in any other place in the body such as in the bowel or the genitals. When in the spine, it usually occurs in the lower back and often goes away on its own.
Enteropathic arthritis is a form of arthritis related to inflammatory bowel disease (IBD). Not everyone with IBD develops arthritis, and of people who do, not everyone gets it in the spine.
Other forms of spondyloarthritis are undifferentiated spondyloarthritis and juvenile spondyloarthritis.

A type of arthritis involving the spine and/or sacroiliac joints is axial spondyloarthritis. If it involves other joints and tendons, this is peripheral spondyloarthritis. Many people experience both of these types at different stages of their spondyloarthritis.

Symptoms of Arthritis of the Spine

Symptoms of spinal arthritis may differ from patient to patient. However, generally, they are:

Back and neck pain, mainly in the lower back
Lack of flexibility, stiffness in the spine
Tenderness and swelling around the affected vertebrae
A grinding feeling while moving the spine
Pain, stiffness, and swelling in other parts of the body especially when it is an inflammatory arthritis
Weakness and fatigue in the whole body.
Pain and numbness in the limbs when the nerves get affected
Headaches in case of neck arthritis

In spinal arthritis, back pain is quite a common symptom. Still, not all people with this problem may experience it. Even some people with advanced spinal arthritis may not have it. In the other scenario, some may experience pain even before arthritis shows up on an X-ray.

Also, in certain types of spondyloarthritis, there might be symptoms like eye inflammation that might lead to pain, blurred vision, and watery eyes.

Diagnosis

Our spine doctors use some or all of the following diagnostic methods to confirm spinal arthritis in patients:

Physical exam and Medical history checkup
Blood tests to find out genetic markers and/or RA antibodies
X-rays of the spine will help locate the arthritic joint
Myelography, bone scan, MRI, and CT scan to detect nerve and spinal cord involvement in the issue while ruling out other causes
Joint aspiration involves testing the synovial fluid inside a joint

To check out the painful joint, your doctor may numb the place with an injection and see if the pain goes away or not.

Arthritis of the Spine Treatment

The treatment for spinal arthritis depends on various factors. While determining the most suitable treatment for your child’s condition, the doctor will consider the age, type, and severity of arthritis, level of pain, personal health goals, etc.

Unfortunately, the spine damage caused by arthritis is irreversible. The treatment generally focuses on preventing further damage and managing pain.

Nonsurgical treatments

Corticosteroids (pills or injections) and nonsteroidal anti-inflammatory drugs (NSAIDs) help reduce pain and swelling.
Other medications target various symptoms, especially the symptoms of inflammatory arthritis
Doctors often recommend physical therapy to improve back muscle strength and range of motion in the spine
Lifestyle changes such as quitting smoking, changing your posture, losing weight, etc. often help reduce inflammation or stress on your spine.

Surgical Treatments

If other treatments don’t sufficiently relieve pain, doctors might recommend surgery for treating spinal arthritis. The surgery may help with:

Decompressing the spinal cord while freeing up the stressed nerve roots from bone spurs and other stressed tissues
Fusing several segments to stabilize the spine. This procedure is called spinal fusion.

Some of these surgeries are open procedures while others are minimally invasive. And there are advantages and disadvantages to every procedure. Your surgeon will recommend the right surgery depending on your child’s condition and your expected results.

Outlook for Arthritis of the Spine

Spine arthritis is a degenerative disease. However, with proper treatment and lifestyle changes, it is possible to slow down its progression and live a pain-free, active life. For a positive result and a better future, do not ignore symptoms, no matter how insignificant they might appear. Talk to your doctor if you or your child has numbness, weakness, pain, or swelling in the back — or any part of your body. If you do not have a doctor, we encourage parents to call the Medical City Children’s Orthopedics and Spine Specialists. We have offices in Arlington, Dallas, Flower Mound, Frisco, and McKinney, TX and we are accepting new patients. We specialize in children and invite you to call and schedule an appointment today.

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Footnote:

Arthritis Foundation: Osteoarthritis of the Back/Spine

Call 214-556-0590 to make an appointment.

Comprehensive services for children from birth through adolescence at five convenient locations: Arlington, Dallas, Flower Mound, Frisco and McKinney.