OA can affect a variety of joints in the body, including the spine. Like OA of the hips and knees, OA of the spine (sometimes called spondylitis) is a degenerative disease.
The spine is made up of many individual bones called vertebrae. Collectively, they provide a strong and flexible support for the body. The bones of the spine touch each other in an area in the back of the vertebrae called the facet joint. Like many other joints in the body, the facet joint is covered with cartilage. This cartilage allows the facet of the adjoining vertebra to easily slide over it. The vertebrae are separated from one another by intervertebral discs, which support the spine and provide additional flexibility and shock absorption when you are walking, running, or jumping. The vertebrae are connected to each other and to the muscles of the neck and back by a complex system of ligaments.
OA of the spine is one of the common causes of neck and back pain in people more than 50 years old. This disease affects the spine at the facet joints. Specifically, the cartilage covering these facet joints becomes inflamed and wears away. The inflammation leads to the development of small irregular growths of bone (called bone spurs or osteophytes) on the facet joints; eventually, bone spurs may form on the bodies of the vertebrae themselves.
These changes in the facet joints create additional mechanical pain on top of the pain resulting from the inflammation. Although the bone spurs do not directly cause pain, if they grow large enough, they can reduce the flexibility of the spine by interfering with the function of the facet joints. If they become large enough, they may press on the roots of the nerves
as they leave the spine or may grow into the spinal canal and press on the spinal cord itself (a condition called spinal stenosis). Irritation of the nerve roots can result in numbness, tingling, or weakness of the hands or feet. Spinal stenosis can occur anywhere in the spine, but most commonly occurs in the neck or low back (lumbar spine). This condition can result in progressive pain and weakness that may affect the arms, legs, or even the bowel and bladder. In such a case, surgery is indicated to remove the bone growths; this treatment may bring about pain relief and return of function if the surgery is performed early enough in the course of the disease.
In the early stages of spinal OA, a person may not have any symptoms, though the disease may be evident on x-rays of the spine. Eventually, the affected individual may complain of mild neck or back pain and stiffness. The stiffness is usually worse in the morning or after sitting for long periods of time. Symptoms typically improve after a few minutes of moving around, but may worsen again at the end of the day. Symptoms can be slowly progressive and insidious. People with these symptoms slowly reduce their activity, resulting in weakened back muscles and more pain.
Engaging in low-impact exercise and stretching can improve symptoms. For example, exercising in a heated pool can help to relax tired muscles and decrease the impact on joints associated with running or walking.
OA has affected my spine more than any other part of my body. The disease caused the cartilage between the discs in my neck to wear away. This resulted in losing the function in my left arm. However, after two spinal fusions I now live a normal life with full use of my arm. I now play golf and swim. It is important to note that I am restricted in lifting heavy objects.