Symptoms of Osteoarthritis of Neck and Back: How to Treat

What is Osteoarthritis of Neck?

• Degenerative changes are common in neck or cervical spine. In some degree they are found almost universally in persons over 50yrs of age.
• Beginning in the inter-vertebral discs, they affect the posterior inter-vertebral (facets) joints secondarily causing pain and stiffness of the neck, sometimes with referred symptoms in an upper limb.

Causes of Neck Osteoarthritis

• The primary degenerative changes are initiated by injury. In other cases the condition is simply a manifestation of normal wear and tear.

Symptoms of Neck Osteoarthritis

• Osteoarthritis (OA) of the neck is common in patients beyond middle life and it is often symptomless.
• The symptoms are in the neck or in the upper limb or both.
• Neck symptoms consist chiefly of aching pain in the back of the neck or in the shoulder blade area, a feeling of stiffness and ‘grating’ sound on movement.
• Occipital or headache of the back portion may be a feature if the upper half of the cervical spine is affected.
• The upper limb there may be a vague, ill defined and ill localized referred pain spreading over the shoulder region or there may be more serious symptoms from interference with one or more of the cervical nerves.
• The main feature of nerve root irritation is radiating pain along the course of the affected nerve or nerves, often reaching the digits.
• There may be paraesthesia (paralysis) in the hand in the form of tingling or ‘pins and needles’.

How Osteoarthritis Neck Is Diagnosed?

• X-ray shows narrowing of the inter-vertebral disc space, with formation of osetophytes (overgrowth of bone) at the vertebral margins, especially anteriorly with degenerative changes.

Treatment for Osteoarthritis of Neck

• In mild cases analgesic drugs and various forms of physiotherapy (radiant heat, short wave diathermy, osteoarthritis massage therapy, traction or exercises) are advised.
• Manipulation is sometimes recommended, but in the presence of extensive osteophytes.
• In the more severe cases it is wise to provide rest and support for the neck by a closely-fitting collar of the plaster or plastic.
• In exceptional cases where the spinal cord in constricted, decompression either from in front or by laminectomy may be required and thereafter it is advisable to fuse the affected vertebra by a bone-grafting operation.

Osteoarthritis of Back

Osteoarthritis of the back can be divided into upper back (thoracic) and lower back (lumbar) inter-vertebral joints. Osteoarthritis of the back is found very commonly in those used to heavy work, but it is not necessarily accompanied by symptoms.

Causes of Osteoarthritis of Back

Predisposing factors are

1. Previous injury to spinal joints
2. Previous disease involving the joints (e.g. Scheuermann’s kyphosis or an inter-vertebral disc lesion).

In other cases the degenerative changes are simply a manifestation of increasing age or ‘wear and tear’.

Symptoms When Person Has Osteoarthritis of Back

• Usually there is a complaint of aching pain in the affected area which is worse on activity. Pain is often worse on first movement in the morning and there may be a feeling of stiffness when rising from a sitting position.
• Back osteoarthritis can exist in quite marked degree without causing symptoms.
• In lumbar region there is tendency of acute rising of sudden pain which usually last for few weeks (acute lumbago).
• If a nerve gets interfered in a narrowed inter-vertebral space (foramen) it leads to radiating pain in the distribution of the affected nerve.

Diagnosis of Back Osteoarthritis

X-ray shows narrowing of the inter-vertebral space and osteophyte formation at the joint margins. Later posterior inter-vertebral joints also show changes. There is narrowing of the joint space with sharpening of the margins of the facets.

Osteoarthritis of Thoracic spine

• In osteoarthritis of thoracic spine the symptoms are seldom severe and is treatment is required in such cases a course of active spinal exercises to strengthen the posterior muscles is usually sufficient.

Osteoarthritis of Lumbar spine

• In lumbar spine treatment with moderate disability a well fitted surgical corset will usually afford adequate relief.
• Physiotherapy mainly by exercise and passive mobilization may also be helpful. Heavy lifting and similar strains to the back should be strictly avoided. Rarely, if a pain from a localized lesion is bad enough to cause serious hardship, operative fusion of the affected segments of the spine may be required.

Treatment of Osteoarthritis of Back

Treatment depends up on the severity of the disability of the patient in movement. In mild cases treatment is unnecessary; explanation and reassurance is the only treatment.

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