What is Spinal Arthritis?
Spinal arthritis in the most basic terms, refers to inflammation of the joints in the back or neck. There are two broad categories of causes: 1.) Degenerative disease or Osteoarthritis (the most common) is caused by wear and tear of the joint surface cartilage over time; 2.) Inflammatory arthritis is a broad category of diseases caused by autoimmune inflammation of the joint lining and occurs in conditions such as Rheumatoid Arthritis. The inflammation of the joints can be intense and destroy the joint cartilage and surrounding ligaments and connective tissues. Many inflammatory conditions may have an element of arthritis as a part of the disease process, some affecting primarily the cervical spine (neck area) and others with a broader spinal involvement. One inflammatory arthritis called Ankylosing Spondylitis also commonly involves the sacroiliac joints between the spine’s sacrum and the ilium of the pelvis. Spinal arthritis will often cause joint stiffness, be occasionally or regularly very painful, become chronic, and can be functionally limiting in moderate and advanced cases.
How is Arthritis Diagnosed?
Physicians may use a range of methods to confirm a spinal arthritis diagnosis. Initially, your doctor will take your history, perform a physical exam, and review your medical history. Blood tests may be used to identify genetic markers, signs of inflammation, and specific tests such as rheumatoid arthritis antibodies. X-rays assist in assessing the nature and severity of the arthritic joints. In appropriate circumstances, an MRI, CT scan, bone scan, or ultrasound can help identify and detect nerve and spinal cord involvement and other important findings. Joint aspiration, which involves testing synovial fluid inside a joint, may also be used in the diagnostic process though it is not typically done for spinal arthritis.
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How is Arthritis Treated?
You and your doctor will discuss your treatment options for spinal arthritis based on factors such as age, level of pain, the type and severity of arthritis, and your personal goals. Because the damage caused by arthritis isn’t reversible, treatment options aim to mitigate the pain associated with the condition and improve your level of function. You and your doctor, consulting together, will decide on the best path forward for improving your condition. You always have options.
Nonsurgical treatments commonly prescribed include nonsteroidal drugs (NSAIDs) and Physical Therapy which can help improve overall muscle strength, flexibility, and endurance. A daily home-exercise program is usually beneficial. Lifestyle changes may be recommended to reduce inflammation and stress on the spine. Corticosteroids in the form of pills or injections may be useful to reduce pain and swelling. Other minimally invasive, needle-based procedures are sometimes indicated and can be coordinated through a recommended Pain Management physician. Most people with arthritis will never need surgery. Most people will experience improvements in arthritic pain and dysfunction with conservative care.
If nonsurgical treatments are ineffective and your problem has a surgical solution, your doctor may recommend various surgical options where research and time-tested results have shown a high likelihood of success. Surgically decompressing pinched spinal nerves and the spinal cord or stabilizing the spine via spinal fusion can often be performed with a minimally invasive approach.
What Can I Expect After Treatment?
Following surgical treatment, your doctor may initially prescribe medication to help you deal with any immediate post-op pain while the spine heals. In addition, aerobic and strengthening exercises can help improve the muscles that support the spine, and range of motion exercises increase flexibility which aids in lowering stress on the back and spine. If surgery is required, your doctor may recommend additional recovery measures to facilitate a full recovery. Most non-emergent spinal surgeries performed in the modern era carry a 75% – 95% success rate, depending on the circumstances and underlying conditions. Ask your surgeon what the success rate is for your surgery as it specifically relates to you. Also ask about the frequency of surgical complications. With advances in modern surgical techniques, most people who choose to undergo needed spinal surgery experience favorable results and improvement in pain, with complications being relatively uncommon, and almost always manageable.
Dear Dr. Young,
Thank you for your excellent care and reduction of my chronic neck pain!!! Your patience, willingness to answer even the simplest questions, and your sense of humor helped me get through the surgery, hospital stay, and follow-up appointments.
Also, thanks to Jeanne and the receptionist at Thompson Peak office for their efficiency, kind welcoming, and attention to detail. They also offer a kind sense of humor.
Once again, Dr. Young, thank you for your superior care!!