Spine Health

Spinal Arthritis: Spondylosis, Other Types, Symptoms, and Management

By Hart 7 min read

Arthritis in the spine is most commonly referred to as spondylosis, a degenerative condition involving age-related wear and tear on spinal discs and joints, though other inflammatory types also exist.

What is arthritis in the spine called?

Arthritis in the spine is most commonly referred to as spondylosis, which is a general term for age-related wear and tear affecting the spinal discs and joints, essentially spinal osteoarthritis. However, several other distinct forms of arthritis can also affect the spine, each with unique characteristics.

Understanding Arthritis in the Spine: The Primary Term

The most prevalent form of arthritis affecting the spine is spondylosis, also known as spinal osteoarthritis. This condition is degenerative, meaning it results from the gradual breakdown of cartilage and bone in the spine over time.

  • What is Spondylosis? Spondylosis specifically refers to changes in the spine, including the intervertebral discs and facet joints. It involves:

    • Degeneration of Intervertebral Discs: The soft, gel-like discs between vertebrae can lose hydration, flatten, and sometimes bulge or herniate.
    • Bone Spurs (Osteophytes): As discs degenerate, the body may attempt to stabilize the spine by growing new bone along the edges of the vertebrae, forming bone spurs. These can narrow the spinal canal or nerve root openings, leading to nerve compression.
    • Facet Joint Arthropathy: The small joints (facet joints) at the back of the vertebrae, which allow for spinal movement, can also experience cartilage breakdown and bone spur formation, similar to osteoarthritis in other joints.
  • Common Locations: Spondylosis can occur in any part of the spine, but it is most common in the:

    • Cervical Spine (Neck): Cervical spondylosis.
    • Lumbar Spine (Lower Back): Lumbar spondylosis.
    • Thoracic Spine (Mid-Back): Thoracic spondylosis (less common but can occur).

Beyond Spondylosis: Other Forms of Spinal Arthritis

While spondylosis is degenerative, other types of arthritis that affect the spine are primarily inflammatory or autoimmune in nature. These conditions can cause significant pain, stiffness, and structural damage if not managed.

  • Ankylosing Spondylitis (AS): This is a chronic inflammatory disease primarily affecting the spine and sacroiliac (SI) joints (where the spine connects to the pelvis). AS can lead to fusion of vertebrae, resulting in a rigid, inflexible spine (known as "bamboo spine" in advanced cases). It is part of a group of diseases called spondyloarthritis.
  • Psoriatic Arthritis (PsA): This inflammatory arthritis affects some people with psoriasis, a skin condition. PsA can affect peripheral joints, but it also commonly involves the spine, causing inflammation in the vertebrae and SI joints similar to AS.
  • Rheumatoid Arthritis (RA): While RA typically affects smaller peripheral joints (like hands and feet), it can also impact the spine, particularly the cervical spine. Inflammation in the upper neck can lead to instability between the skull and the top two vertebrae (atlantoaxial instability), which can be serious.
  • Enteropathic Arthritis: This form of inflammatory arthritis is associated with inflammatory bowel diseases (IBD) like Crohn's disease and ulcerative colitis. It can cause inflammation in the spine and SI joints, mimicking AS or PsA.

Common Symptoms of Spinal Arthritis

The symptoms of spinal arthritis can vary depending on the type and severity, but common manifestations include:

  • Back Pain: Often dull, aching, or throbbing, which may worsen with activity or after periods of rest.
  • Stiffness: Particularly noticeable in the morning or after prolonged inactivity, often improving with movement.
  • Reduced Range of Motion: Difficulty bending, twisting, or extending the spine.
  • Radicular Symptoms: If bone spurs or disc degeneration compress nerves, symptoms can radiate into the arms (cervical spine) or legs (lumbar spine), causing:
    • Numbness or tingling.
    • Weakness.
    • Sharp, shooting pain (sciatica if in the leg).
  • Headaches: Especially with cervical spondylosis, due to muscle tension or nerve irritation.
  • Fatigue: More common with inflammatory forms of arthritis.
  • Systemic Symptoms: Inflammatory types like AS or PsA may also present with eye inflammation (uveitis), skin rashes (psoriasis), or bowel issues (IBD).

Causes and Risk Factors

The causes and risk factors differ between degenerative (spondylosis) and inflammatory forms of spinal arthritis.

  • Osteoarthritis (Spondylosis) Factors:
    • Age: The primary risk factor, as wear and tear accumulate over decades.
    • Genetics: A family history of osteoarthritis.
    • Previous Spinal Injuries: Trauma or surgery to the spine.
    • Repetitive Stress: Occupations or activities involving heavy lifting, twisting, or prolonged standing/sitting in poor posture.
    • Obesity: Increases mechanical stress on the spine.
    • Smoking: Can accelerate disc degeneration.
  • Inflammatory Arthritis Factors:
    • Genetics: Strong genetic links, particularly the HLA-B27 gene for AS and PsA.
    • Autoimmune Dysfunction: The immune system mistakenly attacks healthy joint tissues.
    • Environmental Triggers: Infections or other factors may trigger onset in genetically predisposed individuals.

Diagnosis of Spinal Arthritis

Diagnosing spinal arthritis involves a comprehensive approach:

  • Medical History and Physical Examination: A detailed history of symptoms, lifestyle, and family history, along with a physical assessment of spinal range of motion, posture, tenderness, and neurological function.
  • Imaging Studies:
    • X-rays: Can show bone spurs, disc space narrowing, and facet joint changes (spondylosis) or characteristic fusion (AS).
    • MRI (Magnetic Resonance Imaging): Provides detailed images of soft tissues like discs, nerves, and ligaments, and can detect inflammation.
    • CT Scan (Computed Tomography): Offers detailed bone images.
  • Blood Tests: Especially for inflammatory arthritis, specific markers may be present:
    • ESR (Erythrocyte Sedimentation Rate) and CRP (C-Reactive Protein): Indicate general inflammation.
    • HLA-B27: A genetic marker associated with AS and PsA.
    • Rheumatoid Factor (RF) and Anti-CCP Antibodies: For Rheumatoid Arthritis.

Management and Kinesiological Interventions

Managing spinal arthritis focuses on pain relief, preserving function, improving mobility, and preventing further progression. Kinesiological interventions are a cornerstone of effective management.

  • Exercise and Physical Therapy: A tailored exercise program is crucial for all types of spinal arthritis.
    • Strengthening Exercises: Focus on core musculature (abdominal and back muscles) to provide spinal stability. Examples include planks, bird-dog, and glute bridges.
    • Flexibility and Mobility Exercises: Gentle stretching to maintain or improve spinal range of motion and reduce stiffness. Examples include cat-cow, pelvic tilts, and hamstring stretches.
    • Aerobic Exercise: Low-impact activities like walking, swimming, cycling, or using an elliptical to improve cardiovascular health, reduce pain, and manage weight without excessive spinal stress.
    • Posture Correction: Education and exercises to improve standing and sitting posture, reducing undue stress on the spine.
    • Manual Therapy: Techniques performed by a physical therapist to mobilize joints and reduce muscle tension.
  • Pain Management Strategies:
    • Heat and Cold Therapy: Applying heat can relax muscles and improve blood flow, while cold can reduce inflammation and numb pain.
    • Medications: Over-the-counter pain relievers (NSAIDs), muscle relaxants, or prescription medications (e.g., DMARDs, biologics for inflammatory arthritis) as prescribed by a physician.
  • Lifestyle Modifications:
    • Weight Management: Reducing excess body weight significantly decreases stress on the spinal joints.
    • Ergonomics: Adjusting workstations and daily activities to support proper spinal alignment.
    • Smoking Cessation: Quitting smoking can slow disc degeneration and improve overall health.
    • Stress Management: Chronic stress can exacerbate pain; techniques like mindfulness, meditation, or yoga can be beneficial.

When to Seek Medical Attention

It's important to consult a healthcare professional if you experience:

  • Persistent or worsening back pain and stiffness.
  • Numbness, tingling, or weakness radiating into the limbs.
  • Loss of bowel or bladder control (a medical emergency).
  • Unexplained weight loss or fever accompanied by back pain.
  • Symptoms that significantly interfere with daily activities or sleep.

Early diagnosis and a comprehensive management plan, especially one that incorporates appropriate exercise and physical therapy, are vital for effectively managing spinal arthritis and maintaining quality of life.

Key Takeaways

  • Spondylosis is the most common form of spinal arthritis, stemming from age-related degeneration of spinal discs and facet joints, often leading to bone spurs.
  • Beyond spondylosis, other inflammatory spinal arthritis types include Ankylosing Spondylitis, Psoriatic Arthritis, Rheumatoid Arthritis (affecting cervical spine), and Enteropathic Arthritis.
  • Common symptoms involve back pain, stiffness, reduced range of motion, and potential nerve compression causing radiating pain, numbness, or weakness.
  • Diagnosis relies on medical history, physical exams, imaging like X-rays and MRI, and specific blood tests for inflammatory markers.
  • Effective management emphasizes physical therapy with core strengthening and flexibility exercises, along with pain management, weight control, and ergonomic adjustments.

Frequently Asked Questions

What is the most common term for arthritis in the spine?

The most common term for arthritis in the spine is spondylosis, also known as spinal osteoarthritis, which describes age-related wear and tear affecting the spinal discs and joints.

Are there other types of arthritis that affect the spine?

Yes, besides spondylosis, other inflammatory types of arthritis that can affect the spine include Ankylosing Spondylitis, Psoriatic Arthritis, Rheumatoid Arthritis, and Enteropathic Arthritis.

What are the typical symptoms of spinal arthritis?

Common symptoms of spinal arthritis include back pain, stiffness (especially in the morning), reduced range of motion, and potentially radicular symptoms like numbness, tingling, or weakness if nerves are compressed.

How is spinal arthritis diagnosed?

Diagnosis of spinal arthritis involves a medical history, physical examination, imaging studies such as X-rays, MRI, or CT scans, and sometimes blood tests to check for inflammatory markers.

What are the primary management strategies for spinal arthritis?

Management focuses on exercise and physical therapy (strengthening, flexibility, aerobics), pain management (heat/cold, medication), and lifestyle modifications like weight management, ergonomics, and smoking cessation.