Arthritis of the Spine (Back, Neck)

Inflammatory arthritis versus osteoarthritis

Arthritis of the spine falls into two basic categories:

Inflammatory arthritis – chronic autoimmune disorders such as ankylosing spondylitis, a condition which often begins at a young age and is characterized by low back and/or neck pain, morning stiffness, and limited motion in the back, which is improved by exercise and unrelieved by periods of rest.
Osteoarthritis – degenerative changes in the joints that occur as a person ages. Osteoarthritis of the spine causes joints along the spine to deteriorate and may result in the formation of bone spurs, cysts, and a narrowing of the disc space.

Osteoarthritis of the back or neck is significantly more common than is inflammatory arthritis. Below is a narrated video animation about osteoarthritis of the spine.

Low back pain caused by osteoarthritis

The most common symptom of spinal osteoarthritis is pain in the lumbar spine (low back – see further below for an explanation of spine anatomy). This pain may also radiate down to the pelvis, buttocks, groin or thighs. It is usually treated through a combination of:

Physical therapy and exercise that strengthens a person's core (such as yoga, Pilates or aquatic therapy)
Nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and/or adjuvant pain medication

When these treatments are not enough to alleviate pain and stiffness, a patient may require procedural pain management, such as corticosteroid injections or blocking of the medial nerve through radiofrequency neurotomy, where heat generated by radio waves disrupts the nerve’s ability to transmit pain signals.

Neck pain caused by osteoarthritis

Osteoarthritis of the neck, called cervical spondylosis, is also common. This is characterized by arthritic deterioration of the discs and facet joint cartilage of the cervical spine. Spondylosis is nearly universal in elderly patients, but can also affect younger people. Some people experience no symptoms, while others may feel stiffness and/or pain in the neck, shoulders and/or between the shoulder blades. See also Cervical Radiculopathy.

Anatomy of the spine

The bones that compose the spine (or backbone) are divided into four basic segments. From top to bottom, these are:

The cervical spine (the neck) – the first seven vertabrae located just below the skull
The thoracic spine – the 12 vertabrae of the upper back
The lumbar spine – the five vertabrae of the lower back
The sacral spine – composed of a triangular structure called the sacrum (five individual vertabrae that fuse together between the age of 18 and 30) and the coccyx (commonly called the tailbone and composed of three to five individual vertabrae, some of which may fuse together in adulthood)

Image: Graphic of spine anatomy with segments and structures labeled.