There are several conservative care (non-surgical) options available that are the first line of treatment to help alleviate the pain and stiffness caused by spinal arthritis and associated disc degeneration. Most treatment plans will include a combination of these options, based on assessing several factors for the individual patient, such as: severity of the osteoarthritis, which joints are affected, nature of the symptoms, other existing medical conditions, age, occupation, lifestyle factors and everyday activities.
In cases where the patient’s osteoarthritis is causing significant pain, it is imperative to address the arthritis pain and bring it down to a manageable level in order for the patient to continue with daily activities and preferably be able to participate in a reasonable level of rehabilitation and exercise. Helpful first line pain management techniques include rest, heat and/or cold therapy and various medications for reducing pain and/or inflammation. Often a combination of several or all of these techniques will work best for patients.
Rest to Prevent Painful Spinal Arthritis Flare-Ups
Treatment plans for osteoarthritis should include regularly scheduled rest and breaks, including taking breaks from such tasks as using a computer. Patients will benefit from learning to recognize the body's signals, and knowing when to stop or slow down. Resting sore joints decreases stress on the joints and muscles, and relieves pain and muscle spasms. Patients are asked to simply decrease the intensity and/or frequency of the activities that consistently cause them joint pain until they can get their muscles stronger.
Heat/Cold Therapy for Temporary Pain Relief of Spinal Arthritis
People with osteoarthritis often find that warmth, through warm towels or hot packs applied to the joint, or a warm bath or shower, can relieve pain and stiffness. Heat is known to help reduce inflammation and swelling in the joints and can help improve circulation. Water therapy in a heated pool or whirlpool may also help. In some cases, cold, through cold packs or a bag of ice or frozen vegetables wrapped in a towel, can relieve pain or numb the sore area. Often, applying heat for 20 minutes before doing an exercise routine or activity, and following up with applying cold to the affected area afterwards, will help alleviate activity and exercise related pain in the joints. A doctor or physical therapist should be consulted to determine if heat, cold, or a combination is the best treatment.
Medications to Help Relieve Spinal Arthritis Pain and/or Inflammation
There are many types of medications available to help patients control the pain level and to reduce the swelling around the painful joints that leads to pain. Some medications, such as Tylenol, focus just on reduction of pain. Others, such as NSAIDs (e.g. aspirin, ibuprofen, and Cox-2 inhibitors), focus on reduction of joint inflammation as well as pain relief. There are also creams for pain relief and nutritional supplements (e.g. glucosamine and chondroitin) that are believed to provide pain reducing benefits to patients.
Many patients will need to regularly employ a combination of all three of the above techniques, as well as others discussed later in this article, in order to be able to focus on rehabilitation, exercise and maintaining a healthy level of daily activities.
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Osteoarthritis Treatment May Require a Multi-Disciplinary Medical Team
Due to the varied treatment plans for osteoarthritis, there will likely be several health professionals involved in a patient's care. This integrated approach has been show to result in better pain reduction and function improvement for patients with osteoarthritis. However, with many different specialties involved, there can be differing points of view, and this may create confusion. The patient plays a critical role in communicating openly and honestly among this team.
For example, members of your osteoarthritis treatment team may include a combination of the following back health professionals:
- Primary care physicians. Doctors who treat patients before they are referred to other specialists in the health care system (may include medical doctors, osteopathic physicians and/or chiropractors).
- Rheumatologists. Medical doctors who specialize in treating arthritis and related conditions that affect joints, muscles, and bones.
- Physiatrists (rehabilitation specialists). Doctors who help patients make the most of their physical potential, usually with a special focus on rehabilitation.
- Physical therapists. Health professionals who work with patients to improve joint function and physical conditioning.
- Occupational therapists. Health professionals who teach ways to protect joints, minimize pain, and conserve energy in the home environment and/or work environment.
- Psychologists and psychiatrists. Health professionals who help patients cope with emotional, social and/or psychological difficulties in the home and workplace resulting from their medical conditions (e.g. sleep difficulties, depression).
- Social workers. Professionals who assist patients with social challenges caused by disability, unemployment, financial hardships, home health care, and other needs resulting from their medical conditions.
- Dietitians. Health professionals who teach ways to use a good diet to improve health and maintain a healthy weight.
- Nurse educators. Nurses who specialize in helping patients understand their overall condition and implement their treatment plans.
- Orthopaedists. Doctors who specialize in surgical treatment for bone and joint diseases. Orthopedic physicians may specialize specifically in spinal conditions.
- Licensed acupuncture therapists. Health professionals who reduce pain and improve physical functioning by inserting fine needles into the skin at various points on the body.
See also Specialists Who Treat Back Pain for an overview of the many types of medical specialists who treat spinal conditions such as osteoarthritis and related conditions, such as degenerative discs.