A very common type of arthritis is osteoarthritis. Osteoarthritis typically affects middle aged people or older people. Osteoarthritis happens due to the degeneration of cartilage in joints. This can occur in most joints in the body but the most common is the hips, knees, hands, lower back, and neck. Cartilage works to absorb shock and lower friction in the joints as it is a firm, rubberlike material.
Spondylosis happens as osteoarthritis affects the spine. Spondylosis is a degenerative condition and can lead to normal spinal structure and function to be lost. A common cause of spondylosis is aging. Depending on the person, the placement and how fast the degeneration occurs will vary. This disorder can affect the cervical, thoracic, or lumbar regions of the spine and can cause the degeneration of disc and osteophytes (bone spurs) that can squeeze nearby nerves.
Spinal stenosis may occur as spondylosis gets worse due to constant narrowing of the spine from bone spurs. Spinal stenosis is a narrowing of the spinal canal that can put pressure on nerves or the spine. When the nerves or spine is compressed, there may be function loss or pain. When the compression is on the upper region of the spine, this can cause numbness or pain in the shoulders and arms. When the compression is on the lower regions of the spine or on nerve roots that branch out, pain and numbness may occur in the legs. When the lumbar spine is affected, typically multiple vertebrae are involved. The lumbar spine holds the majority of a body’s weight so activity or even inactivity can cause symptoms. Certain motions, sitting, lifting, or bending can elevate pain.
One vertebra slipping over another vertebra is degenerative spondylolisthesis. This happens from osteoarthritis of the facet joints. It typically happens when the L4 slips over the L5 vertebra. This often affects people over the age of 50. The symptoms of degenerative spondylolisthesis is lower back pain, muscle spasms, thigh or leg pain, weakness or stiffness of hamstring muscles.
INCIDENCE AND PREVALENCE
- Over 54 million people are affected by osteoarthritis in the United States
- It is estimated that in 2040, 26% of the United States will be affected by osteoarthritis
- Half of people over 65 years of age show at least one joint affected by osteoarthritis in an X-ray
- Osteoarthritis occurs more in men under the age of 45 and in women over the age of 50
CAUSES
The cause of osteoarthritis is unknown. The following are factors that tend to increase the probability of getting osteoarthritis:
- Age
- Heredity
- Overweight
- Injury to joints
- Injury to nerves
- Overuse of certain joints
- Limited physical activity
SYMPTOMS
- Stiffness or pain in the lower back
- Stiffness or pain in the neck
- One of both arms feeling weak or numb
- Morning pain or stiffness that lasts for 30 minutes because of limited activity
- Increase in pain during the day because of movement
- Limited motion
SEEKING MEDICAL CARE
Have an evaluation with a primary care doctor. The primary care doctor will see what steps to proceed with.
TESTING AND DIAGNOSIS
Based on symptoms, an examination, and X-rays, a diagnosis can typically be made. To see the damage on the spine an MRI can occasionally be ordered. The MRI can show cartilage damage, bone spurs, and limited joint space.
TREATMENT
Nonsurgical treatment
Most treatment for osteoarthritis and spondylosis is non surgical. Anti-inflammatory medicine like ibuprofen or non-steroidal anti-inflammatory medications may be used to decrease inflammation and pain. In some cases, a doctor may order prescription medication. To help lower swelling, cortisone injections may be ordered. Epidural injections of cortisone do not provide long term pain relief. Physical therapy and certain exercises can work to stabilize the spinal cord, build strength, and improve flexibility. One important factor in managing osteoarthritis is maintaining a healthy weight.
Surgical treatment
It is very uncommon to treat spondylosis with surgery. Surgery may be used if the spinal stenosis is so severe it has led to neurological deficits. If nonsurgical treatments have not proven effective and daily function is imparied, surgery could be considered. Age and health are taken into consideration when looking at applicants for surgery.
FOLLOW UP
A primary care physician usually helps with managed arthritis as it is a chronic condition. If there are neurological deficits that occur from spondylosis a patient may see a surgeon and then return to their primary care physician.
