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OSTEOARTHRITIS of the BACK
A stiff, painful back is often the legacy of years of wear and tear on the spine. Medications and gentle exercise can usually make spinal osteoarthritis manageable.
Osteoarthritis (OA) affects millions of older Americans, and the back is a common site. As we age, the joints in the spine may degenerate, leading to inflammation and pain. Usually we feel it in the lower back, or lumbar region. But arthritis can also affect the cervical spine-the neck. The severity of symptoms varies greatly. Some people suffer near-immobilizing pain, some experience only stiffness, and others have no symptoms.
Back breakdown
The degenerative process centers on the facet joints between the vertebrae (spinal bones) and the protective disks that separate these bones.
The facet joints connect the vertebrae and allow the back to twist and bend. As we move, bones in the joints rub against each other. Changes caused by this wear and tear can lead to inflammation and degeneration of the cartilage that covers the ends of bones in the joints.
The spongy disks that cushion the vertebrae are the other structures that may degenerate. As the cushion is worn down, the adjacent vertebrae press against the disk, causing it to bulge into the space at the center of the spinal column. Through this canal runs the bundle of nerves known as the spinal cord. The cord may be pressured by the bulging disk. In addition, over time, developing bone spurs and enlarged ligaments may protrude into the canal. This narrowing, or stenosis, of the canal and the openings through which the nerves pass as they extend to various parts of the body causes compression of nerves-and pain. Being overweight or having weak back or abdominal muscles aggravates the problem.
Symptoms of spinal change
With stenosis, the spine gradually stiffens and may become inflexible. People with stenosis of the lumbar spine usually have pain in the lower back; over time it can move into the legs. The numbness, weakness, or cramping that may develop can be lessened by sitting or bending forward. Pressure on certain nerves can affect bowel or bladder control or sexual function. People with cervical spinal stenosis may suffer similar symptoms.
Looking deep for answers
To diagnose arthritis, a physical exam is performed and standard x-rays are taken. Occasionally magnetic resonance imaging (MRI), computerized tomography (CT), or bone or blood tests are done to rule out other underlying problems.
Easing the problem
Once the diagnosis is made, the goal is to minimize pain and allow the person to remain active. That involves medications and lifestyle measures.
Various medications are available.
Over-the-counter creams, gels, and ointments may provide temporary relief for mild to moderate pain. Examples include Aspercreme and remedies containing capsaicin, menthol, or camphor.
Nonsteroidal anti-inflammatory drugs (NSAIDs) relieve pain and reduce inflammation. These include aspirin, Advil or Motrin (ibuprofen), and Aleve (naproxen). Gastrointestinal (GI) bleeding is a risk with ongoing use.
COX-2 inhibitors provide pain relief with a lower risk than NSAIDs of GI side effects. Some carry heart risks.
Painkillers such as Tylenol (acetaminophen) don't reduce inflammation.
In severe cases, to relieve pain and inflammation a corticosteroid can be injected into facet joints or, for people with spinal stenosis, the epidural space surrounding the spinal canal.
Lifestyle modifications can make back arthritis more bearable.
Regular low-impact exercise such as swimming and walking improve mobility. Strengthening and stretching exercises help support the spine.
For spinal stenosis, physical therapy can strengthen back muscles, build endurance, and improve blood supply to the nerves. For pain, rest helps.
Losing excess weight takes some strain off the back.
Applying hot or cold packs for short periods is a good temporary measure.
For spinal stenosis, a lumbar brace or corset can provide back support, and a cane or walker aids mobility.
As a last resort, surgery can reduce pressure on the nerves.
From Mayo Clinic Health Letter and Arthritis Self-Management
Published: Mar/Apr 2005
OSTEOARTHRITIS of the BACK
A stiff, painful back is often the legacy of years of wear and tear on the spine. Medications and gentle exercise can usually make spinal osteoarthritis manageable.
Osteoarthritis (OA) affects millions of older Americans, and the back is a common site. As we age, the joints in the spine may degenerate, leading to inflammation and pain. Usually we feel it in the lower back, or lumbar region. But arthritis can also affect the cervical spine-the neck. The severity of symptoms varies greatly. Some people suffer near-immobilizing pain, some experience only stiffness, and others have no symptoms.
Back breakdown
The degenerative process centers on the facet joints between the vertebrae (spinal bones) and the protective disks that separate these bones.
The facet joints connect the vertebrae and allow the back to twist and bend. As we move, bones in the joints rub against each other. Changes caused by this wear and tear can lead to inflammation and degeneration of the cartilage that covers the ends of bones in the joints.
The spongy disks that cushion the vertebrae are the other structures that may degenerate. As the cushion is worn down, the adjacent vertebrae press against the disk, causing it to bulge into the space at the center of the spinal column. Through this canal runs the bundle of nerves known as the spinal cord. The cord may be pressured by the bulging disk. In addition, over time, developing bone spurs and enlarged ligaments may protrude into the canal. This narrowing, or stenosis, of the canal and the openings through which the nerves pass as they extend to various parts of the body causes compression of nerves-and pain. Being overweight or having weak back or abdominal muscles aggravates the problem.
Symptoms of spinal change
With stenosis, the spine gradually stiffens and may become inflexible. People with stenosis of the lumbar spine usually have pain in the lower back; over time it can move into the legs. The numbness, weakness, or cramping that may develop can be lessened by sitting or bending forward. Pressure on certain nerves can affect bowel or bladder control or sexual function. People with cervical spinal stenosis may suffer similar symptoms.
Looking deep for answers
To diagnose arthritis, a physical exam is performed and standard x-rays are taken. Occasionally magnetic resonance imaging (MRI), computerized tomography (CT), or bone or blood tests are done to rule out other underlying problems.
Easing the problem
Once the diagnosis is made, the goal is to minimize pain and allow the person to remain active. That involves medications and lifestyle measures.
Various medications are available.
Over-the-counter creams, gels, and ointments may provide temporary relief for mild to moderate pain. Examples include Aspercreme and remedies containing capsaicin, menthol, or camphor.
Nonsteroidal anti-inflammatory drugs (NSAIDs) relieve pain and reduce inflammation. These include aspirin, Advil or Motrin (ibuprofen), and Aleve (naproxen). Gastrointestinal (GI) bleeding is a risk with ongoing use.
COX-2 inhibitors provide pain relief with a lower risk than NSAIDs of GI side effects. Some carry heart risks.
Painkillers such as Tylenol (acetaminophen) don't reduce inflammation.
In severe cases, to relieve pain and inflammation a corticosteroid can be injected into facet joints or, for people with spinal stenosis, the epidural space surrounding the spinal canal.
Lifestyle modifications can make back arthritis more bearable.
Regular low-impact exercise such as swimming and walking improve mobility. Strengthening and stretching exercises help support the spine.
For spinal stenosis, physical therapy can strengthen back muscles, build endurance, and improve blood supply to the nerves. For pain, rest helps.
Losing excess weight takes some strain off the back.
Applying hot or cold packs for short periods is a good temporary measure.
For spinal stenosis, a lumbar brace or corset can provide back support, and a cane or walker aids mobility.
As a last resort, surgery can reduce pressure on the nerves.
From Mayo Clinic Health Letter and Arthritis Self-Management
Published: Mar/Apr 2005
i am
going for complete blood workup on the 16th and a
physical 10 days later....i may ask for more detailed
investigaiton on my own back.
Seems
it's always something else!
Mosken
Good
post...have had OA of back, neck and shoulders. Thanks
Annette
