Spinal arthritis leads to painful inflammation in the joints of the spine. While there is no cure, various conservative treatment options can effectively manage symptoms long-term. For patients with more severe arthritis, injections or surgery may provide relief when other measures fail.
Conservative Treatments
Most people with spinal arthritis can manage their condition for many years without surgery using more conservative therapies. Trying these options first is generally recommended.
Medications
Prescription and over-the-counter drugs help relieve inflammation and arthritis pain.
NSAIDs
Non-steroidal anti-inflammatory medicines like ibuprofen or naproxen reduce swelling. But they have significant cardiovascular and gastrointestinal side effects with prolonged use.
Acetaminophen
For milder spinal arthritis pain, acetaminophen (Tylenol) often eases discomfort with less risk of complications.
Steroids
Injecting corticosteroid medication directly into spinal joints temporarily reduces inflammation. However, frequent steroid injections can progressively damage tissue.
DMARDs
Disease-modifying anti-rheumatic drugs work by slowing progression of inflammatory types of arthritis like rheumatoid arthritis.
Lifestyle Changes
Certain lifestyle measures complement medication in conservative spinal arthritis management:
Weight Loss
Slimming down even 10-15 pounds can lessen the burden on spine joints, noticeably decreasing pain for some patients.
Quit Smoking
Smoking worsens inflammation and joint degeneration. Kicking the habit preserves spine health longer term.
Diet
An anti-inflammatory diet high in fruits, vegetables, fish and whole grains may ease arthritis symptoms. Limiting processed foods and added sugar aids weight control.
Exercise
While excess activity strains inflamed joints initially, gentle stretching and low-impact exercise boost strength and flexibility vital for spine support. Walking, swimming and yoga suit most spinal arthritis patients.
Physical Therapy
Working with a physical therapist ensures patients practice appropriate exercises without worsening pain or instability. Massage, transcutaneous electrical nerve stimulation, hot/cold therapy and other modalities also relieve muscle tension and arthritis pain.
Alternative Medicine
Some patients also find relief using alternative therapies like:
- Acupuncture
- Supplements such as glucosamine, turmeric or omega-3 fatty acids
- Mindfulness meditation
- Medical marijuana or CBD oil (law dependent)
Evidence on these complementary options is limited currently, but they appear relatively safe to try.
Interventions
If conservative treatment fails to manage symptoms after several months, patients may consider more advanced options under a spine specialist’s care.
Injections
Steroid Injections
Injecting corticosteroid medication directly into inflamed spinal joints provides potent anti-inflammatory effects. However, pain relief tends to be temporary and tissue problems can develop with repeated injections.
Hyaluronic Acid
This thick fluid occurs naturally in joint fluid. Hyaluronic acid shots may replenish lubrication and cushion spinal joints damaged by arthritis. Research shows variable patient outcomes so far.
Surgery
Only about 1 in 10 spinal arthritis patients require surgery. It is generally a last resort for severe, intractable pain unresponsive to other measures. Common procedures include:
Decompression Surgery
Removing a small section of bone takes direct pressure off compressed nerves causing radiating lower body pain. This does not address joint problems directly. Risks include spinal fluid leak.
Spinal Fusion
Fusion surgery stabilizes the spine using metal implants attached to vertebrae. It permanently limits flexibility and mobility. Possible complications include excessive bone growth or implant issues later.
Given the intricate anatomy of the spine, all spine operations carry risks – infection, bleeding, chronic pain. Thoroughly discussing pros and cons of surgery with the care team is essential.
Radiofrequency Ablation
Also termed rhizotomy, this minimally invasive treatment uses heat to disable irritated facet joint nerves transmitting pain signals. Benefits may last 9 months to 2 years.
Emerging and Experimental Therapies
Exciting research surrounds several new approaches for spinal arthritis:
Stem Cell Therapy
Extracted adult stem cells injected into damaged joints show early promise regenerating cartilage and reducing inflammation. However, more evidence confirming efficacy and long-term outcomes is still needed.
Prolotherapy
This technique promotes healing by injecting natural irritant solutions prompting brief inflammation, increased blood flow and tissue renewal. Some arthritis patients report noticeable pain relief.
While not yet universally legal, medical marijuana and CBD oil have demonstrated abilities minimizing arthritis inflammation and discomfort for many patients. More research should further clarify appropriate therapeutic applications for managing spinal arthritis.
Finding the Optimal Treatment Plan
There is no single “best” solution working for all spinal arthritis cases. The most effective approach integrates multiple conservative treatments for lasting pain relief. Beginning with gentle exercise, weight control and over-the-counter analgesics makes sense before progressing to other options if symptoms persist.
Regular doctor visits ensure the treatment regimen adapts appropriately as the condition progresses. Being realistic about activity limitations and recovery pace helps calibrate expectations.
In rare stubborn cases, prescription drugs, injections or surgery may be required eventually. Thankfully, exciting research provides hope for making spinal arthritis increasingly manageable. Tailored treatment coupled with patience offers the best outcome for this common source of back pain.
Written by Dr. Tony Mork
Orthopedic Spine Surgeon
I’m Dr. Tony Mork, MD, a Minimally Invasive Orthopedic Spine Surgery Specialist in Newport Beach, California. With over 40 years of experience, I’m dedicated to providing information for all topics that involve neck and back pain.
January 23, 2024
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