Osteoarthritis (OA) is the degenerative form of joint arthritis. It is a progressive joint disease associated with aging. In the spine, OA can affect the facet joints, the intervertebral discs, and the ligaments supporting the spine.
Back pain is the typical symptom associated with OA of the spine. The pain is typically felt deep in the muscles. Being upright aggravates the pain, and lying down typically helps. The first symptom of spine OA is intermittent low back pain that is usually most severe in the morning or after inactivity. Other symptoms depend on the disease stage and may include: stiffness and limited motion of the lumbar spine; pain and limited chest expansion; arthritis involving the shoulders, hips, and knees; kyphosis (curvature of the spine) in advanced stages, sometimes caused by the tendency for these patients to assume a stooping posture in an attempt to reduce their symptoms; hip deformity with limited range of motion; and tenderness over the inflammation site. These symptoms progress unpredictably, and the disease can disappear temporarily or permanently at any time.
Physical examination is typically not very specific in this illness. X-rays and MRIs show narrowed or collapsed disc spaces, and sometimes there is forward slip of one vertebra versus the other. The MRI sometimes shows a tear in the outer layer of the disc and may even show edema in the bone adjacent to the arthritic level.
Most OA of the spine will not need surgery. Physical therapy, weight loss, and anti-inflammatory medications are the first line of treatment. If surgery is needed, fusion of the spine or disc replacement arthroplasty could be an option.
