Diagnosis and treatment of spinal osteoarthritis

Osteoarthritis of the spine is the degeneration of the nucleus pulposus of the intervertebral disc, It loses thickness and density. It is produced by the normal wear of the intervertebral disc.

How does osteoarthritis of the spine evolve?

In youth, the disc is thick and of gelatinous consistency. As the years go by, the disc becomes dehydrated and loses height when the composition of the nucleus pulposus is modified.

From 30 or 40 years of age it is normal that Radiology shows initial signs of vertebral arthrosis. They show up at some level of the spine, whether or not pain is suffered.

When the disc wears down, its damping capacity decreases, increases the load that the vertebra supports, and the bone grows, appearing osteofitos or peaks of parrot, that sometimes can get to join adjacent vertebrae.

They only cause problems in cases where they produce a spinal stenosis or compress the nerve. The more or less early appearance of this process and in its progression influence genetic, nutritional, traumatic and mechanical factors.

80% of the general population has back pain at some point in their life, and all adults above a certain age they show signs of disc degeneration.

Risk factor's

Different scientific studies have shown that:

  • Body overweight does not accelerate disc degeneration. On the contrary, a progressive increase in body weight of up to 12 kg delays degeneration. Although the effect is unknown when the overweight is greater.
  • Smoking has a negative effect.
  • Working with heavy loads also has a minimal effect on degeneration.
  • The genetic load is the main determinant of disc degeneration.

You may also be interested in: Prevention of osteoarthritis

Symptoms of spinal osteoarthritis

Some of the symptoms of osteoarthritis of the spine are:

  • Low back pain that comes and goes.
  • Spine stiffness in the morning that is relieved in the course of the day and decreases with activity.
  • Lumbar pain that radiates to the buttocks, thighs and pelvic region.
  • Loss of strength in the legs.
  • Pain and stiff neck.
  • Limitation of mobility in the spine and difficulty in stooping and walking.

As the disc wears out, the musculature has to do progressively more work to hold the spine and maintain balance during movement. If the musculature is sufficiently powerful and resistant, and the different muscle groups coordinate well, you can take on that extra effort.

However, studies show that there is no correlation between the degree of wear of the intervertebral disc and the existence or not of pain. The greater the muscular development, the less direct that relationship is. For this reason, there are cases in which signs of very advanced degeneration are observed in people who do not have any pain, but a sufficient musculature.

Read also: Prevention of osteoarthritis

How is the diagnosis made?

The diagnosis of spinal osteoarthritis is based on symptoms such as pain, stiffness and limited movement. In addition, exploration is considered in which pain and limited mobility of the lumbar spine are usually highlighted. The complementary tests that are requested more frequently are the spine radiographs.

Treatment

The goal of the treatment is relieve pain and improve the quality of life. For this, several alternatives are available such as: physical measurements, drugs and surgery.

The treatment consists of use of analgesics such as paracetamol. However, if it is not enough, they can be associated with anti-inflammatories during the acute phase of pain. In cases where anti-inflammatories can not be used, opioid analgesics such as tramadol may be useful.

People affected by osteoarthritis of the severe spine may present an associated neurological complication. In these cases, the compression of a nerve or the stenosis of the canal, makes it necessary to treat other types of drugs such as pregabalin or gabapentin.

Guidelines and treatments directed by a physiotherapist are also helpful. In this way, combining all the options relieves the symptoms of osteoarthritis of the spine.