Back arthritis

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

One of the more common areas affected by arthritis is the back, often referred to as the spine.

The spine is made up of individual bones called vertebrae, which provide support for the spine. These vertebrae are connected in the front of the spine by intervertebral discs that help support the spine and also allow it to move. The many ligaments and muscles that are attached to the back of the spine provide the power for movement.

Arthritis occurs when the cartilage in the joints is worn down as a result of wear and tear, aging, injury or misuse. Osteoarthritis, the most common form of arthritis, also includes loss of cartilage, overgrowth of bone and the formation of bone spurs. This causes the bones under the cartilage to rub together, causing pain, swelling and loss of motion of the joint. Osteoarthritis can occur in any joint but most often occurs in the hips, knees, hands or the spine.

In the spine, osteoarthritis can cause stiffness and pain in the neck or in the lower back. Cervical arthritis (also called cervical spondylosis) affects the upper spine and neck. Lumbar or lumbosacral arthritis affects the lower back and pelvic area. Ankylosing Spondylitis is another type of spinal arthritis.

Some people are more at risk for developing arthritis than others. The following are some factors that contribute to a person's risk of developing arthritis:

Age: arthritis is more common in people over the age of 50

Overused joints from work or sports related activities

Injury or trauma to the bones (like fractures)

Obesity: excessive weight places stress on joints

Family history

Gender: women are twice as likely to get arthritis

Chronic illness such as diabetes, cancer or liver disease

Generally, the signs and symptoms of arthritis include inflammation, stiffness and pain in the joints. In the spine, symptoms may also include one or more of the following:

• Back pain that comes and goes
• Spinal stiffness in the morning such as after getting out of bed or after activity.
Often this pain decreases with rest or, for some, after exercise
• Pain, tenderness or numbness in the neck
• Lower back pain that runs down into the buttocks, thighs, or pelvic area
• Pain or tenderness in the shoulders, hips, knees or heels
• A crunching feeling or sound of bone rubbing on bone
• Weakness or numbness in legs or arms
• Limited range of motion, difficulty bending or walking
• Spinal deformity


If your back pain is severe, it is a good idea to visit your doctor. He or she will ask you about the history of your pain. Be sure to talk to your doctor about when the pain started, when it feels better or worse, how long it lasts and what you have done to relieve the pain. Also, make sure you inform your doctor about any other health problems you are experiencing or have had in the past.

Your doctor will then examine your back. You may be asked to do a few simple exercises so your doctor can see if your range of motion has been affected. These exercises may include bending forward, side-to-side or backwards. You may also be asked to lie down and raise your legs. Be sure to tell your doctor when or if any of these exercises causes pain.

The symptoms of arthritis, especially in the spine, are similar to other spinal conditions. Therefore, it is important for your doctor to rule out other, possibly more serious problems. To do this, you may need to undergo a variety of tests such as:

• Blood tests - these will help determine the type of arthritis.
• X-rays - these tests can show the structure of the vertebrae and the outlines of joints and can help determine if there has been any deterioration of cartilage.
• MRI (magnetic resonance imaging) - this test gives a three-dimensional view of parts of the back and can show the spinal cord, nerve roots and surrounding spaces.
• Computerized axial tomography (CAT scan) - this test shows the shape and size of the spinal canal, its contents and structures surrounding it. It shows bone better than nerve tissue.
• Bone scan - This test uses injected radioactive material that attaches itself to bone. A bone scan can detect arthritis, but may not be able to differentiate it from other disorders. Therefore, bone scans are usually performed along with other tests.
• Myelogram - a liquid dye is injected into the spinal column and appears white against bone on an x-ray film. A myelogram can show pressure on the spinal cord or nerves from herniated discs, bone spurs or tumors.


If your doctor determines that you have arthritis in your spine, there are a number of treatment options. Keep in mind, there is no cure for arthritis, but you can treat the pain and discomfort using medications, physical therapy, exercise, heat/cold therapy and rest. Your doctor will talk to you about these options and together you can develop a treatment plan that works for you.

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