There are more than 100 types of arthritis.  The most common type that affects the spine is spondylosis, or simply osteoarthritis.  Inflammatory types of arthritis also can cause joint stiffness and pain.  These include juvenile or adult rheumatoid arthritis and ankylosing spondylitis.  Spinal arthritis can affect the cervical (neck), thoracic (mid-back), and lumbar (low back) spine.

Degenerative disorder
Spondylosis is a degenerative, wear and tear disorder related to growing older.  This type of arthritis affects the spine’s joints; the facet joints.  At the back of each vertebral body is a pair of facet joints.  Like other joints, each facet joint is covered in cartilage to facilitate smooth movement.  Age- and activity-related spinal degeneration contributes to erosion of cartilage.  As cartilage wears away, joints become inflamed, stiff, and painful.

A degenerative cascade of cumulative effects causes osteoarthritis to alter the spine’s structures.  Degeneration at one level can lead to change (deterioration) at another level of the spine.  These changes can create stress and increase wear and tear of the spine’s discs and ligaments.  Many patients with spondylosis also have degenerative disc disease.

Are you at risk?
Similar to other disorders, some risks are controllable and others are not.

Risks you control

• Balanced diet
• Body weight; extra weight (obesity) stresses spine structures
• Do not smoke (tobacco use)
• Exercise
• Overuse of joints during work or sports-related activities

Risks beyond your control

• Age; everyone ages (arthritis is common in people over age 50)
• Family history of arthritis
• Gender: women are at higher risk
• Spine injury, trauma

Talk with your doctor
Sometimes arthritis symptoms flare up, such as during periods of increased activity, illness, or weather changes.  No two patients with osteoarthritis are the same.  Pain that is chronic, severe, and/or progressive is a good indication that you should see your doctor.

Treatment
Few patients require surgery to treat spondylosis.  Most patients lead full and productive lives and manage osteoarthritis with cold/heat therapy, exercise, medications, spinal injections, and alternative treatment such as acupuncture.

Your doctor may recommend a physical therapy program to improve your posture, increase flexibility, and build strength and endurance.  Biomechanics and ergonomic training is part of an organized program of physical therapy.  Proper posture and movement at rest or during any activity benefits patients with spondylosis. 

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