Stiffness and pain in the neck and back might often be the natural consequence of long hours sitting by the desk or waking up after a terrible night’s sleep. But when that pain persists, recurs, and becomes part of your day-to-day, it may be a sign of something less acute and more chronic. Sometimes, it may be the first telltale sign of spinal arthritis. Stiffness and pain in the neck and lower back are associated with many different spinal conditions. But when the pain seems to worsen in the mornings and late at night, your symptoms may be related to swelling and inflammation near your vertebrae and spinal nerve roots.
Spinal arthritis usually affects the back and neck, much like arthritis can affect the elbows, wrists, fingers, knees, and other joints in the body. While generalized lower back pain can have an exceptionally long list of potential causes and comorbidities, a few characteristics are more often associated with spinal arthritis than other conditions. But even so, that doesn’t mean your pain is solely to blame on arthritis. Your pain may be masking another spinal condition. As with any other recurring or longstanding health issues, if you’ve been struggling with back or neck pain for quite some time, it’s critical to see a specialist and get a proper diagnosis.
Osteoarthritis and the Spine
Osteoarthritis is the medical term for when the cushions at the ends of your bones, called your joint cartilage, wear down to the degree that your bones begin to grind onto one another. It is generally the most common form of arthritis and occurs naturally over time. Some factors accelerate this type of arthritis (like smoking, excessive body weight, bone deformations, and a sedentary lifestyle or physically stressful job), while others slow it down (like staying fit, enjoying a nutrient-rich diet, and good genes).
As your cartilage breaks down, other things begin to happen to your joints. The bones themselves begin to deteriorate due to the impact of bone on bone. The connective tissues and muscles that attach to the bones get inflamed. And the joint lining, which is a piece of connective tissue in each joint capsule in the body, can also swell and become painful. Your spine does not have quite the same kind of cartilage as the rest of your body. Instead, the spinal bones are supported and separated by specialized rubbery discs filled with a softer gel core.
These can dehydrate and break down over time, leading to spinal instability and pain, especially in the more vulnerable parts of the spine (the neck and lower back). Spinal osteoarthritis should not be confused with DDD or a slipped or herniated disc. However, the latter can and does often cooccur with spinal arthritis. In general, spinal arthritis is diagnosed when a patient is experiencing recurring back pain, swelling, and inflammation due to weakened or shrunken discs and damaged vertebrae.
Signs and Symptoms of Spinal Arthritis
Spinal arthritis is characterized by weakened bones and spinal discs, bone-on-bone contact, swelling near and around certain nerve roots, and pain. Some of the characteristics central to spinal arthritis include:
- Loss of flexibility in the back.
- Pain aggravated by motion in the back or neck.
- Disrupted sleep, waking up at night due to pain.
- Stiff areas feel painful or tender when touched.
- Stiffness, usually in the lower back and/or neck.
- Elevated pain levels and stiffness in the late hours (closer to bedtime).
- Crunching, popping, or other unusual sounds in the back and neck (crepitus).
- Elevated pain levels and stiffness right after waking up (usually lasting about half an hour).
- Increased warmth and swelling in the back or neck, especially before storms or big weather shifts.
Another common sign of spinal arthritis is so-called facet joint pain or facet joint syndrome. Facet joints connect the vertebrae by their facets connected to the lamina and spinous process, the little protrusions (or processes) you see on each vertebra. Each vertebra has two facets and two facet joints connecting to the next vertebra. Each facet joint is composed of connective tissue and synovial bursa (sacs filled with viscous fluid). As with the spinal discs themselves, general wear-and-tear can break these joints down over time, causing your facets and other parts of the vertebrae to grind against each other. Swelling in the area can also compress and fracture, aggravating the surrounding nerve roots and resulting in more pain.
How Is Spinal Arthritis Diagnosed?
When checking for spinal arthritis, a doctor will rely on patient information and history, a thorough physical examination, and an imaging test. Patient information and history and a physical examination can help a doctor eliminate certain factors and ascertain the exact characteristics of the patient’s pain. If multiple signs are pointing towards osteoarthritis in the spine – such as a family history of osteoarthritis and other forms of arthritis, similar complaints in the past, history in manual labor, current medication, and more – then they may move on examining the patient’s nerve function and pain levels, determining where the pain is originating, checking for inflexibility and loss of strength, as well as basic movements, such as bending or reaching. Imaging tests can further help determine what’s going on inside the body.
X-rays and CT (computer tomography) scans help get an accurate picture of the bones. Still, an MRI (magnetic resonance imaging) test is needed to view and examine soft tissue, discover ligament tears or cartilage damage, and see swelling. A diagnosis of spinal arthritis may not explain all of a person’s symptoms. The doctor may run multiple tests further to determine the cause of the patient’s pain. Many degenerative disc disease (DDD) and osteoarthritis patients are asymptomatic, which means they aren’t experiencing disease symptoms, such as pain or loss of mobility. Our bodies do break down naturally over time, and a degree of deterioration is expected at a certain age. Certain symptoms require emergency help. If you are experiencing fever, bladder or bowel control problems, severe weakness in your extremities, or severe pain, seek help immediately.
Spinal Arthritis Treatments
Spinal arthritis coupled with pain can be treated conservatively under most circumstances. This means that a doctor will likely prescribe pain medication and other pain management options. Certain changes may be recommended depending on the patient’s age and lifestyle – ranging from losing a few pounds to taking it easy with certain sports and activities and eating a different range of foods. Pain management will also depend on the severity and location of the patient’s pain.
Debilitating and life-altering pain may require the use of minimally invasive pain management options, like nerve blocks or corticosteroid injections. Some spinal conditions require surgery, including painful bone spurs, severe spondylolisthesis (a shifted or slipped vertebra), or progressive spinal stenosis (narrowing the spinal shaft). Surgical solutions for severe spine problems include a laminectomy (removing bone from the vertebrae) and spinal fusion (mechanically wiring unstable spine sections to prevent paralysis and pain).
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