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Spinal Arthritis (Facet Syndrome)

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Disease Awareness Page for R3 Stem Cell – Spinal Arthritis (Facet Syndrome)

 

What is Spinal Arthritis

Spinal arthritis also called osteoarthritis of the spine, is a condition that involves the breakdown of the ligaments and discs of the vertebrae (back bones). It usually affects the neck and lower back; it is rarer in the chest area. Spinal osteoarthritis causes low back pain and other symptoms like radiating pain and impaired sensation.

How does spinal arthritis progress?

In many other joints of the body, arthritis involves an inflammation of the joint lining. In addition to this inflammation, there is erosion of the cartilage, degeneration of the supporting ligaments, and reduction of the space in the joint. However, inflammation of the synovial lining is not present in spinal arthritis because the spinal joints lack synovial linings. The way the joints in the back are oriented is that an intervertebral disc separates two vertebrae. The union is then supported in front and behind by cartilages.

In the early stages of the disease, there are small bony growths that protrude from the edges of the vertebrae. These are called osteophytes, and they are usually considered warning signs of the disease. However, they are not an indication of spinal arthritis; individuals can have osteophytes without ever developing spinal arthritis. 

Following the growth of osteophytes, the joint cartilage eventually begins to degenerate. Then the joint space reduces, and eventually, if left unchecked, the edges of the vertebrae begin to rub off against each other. At this stage, the pain experienced by the individual is usually very severe.

Causes of spinal arthritis

Spinal arthritis is a very common form of arthritis. It develops as a result of age, and the older an individual gets, the more likely they are to develop the condition. It is so prevalent because the back is always working to keep us erect; either when we’re sitting or standing. As a result, it bears continuous load form the time we are born to the time we die.

Besides age, other causes of spinal arthritis include:

  • Trauma
  • Family history
  • Stress
  • Degenerative cartilage disease
  • Tuberculosis

 

Conditions caused by spinal arthritis 

Because the back plays such an important role in the overall body function, a disease affecting it, like spinal arthritis, can also lead to other conditions. Some of them include:

  • Sciatica
  • Pudendal neuropathy
  • Arthritis in other joints. Here, because the individual is trying to avoid pain, they compensate by using one side of the body more, like leaning more to the left. This excessive load can then lead to arthritis in the joint.
  • Ankylosing spondylitis
  • Spondylolisthesis. This is a shift of the vertebrae, either forward or backwards, and the mechanism is similar to that found in “arthritis in other joints”.
  • Spinal stenosis
  • Spondylitis

What is the difference between spinal arthritis and other spinal conditions

Spinal arthritis often presents symptoms similar to other conditions like spinal stenosis and disc hernias. Symptoms like back pain, impaired sensation, and muscle weakness. Because of their similar symptoms, they may be difficult to tell apart. 

However, the difference between them can always be traced back to their causes. Like you know, spinal arthritis is caused by degeneration of the cartilages in the back. For spinal stenosis, the space in the spinal canal is reduced, and that’s what compresses the nerves and the spinal cord and produces its symptoms. 

Disc hernias are similar to stenosis int hat there is also a reduction in the space in the spinal canal. However, the vertebral disc is what causes the reduced space, not bony growth.

How common is it, and who is at risk?

Low back pain is a very common condition, with a prevalence of 90%. This means that 9 out of 10 people will suffer from low back pain at some point in their lives. According to the arthritis foundation, 20% of these low back pain cases have spinal involvement. Current Rheumatology Reports suggests that between 40% and 85% of all spinal arthritis is lumber arthritis. 

The most significant risk factor of spinal arthritis is age. In fact, it is considered a part of the ageing process, and you’re more likely to develop the condition as you grow older. Besides age, other factors that can increase the chances of you getting spinal arthritis are: 

  • Diabetes
  • Obesity
  • Family history
  • Jobs that require them to stress their back
  • Gout
  • Psoriasis
  • Tuberculosis. Tuberculosis can affect the back as well as the lungs. When it does, it leads to degeneration of the cartilage and ligaments around the joint. In other words, it leads to osteoarthritis. 

What are the symptoms?

There are quite a few symptoms seen in spinal arthritis because nerves are affected, in addition to the denegeration of the cartilages. Spinal nerves leave the spinal cord and travel through the spaces in between the vertebrae. A reduction in the joint space can pinch on these nerves and cause symptoms like:

  • Impaired sensation. The impaired sensation in this point refers to abnormal feelings like pins and needles, burning, and electric-like-shock. 
  • Radiating pains. Individuals who have spinal arthritis often feel pain and other sensations listed above travelling down their legs. The pain travels along the course of the nerve. This can often mimic other conditions like sciatica,
  • Muscle weakness
  • Loss of skin sensation
  • Impaired urinary and bowel control
  • Complete loss of urinary and bowel control

Other non-nerve related symptoms of spinal arthritis include: 

  • Joint tenderness
  • Joint stiffness
  • Limited range of motion at the spine. This refers to movements like bending forward and backwards

Some symptoms of spinal arthritis are worse with certain actions. For example, standing or sitting may aggravate the symptoms, and so does any activity that involves putting a load on the spine, like lifting heavy objects. It is also important to note that some individuals can have spinal arthritis without any of these symptoms. 

Several of the symptoms of spinal arthritis are long lasting and can be present for years. With interventions that help manage the pain and slow down the progression, individuals can lead long, fruitful lives, even with the symptoms present. 

How is it diagnosed?

Spinal arthritis is diagnosed using a combination of different approaches. Since it is a part of the ageing process and a significant number of the population experiences it, its diagnosis is a little easier and more straight forward than conditions like disc hernias.

The diagnosis of spinal arthritis often involves history taking and physical examination. During the history, causes and risk factors like trauma, hereditary, obesity and degenerative cartilage disease. The physical examination will assess things like tenderness and reduced motion and try to identify the specific joints involved.

An X-ray of the spine usually reveals several signs of the disease like the reduced joint space and growth of osteophytes. Advanced imaging scans like MRIs and CTs can be done to assess the cartilage and see the extent of the damage. These advanced images can also be used to assess compression or injury to the spinal nerves as they leave the spinal cord.

How is it treated?

Spinal arthritis does not have a cure, and so, the focus of treatment is on maintaining the highest possible quality of life for the individual, as well as preventing any progression of the disease. Physiotherapy is often recommended in the treatment of this condition. The exercises can aid in maintaining flexibility and strengthen the core muscles. 

Medications like analgesics are also prescribed to help with the pain, while Non-steroidal anti-inflammatory drugs (NSAIDs) are prescribed to counteract any swelling that may develop. Surgical intervention is usually reserved for severe conditions, like the situation in which there is compression of nerves and impairment of motor function.

 

Learn More about ongoing clinical studies sponsored by R3 Stem Cell HERE.

 

References

“Osteoarthritis”National Institute of Arthritis and Musculoskeletal and Skin Diseases. April 2015. Archived from the original on 18 May 2015. Retrieved 13 May 2015.

What it is: Arden N, Blanco F, Coope r C, Guermazi A, Hayashi D, Hunter D, Javaid MK, Rannou F, Roemer FW, Reginster JY (2015). Atlas of Osteoarthritis. Springer. p. 21. ISBN 978-1-910315-16-3Archivedfrom the original on 2017-09-08.  

https://www.webmd.com/osteoarthritis/spinal-osteoarthritis-degenerative-arthritis-of-the-spine

 https://www.healthline.com/health/osteoarthritis-spine 

 https://www.medicalnewstoday.com/articles/319323.php 

 https://www.arthritis.org/about-arthritis/where-it-hurts/back-pain/causes/back-arthritis.php 

https://physioworks.com.au/injuries-conditions-1/spondylosis-spine-arthritis 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1395797/ 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2206347/ 

https://www.mayoclinic.org/diseases-conditions/arthritis/diagnosis-treatment/drc-20350777 

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