Arthritis – Extremities & Spine


According to the National Health Interview Survey of the CDC, 52 million American adults have arthritis. Knee painArthritis is a serious debilitating condition that contributes to lost workdays and disability. There are several different types of arthritis, but the most common kind is osteoarthritis. With this bone condition, the weight-bearing joints of the spine, hips, knees, and feet are affected.

Normal joints are covered by cartilage, and they are lubricated on the inside with synovial fluid. This allows the joint to move easily with no friction. As the joint ages and after years of wear-and-tear, there is less production of synovial fluid and the cartilages becomes rough and degenerated. When these things happen, the bones rub against one another, creating pain, stiffness, and spur formation.

Spine Conditions caused by Arthritis

  • Facet joint arthritis – The joints most affected by arthritis are the extremities and spine. Cartilage degeneration of the knees and hips often is severe enough to require joint replacement, and spinal arthritis leads to significant back and leg pain. The facet joints (between the vertebrae of the spine) become inflamed with progressive degeneration. This leads to decreased back motion and flexibility, which is referred to as facet joint arthritis.

 

  • Spinal stenosis – Bones spurs called osteophytes form on the facet joints, making the joint unstable. When bone spurs are large, they cause nerve irritation or entrapment of nerves that pass through the spinal structures down to the lower body regions. This creates a condition called spinal stenosis.Arthritis cartoon picture

 

  • Lumbosacral arthritis – When the osteoarthritis affects the lower spine and sacroiliac joint (between the pelvis and spine), it produces pain and stiffness of the low back. This is referred to as lumbosacral arthritis.

 

  • Cervical spondylosis – If arthritis develops in the cervical (neck) region of the spine, it is often referred to as cervical spondylosis. This can create pain in the upper spine, neck, arms, shoulders, and head.

Causes and Risk Factors for Arthritis of the Extremities and Spine

The most common reason for arthritis is age. However, several other factors contribute to the development of disabling joint condition. These include:

  • Weight – Excessive weight puts pressure on the joints, especially the knees. For every single pound of weight a person gains, there is 4 pounds of pressure on the knees.

 

  • Heredity – Researchers have found certain genes associated with arthritis, and they believe that xraynorm-arthritisinherited bone shape abnormalities contribute to this disorder.

 

  • Gender – Women who are 55 years old and older are more likely to have OA.

 

  • Repetitive stress injuries – The spine and extremities are damaged due to occupations that require a person to kneel, squat, lift, bend, and tug.

 

  • Athletics – Long-distance runners and people who play sports are at a higher risk for developing osteoarthritis of the weight-bearing joints.

Treatment of Arthritis Pain

  • Facet joint injections – Given into the facet joint of the spine, the doctor injects anti-inflammatory steroid along with an anesthetic to provide pain relief.

 

  • Facet joint denervation – Spine needles are placed in the facet joint region under x-ray guidance, and radiofrequency energy is then passed through the needles. This allows the doctor to coagulate and destroy the nerves that produce pain.

 

  • Epidural steroid injection – With this procedure, a long-lasting anesthetic and a steroid are injected into the spinal epidural space.knee injection

 

  • Transforaminal epidural injection – Used to treat cervical or lumbar radiculopathy, this is often done along with the epidural steroid injection.

 

  • Sacroiliac joint steroid injection – The doctor injects an anesthetic and steroid into the sacroiliac joint. This is used for arthritis of the very low back region.

 

  • Selective nerve root block (SNRB) – For the diagnosis and treatment of back pain, the doctor uses an injection technique to find the exact nerve root that causes the pain. Once it is located, he/she injects an anesthetic to numb the region.

 

  • Joint Injection – Options for injection include steroid medication, hyaluronic acid, platelet rich plasma therapy and stem cells.

 

Resources

Borenstein D (2014). Does osteoarthritis of the lumbar spine cause chronic low back pain? Current Pain and Headache Reports, 8(6), 512-517.

Center for Disease Control and Prevention (2014). Arthritis: Data and Statistics. Retrieved from: http://www.cdc.gov/arthritis/data_statistics.htm