Osteoarthritis, also called degenerative arthritis, is the most common form of arthritis. It is the result of wear and tear and affects the spine in much the same way it affects other joints in the body.

What causes it?

In the earliest stages, osteoarthritis occurs when the discs that separate the vertebrae in your back and neck begin to dry out. Normally the discs act as shock absorbers, cushioning the stresses on vertebrae. Once the discs dry out, they can no longer absorb shock, and the surrounding cartilage and ligaments begin to deteriorate. As the arthritis advances, other portions of the spine are affected, especially the small spinal joints called facets. Arthritis also narrows the discs and causes irritating spurs on the vertebrae. If not treated, arthritis can lead to a stiff and painful back or neck.

What are the symptoms?

The primary symptom is a gradual onset of pain in the back or neck. The pain is the result of irritated nerve endings in the damaged areas. Frequently, stiffness occurs and certain positions increase the pain. The muscles overlying the arthritic areas often become tight and painful, further complicating the problem. As the arthritis progresses, sensitive spinal nerves become "pinched" by arthritic bone spurs or become irritated by inflammation. Pain felt in the legs that is coming from an irritated spinal nerve is called sciatica.

What can a back specialist do for you?

It is always important to treat the underlying problem. Although arthritis can involve the entire spine, the specific area causing pain must be treated. To pinpoint the cause of the pain, the doctor may use x-rays and an extensive physical examination.

If a pinched nerve of spinal stenosis (narrowing of the spinal canal as a result of arthritis) is suspected, special scans such as CT or MRI are useful to see the internal structure of the spine. EMG (electromyogram) and nerve conduction studies may be needed to check the function of your spinal nerves.

Several treatments are available, depending on which areas are contributing to your pain. Anti-inflammatory medicines, facet injections, nerve root injections (blocks), or an Epidural Steroid Injection (ESI) can ease pain and inflammation. Once the pain cycle is controlled, a physical therapy program is very helpful to prevent recurrent episodes.

How are injections done?

A cortisone-like drug is placed into the affected are or facet joint. These cortisone compounds are potent anti-inflammatory agents that deliver medication directly to the area of inflammation. Dramatic and sometimes permanent relief of symptoms is usually the result. A local anesthetic is used to numb the area and there is relatively little discomfort. An injection is done by a doctor in about the same time it takes for a routine office visit. Epidural injections are typically performed by an anesthesiologist as an out-patient hospital procedure. After an injection, most people can expect an immediate (same day) return to their usual activities, or within 24 hours.

What can Physical Therapy do?

Poor posture and improper body mechanics (the way you move your body) often lead to painful episodes of arthritis. A balanced problem of physical therapy and exercises will strengthen and stretch the muscles that support your back.

Is Surgery helpful?

When conservative treatments fail to relieve the pain and disability of proven spinal stenosis or herniated disc, surgery may be recommended.

Diagnostic Services:

Your doctor may order one or more special tests to help confirm your diagnosis, rule out other problems and pinpoint the source of your spine pain.

X-rays show the general condition of your vertebrae (bones) and are very helpful in determining the cause of pain. Although x-rays cannot reveal a ruptured disc, for instance, they may reveal a narrowed disc space which can be an indication of trouble in that area of the spine.

MRIs (magnetic resonance imaging) and CTs (computerized tomography) produce detailed computer images of soft tissue and bones. MRIs are especially beneficial for the study of soft tissue abnormalities such as disc degeneration, protrusion or rupture. CT scans can also show a ruptured disc, tumor, etc. They are particularly good for diagnosing spinal stenosis.