Spinal Stenosis and Arthritis

arthritis in the spineSpinal stenosis arthritis may be due to changes in the spine, either through wear and tear or inflammation and hypertrophy associated with rheumatoid arthritis.  Spondylosis is the term used to describe spinal arthritis and its changes include degeneration of the connective tissues, discs, and bones of the spine which can then cause alterations in posture, mobility, blood circulation, and nerve conductivity.  Those engaged in particular professions, such as construction or professional athletics, are more prone to developing osteoarthritis in the spine, as are those who have suffered an acute injury such as a fall or whiplash from a car accident.  Acute damage to the spine may lead to subtle or overt structural changes which then affect posture and alignment causing a shift in weight distribution and stress being placed on specific joints.  Hypermobility of the spine, through bone damage, ligament problems, or a congenital defect, may lead to the growth of bone spurs in the spinal column in an attempt by the body to provide more stability.  Unfortunately, these osteophytes due to arthritis in the neck and back reduce the spaces through which nerves travel and may result in a pinched nerve, blood vessel obstruction, or increased intervertebral disc pressure and herniation.

Spinal Stenosis Arthritis

Spinal Stenosis Arthritis can occur neck, mid-back and lower back

Causes and Symptoms of Spinal Stenosis and Arthritis

Spondylosis may also lead to curvature of the spine which can itself result in spinal stenosis and spinal stenosis arthritis.  If the vertebral levels slip forward (spondylolisthesis) then the foramen are often narrowed, putting pressure on the spinal nerves as they exit the spine. Radiculopathy, back aches and pains, and inflammation can occur and patients may restrict their exercise in an attempt to reduce their symptoms of spinal stenosis.  This reduction in activity often leads to muscle atrophy, stiffness, and poorer long-term mobility, which is why it is important to maintain a regular regime of appropriate exercise as approved by a physical therapist or MD.  Obtaining a diagnosis of arthritis in the spine usually involves the detection of disc degeneration, bone spur growth, and/or calcification of spinal ligaments and tissue on X-Rays, CT or MRI scans.  On occasion, spondylotic changes may be present but remain asymptomatic for many years with no immediate need for treatment.  Strengthening and stretching exercises for the spine may then be helpful to stave off further degeneration and maintain spinal stability.

spinal stenosis arthritis symptoms

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Spinal Stenosis and Osteoarthritis

Osteoarthritis of the spine often affects men earlier in life than women but everyone with spondylosis is at risk of myelopathy as a result of stenotic changes in the spine.  Myelopathy can cause weakness, numbness, paraesthesia, and bowel/bladder incontinence in some patients and is usually only treatable through spinal surgery, unlike radiculopathy which often responds to anti-inflammatory medications.

Spinal Stenosis and Rheumatoid Arthritis



Rheumatoid arthritis in the spine involves the gradual destruction of the synovial joints and often affects the cervical spine in particular due to the increased mobility of this spinal region.  As the synovial fluid and joint become worn away the bones begin to rub together and this can cause pain, osteophyte growth, and nerve entrapment.  In some cases the atlantoaxial joint at the top of the cervical spine may be affected which can cause spinal cord compression and usually necessitates some kind of spinal fusion surgery to decompress and stabilize the spine.  The lower portions of the spine may also be affected by rheumatoid arthritis but the lesser degree of mobility in these regions usually means that the degeneration is not as pronounced.  It is possible for a patient to have both rheumatoid and osteoarthritis of the spine causing spinal stenosis arthritis and it is important that a physician investigates the possibility of both prior to carrying out treatments.

8 replies
  1. Robert S. Katherman
    Robert S. Katherman says:

    Standing or walking for more than ten minutes will caue severe lower back pain. It is relieved almost immediately by sitting or lying down. Numbness in right leg and foot. ??????????????????????????????

    Reply
  2. craig
    craig says:

    Stopping and sitting or leaning on a railing to remove the pressure on lower back. Anti inflammatory meds help although marginally for me. Narcotic pain meds help although must be used with extreme caution.

    Reply

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