Back Pain! Is It Osteoarthritis of the Spine?
“With an aging U.S. population, back pain may be growing into an even greater problem, since osteoarthritis (OA) typically emerges in people over 40, and the spine is a prime target for this common joint condition. But just how much of our nation’s back pain is caused by OA?” (Arthritis Today, 2012) http://www.arthritistoday.org/conditions/osteoarthritis/oa-beyond-the-basics/oa-and-back-pain.php
“Degenerative changes” in the spine is also termed degenerative joint disease or degenerative arthritis and occurs most commonly in the neck and lower back. Osteoarthritis of the spine results in a narrowing of the spaces between the vertebrae. The gradually rubbing together of the vertebrae causes bone spurs to form which then cause the spine to stiffen and lose flexibility. This rubbing together causes the vertebrae and areas surrounding the cartilage to become inflamed and painful. (http://www.mayoclinic.com/health/medical/IM01682). “Cartilage is a form of usually slick, slightly elastic, connective tissue that covers the ends of the bone joints. In part, cartilage serves as a protective shock absorber to minimize the impact of bouncing, jumping and other types of daily activities on the joints – and is thus subjected to considerable wear and tear during life. Indeed, heavy work, sports, repeated injuries and obesity take a heavy toll on the joints of the limbs and spine. To be healthy, all joints should be exercised” ((http://www.spine-health.com/conditions/arthritis/osteoarthritis-spine). Because of pain, an individual often begins to lessen daily movement and physical activity. The more there is less physical inactivity and less neck/upper/lower back movement (it hurts to move!), the more there is stiffening of the spine.
Another point of explanation about back pain is that “As we age, persistent pressure on the spine wears away the tough cartilage lining facet joints. Meanwhile, disks in the spine begin to narrow due to water loss, adding to pressure on the facet joints (and subtracting from your overall height, which is why people shrink as they age). As a result of these changes, the facet joints … can develop inflammation” (Arthritis Today, 2012). “In response to spine being unstable, growths called osteophytes, or bone spurs, can form in the joints. While bone spurs appear to be the body’s attempt to restore stability, they can cause the spine to stiffen. As OA worsens, bone spurs can narrow the “frames” where nerves exit the spinal cord. This condition, called spinal stenosis, can pinch nerves and cause numbness and weakness in the legs” (Arthritis Today, 2012).
Osteoarthritis in the spine is divided into:
- “Lower back (lumbar spine) osteoarthritis, sometimes called lumbosacral arthritis, which produces stiffness and pain in the lower spine and sacroiliac joint (between the spine and pelvis).
- Neck (cervical spine) osteoarthritis, sometimes called cervical spondylosis (spondy- implies the spine, and –osis is an abnormal condition), which can cause stiffness and pain in the upper spine, neck, shoulders, arms and head” (http://www.spine-health.com/conditions/arthritis/osteoarthritis- spine).
What else causes back pain? Norman Marcus, MD, author of End Back Pain Forever (Atria, 2012) and director of muscle pain research in the department of anesthesiology at the New York University School of Medicine “argues that weak, stiff or damaged muscles are responsible for three out of four bad backs, regardless of age” (Arthritis Today, 2012). Back pain is often “referred,” (that is, a muscle damaged in another part of the body triggers pain/aching felt in the back. Marcus believes that doctors who target OA of the spine as a significant contributor to this common problem are misguided. According to The Dartmouth Institute, spending on neck and back problems is approximately $90 billion a year. Back pain is the second most common reason why people go to the doctor. What the consumer/patient should do is to have a knowledgeable (about back pain) health care provider rule out (or in) osteoarthritis of the spine.
Exercise: A MUST for reducing back pain! There is no “one-size-fits all” for treatment of back pain. “People often believe their pain is unsafe,” says Carol Hartigan, MD, a spine physician at New England Rehabilitation Hospital in Boston. “They become fearful of moving, and start to anticipate pain and avoid activities” (Arthritis Today, 2012). This makes a person’s muscles weak and tight, which in turn makes one more sensitive to pain. It is most important for one to increase the strength and flexibility of muscles that surround and support the spine.
Sites for additional information (diagnosis, causes, treatments) involving OA and other joints (knees and hips): http://health.nytimes.com/health/guides/disease/osteoarthritis/overview.html http://www.mayoclinic.com/health/arthritis/AN00124
Remember: December 8, 2012 is Bellingham’s 25th year for the Jingle Bell Run/Walk. Please join or donate to our WWURA team. Easy to get to web site: http://bellinghamjbrw.kintera.org/faf/home/default.asp?ievent=1027414 or drop by the Arthritis Foundation office on Chestnut at South Campus of PeaceHealth.
Comment of glucosamine: Are you allergic to shellfish? Several companies manufacture their glucosamine (a dietary supplement) from the shells of shrimp, crab, lobster, and crayfish. People with shellfish allergies are advised not to use such glucosamine supplements.