Understanding Spinal Osteoarthritis

Of the more than 100 different types of arthritis known to the world, osteoarthritis (OA) is the most common and affects millions of people around the globe. Often, people think osteoarthritis affects the hands, knees, and sometimes the feet of older people. However, the degenerative bone condition also impacts the spines of many humans worldwide, some of which are only in their 40s.

OA is characterized by the breakdown of the cartilage that cushions the bones of a joint from painfully rubbing against each other as they move within the body. In the case of the spine specifically, OA results when the cartilage of the joints and discs between spinal vertebrae in the neck and back degenerates. Sometimes, spinal OA can produce bone spurs that can place pressure on the nerves of the spinal column.

While it is true that spinal OA becomes more common as a person ages, younger people can develop the condition too. For example, athletes or people in a car accident can develop spinal OA after experiencing injury or trauma to a joint. People born with a cartilage defect may also experience spinal OA at younger ages. Generally, however, the onset of OA usually comes after the age of 45.

Spinal OA, like other forms of osteoarthritis, occurs most often in people who are overweight. When a person is heavier than their skeletal frame was designed to handle, the load and stress on every joint in the body increases. For example, just 10 pounds of excess body weight can place an extra 15-50 pounds of pressure on the joints. Studies have also shown that excess body fat also speeds up cartilage destruction.

In addition to a person’s age and body weight, spinal osteoarthritis typically affects more women than men after the age of 45 (whereas more men are diagnosed with the condition before 45) and in people who perform jobs or engage in regular activities where a high level of stress is placed upon the spine.

Osteoarthritis is most common in the lower back. Like many spinal conditions, OA of the spine is characterized by back pain. The pain’s location depends on where on the spine the OA is located. The experience of low back pain indicates that spinal OA is present in the lumbar area of the spine, whereas neck pain would suggest that the OA is present in the cervical spine. If bone spurs are also present in a patient with spinal OA, they may experience nerve pain, weakness, or numbness that can also radiate to the arms and legs. Because this type of back pain results from damage to the mechanical workings of the spine, the back pain associated with it is often most noticeable when performing activities that involve bending and twisting.

Because the spine is a cascade of bones, vertebrae, muscles, and other connective tissues, different regions can be put at risk when one part of it breaks down. For this reason, it is crucial to have an incidence of back pain that has lasted longer than 8-12 weeks to be evaluated by a spinal expert. An X-ray examination is usually the first investigative test to determine whether spinal OA is to blame for the back pain a patient is experiencing. However, some cases of spinal OA cause a patient to undergo a significant-enough amount of pain but aren’t prevalent enough yet to show up on an x-ray. This is where a spine health expert can help order additional tests to get to the bottom of what’s going on.

The goals of surgery for spinal OA include spinal decompression if bone spurs are pressing on nerves or other tissues and spinal stabilization by fusing spine segments that are causing pain. In most cases, spine experts will first treat spinal OA with the most conservative treatment options, including lifestyle changes such as increased focus on exercise, nutrition, and achieving a healthier body weight. It is only in the most severe cases, or those which don’t respond to conservative treatment options, that spinal surgery might be recommended.

No matter a person’s age, gender, body weight, or vocational job, no one should have to live with the pain associated with spinal osteoarthritis. If you or someone you care about has been battling chronic back pain that hasn’t been resolved with self-management, it is time to see a spine specialist. Plenty of people living with spinal OA today can manage the condition under a doctor’s guidance and continue living the active lives they love.








Neel Anand MD