Spinal Osteoarthritis – symptoms, diagnosis and treatment

Spinal osteoarthritis (also known as spondylosis) can occur anywhere in the spine, but is most common in the neck (so called cervical spondylosis) and lower back. When osteoarthritis affects the spine, the cartilage between the vertebrae begins to break down, causing pain and stiffness. Osteoarthritis of the spine is often difficult to diagnose, as back pain can be the cause of several different back problems, such as a muscle sprain or a prolapsed disc.

Symptoms of spinal osteoarthritis

Not everyone with degenerative changes in the spine experiences symptoms. However, for those that do, symptoms can be quite disabling. Spinal osteoarthritis symptoms are very similar to those of other back conditions. For example, low back pain is not necessarily a sign of osteoarthritis and the majority of low back pain is non-specific, meaning that there is no known underlying pathology. 

The most common symptoms of spinal osteoarthritis include:

• Back pain, primarily in the lower back or neck
• Back stiffness
• Difficulties getting up or moving around after resting
• Weakness in the lower back
• Lack of energy to stand or sit up straight
• Abnormal fatigue 

If you experience any of these symptoms you should schedule an appointment at your healthcare center to get a diagnosis.

Several risk factors play a part

There is no single cause for the development of spinal osteoarthritis and several risk factors tend to contribute. Common risk factors for spinal osteoarthritis include previous back injuries, age, female sex, long-term joint stress (due to manual labor or high-impact sports) and excess body weight.

Congenital spine conditions, such as scoliosis and spine misalignment, also increase the risk of developing osteoarthritis of the spine.

Diagnosing spinal osteoarthritis

Spinal osteoarthritis is hard to diagnose, as there are several underlying causes of back and neck pain. A large number of conditions are linked to back and neck pain, such as muscle strain, osteoporosis and disk disorders. Infections, fractures and other severe conditions can also be the cause of back and neck pain.  As many symptoms of spinal osteoarthritis are similar to those of other conditions, getting a correct diagnosis is important for treatment. 

Traditionally, osteoarthritis was diagnosed by using an X-ray. Today, it is still a widespread belief that this method is necessary for diagnosis. However, according to the World Health Organization and extensive international research, osteoarthritis should be diagnosed by a healthcare professional through an assessment based on the patient’s medical history, joint function and pain level. The healthcare professional will also take any risk factors for osteoarthritis into account and keep them in mind when establishing the diagnosis. If you experience back or neck pain that doesn’t disappear after a few days, it can be good to contact your primary healthcare center and schedule an appointment with a physical therapist or a doctor.

Occasionally, an MRI examination, CT scan or X-ray of the spine may be required to rule out other spine conditions.

First-line treatment is physical exercise

First-line treatment for both spinal osteoarthritis and many other types of back and neck pain is patient education in combination with individualized exercises. Individualized exercises for the back or neck should be coordinated by a physical therapist, either physically or digitally. These exercises should consistently be adapted to the patient’s abilities based on pain and function level. 

As a complement to first-line treatment, non-prescription painkillers may be used for short periods of time. You should always discuss the use of painkillers with your doctor to avoid side effects and drug interaction. 

Other treatment methods

Some patients find that using a spinal corset relieves lower back pain. However, although it may provide symptom relief, it prevents the patient from using their own back muscles. This over time weakens the muscles in the back, which in the long run can worsen symptoms. 

In rare cases, spinal surgery is considered. All surgery comes with the risk of developing blood clots and infections, but the spine is especially risky to operate on. The spinal nerves control our whole body, including our muscles and organs. Spinal fusion, which involves fusing two or more vertebrae together, is the preferred surgical procedure for osteoarthritis of the spine. However, when fusing together vertebrae, motion is eliminated in that area.