Spinal arthritis is a common cause of back and neck pain, especially as we age. It refers to inflammation or wear-and-tear in the joints of the spine, leading to symptoms like stiffness and discomfort. If you or a loved one is dealing with spinal arthritis, understanding the condition can help you manage it better and stay hopeful about living an active life. In this blog, we explain what spinal arthritis is in clear terms and discuss its symptoms, how doctors diagnose it, and the many options for managing and preventing it.
Understanding Spinal Arthritis
Spinal arthritis simply means arthritis (joint inflammation or joint damage) affecting the spine. The spine contains many small joints between the vertebrae (back bones) called facet joints, and these joints can change just like knees or hips do. The most common type of spinal arthritis is osteoarthritis, often nicknamed “wear-and-tear” arthritis. Over the years of use, the smooth cartilage cushioning the facet joints gradually wears down, causing the bones to rub together and form small bony growths (bone spurs). This degenerative process in the spine is sometimes referred to as spondylosis, for example, age-related arthritis in the neck is called cervical spondylosis. For more on how osteoarthritis damages joints, see our guide to understanding osteoarthritis.
Why does spinal arthritis happen? Several factors can make someone more prone to arthritis in the spine:
- Age and “wear and tear”: Osteoarthritis of the spine is most common in people over 50, as joints naturally degenerate with time.
- Past injuries or strain: A history of back injury, like a bad fall or years of heavy labour, can trigger arthritis in that area later. Repeated strain on the spine over time (for instance, in specific physically demanding jobs) may accelerate joint wear.
- Genetics: If your parents or close family members have osteoarthritis, you may inherit a tendency for faster cartilage breakdown. Learn more about this link in our comprehensive guide.
- Weight and lifestyle: Carrying excess body weight puts additional stress on the spine’s joints, especially the lower back. A sedentary lifestyle with weak supporting muscles can also make the spine more vulnerable to arthritis.
- Primary vs secondary arthritis: Some people develop spinal osteoarthritis as a part of the natural ageing process with no specific trigger. In other cases, there is an underlying cause making it worse, for example, a previous injury or another condition like scoliosis. Learn more about the difference in our post on primary vs secondary osteoarthritis.
Understanding what’s behind your arthritis can help in tailoring the proper treatment and self-care strategies.
Common Symptoms of Spinal Arthritis
Spinal arthritis can cause a range of symptoms that may come and go. The exact symptoms often depend on which part of the spine is affected (neck vs. lower back) and how severe the arthritis is. Common signs and symptoms include:
- Back or neck pain: A dull ache or sharp pain in the affected part of the spine. Lower back pain is widespread in lumbar arthritis, and neck pain is common with cervical arthritis. Pain is often worse with specific movements (for example, twisting or bending) and may improve with rest.
- Stiffness and reduced flexibility: After periods of inactivity, you may experience stiffness in your back or neck. Many people find they are stiffest first thing in the morning or after sitting still for a long time.
- Grinding or popping sensations: Arthritic spinal joints can produce a sensation or sound of grinding, crunching, or popping when you move. This happens because the joint surfaces have become rough due to cartilage loss.
- Nerve-related symptoms: If spinal arthritis leads to bone spurs or disc changes that press on nearby nerves, you might experience neurological symptoms. These can include numbness, tingling, or weakness in the limbs.
- Fatigue or general feelings of illness: Chronic pain can be exhausting. In inflammatory spinal arthritis, people may feel overall fatigue, low energy, or even have mild fevers when the disease is active.
- Tenderness or swelling: Unlike arthritis in fingers or knees, you usually won’t see visible swelling in your back. However, the area might feel tender if you press on the affected joints or muscles around them.
Weather changes can sometimes make joint pain and stiffness worse. Read more about red flags for spinal and joint pain.
Diagnosing Spinal Arthritis
If you have persistent back or neck pain and suspect it might be due to arthritis, a proper medical evaluation is essential. Doctors will typically use several steps to diagnose spinal arthritis and rule out other causes:
- Medical history: Your doctor will start by asking questions about your symptoms. When did the pain start? Is it worse in the morning or evening? Does anything make it better or worse? They will also ask about your medical history and lifestyle.
- Physical examination: A clinical exam helps the doctor pinpoint the problem. They will look at your back and posture, feel along your spine for tender spots or abnormalities, and check your spine’s range of motion. The doctor may also test your reflexes and strength in your arms and legs to see if any nerves are being affected.
- Imaging tests: If spinal arthritis is suspected, imaging can confirm changes in the spine. An X-ray can show characteristic signs of osteoarthritis, such as narrowing of the spaces between vertebrae (indicating cartilage and disc thinning) and bone spurs on the edges of the vertebrae. X-rays can also help rule out other issues like fractures. In many cases, an MRI scan might be ordered, especially if you have nerve symptoms. A CT scan is another imaging tool that gives a very detailed picture of the bones and can be helpful in complex cases or before surgery.
After gathering the above information, the doctor will have a good idea if your pain is due to spinal arthritis or another condition.
Management Options for Spinal Arthritis
There is no cure for spinal arthritis (joint damage can’t be fully reversed once it has happened), but the good news is that there are many ways to manage the condition and improve your quality of life.
Medical Treatments
Medical treatment for spinal arthritis focuses on relieving pain, reducing inflammation, and addressing any specific complications (like nerve compression). Common medical options include:
- Pain relievers (analgesics): Simple painkillers like paracetamol (acetaminophen) are often the first step. If pain is more severe, a doctor might recommend short-term use of more potent pain relievers.
- NSAIDs (anti-inflammatory medications): Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, or diclofenac can significantly reduce inflammation and pain in arthritic joints. If oral NSAIDs aren’t suitable for you, there are also topical NSAIDs (gels and creams) you can rub into the skin over a painful area to get targeted relief with fewer systemic side effects.
- Muscle relaxants: Doctors may prescribe a short course of a muscle relaxant if you have significant muscle tightness. These medications help loosen the muscles and can break the pain-spasm cycle, especially in neck arthritis, where muscle tension often accompanies joint pain.
- Steroid injections: Corticosteroid injections are a potent anti-inflammatory treatment delivered directly to the site of pain. If a particular facet joint is very inflamed or if an arthritic spur is causing nerve irritation, a doctor can inject steroid medication around that area.
- Disease-specific drugs: If your spinal arthritis is part of a systemic condition like rheumatoid arthritis or ankylosing spondylitis, treatment will also involve medications for that disease.
- Surgery (last resort): In the majority of cases, spinal arthritis can be managed with non-surgical treatments. However, if pain remains severe despite all other measures, or if there is significant nerve compression that risks permanent damage (for example, worsening numbness, weakness, or bowel/bladder issues due to spinal cord or nerve root compression), surgery may be considered.
Always discuss with your doctor which treatments are appropriate for you. Every individual’s case is a bit different. Often, a combination of treatments (for example, medication plus physiotherapy and lifestyle changes) works best.
Lifestyle Modifications and Self-Care
Lifestyle modifications and self-care practices are a cornerstone of managing spinal arthritis. The following strategies can empower you to take control of your condition and are often just as crucial as pills or injections:
- Stay active with regular exercise: Gentle, regular exercise helps maintain the flexibility of the spine and strengthens the muscles that support your back.
- Strengthen your core and glutes: The muscles in your abdomen, back, buttocks, and hips form a support system for your spine. Keeping these muscles strong takes pressure off the spinal joints.
- Posture and body mechanics: Paying attention to your posture can significantly reduce stress on your spine. When standing or sitting, try to keep your back straight and shoulders relaxed, not slouched forward.
- Weight management and diet: If you are overweight, losing even a modest amount can relieve some pressure on your spine and other weight-bearing joints.
- Pacing and rest: Living with spinal arthritis means learning to listen to your body. Try to pace yourself: break tasks into smaller steps, intersperse heavier activities with lighter ones, and schedule short rest breaks.
By incorporating these lifestyle adjustments, you take an active role in managing spinal arthritis. It often helps to work with professionals. A physiotherapist can design a tailored exercise plan and ensure you are doing exercises correctly, and an occupational therapist can advise on ergonomic changes or tools.
References
- Versus Arthritis – Osteoarthritis (OA) of the spine. https://www.versusarthritis.org/about-arthritis/conditions/osteoarthritis-oa-of-the-spine/
- Johns Hopkins Medicine – Spinal Arthritis (Arthritis in the Back or Neck). https://www.hopkinsmedicine.org/health/conditions-and-diseases/spinal-arthritis
- NHS – Cervical spondylosis (arthritis in the neck). https://www.nhs.uk/conditions/cervical-spondylosis/
- World Health Organization (WHO) – Osteoarthritis Fact Sheet. https://www.who.int/news-room/fact-sheets/detail/osteoarthritis
- StatPearls (NIH/NLM) – Spinal Osteoarthritis. (Thomas Lindsey & Alexander M. Dydyk, updated 2023). https://www.ncbi.nlm.nih.gov/books/NBK553190/
