Arthritis is a general term that describes many different diseases causing tenderness, pain, swelling, and stiffness of joints as well as abnormalities of various soft tissues of the body. The term comes from "arthros," meaning a joint and its attachments, and "-itis," meaning inflammation.
Various forms of arthritis affect nearly 50 million Americans and contribute to the majority of all physical disabilities. Although arthritis is ultimately associated with a wearing out of joints, nearly a half million children are also affected.
Definition of Osteoarthritis
Of the several varieties of arthritis, the most common, the most frequently disabling, and often the most painful is osteo- (meaning bone) arthritis, mostly affecting the weight bearing joints (hips and knees) plus the hands, feet and spine.
Normal joints are hinges at the ends of bones usually covered by cartilage and lubricated inside a closed sack by synovial fluid.
Normally, joints have remarkably little friction and move easily. With degeneration of the joint, the cartilage becomes rough and worn out, causing the joint halves to rub against each other, creating inflammation with pain and the formation of bone spurs. The fluid lubricant may become thin and the joint lining swollen and inflamed.
Osteoarthritis is also known as degenerative joint disease and affects up to 30 million Americans, mostly women and usually those over 45 or 50 years of age. All races in the U.S. appear to be equally affected. This article focuses on osteoarthritis of the spine, particularly on facet joint arthritis.
Where Osteoarthritis Occurs
Cartilage is a form of usually slick, slightly elastic, connective tissue that covers the ends of the bone joints. In part, cartilage serves as a protective shock absorber to minimize the impact of bouncing, jumping and other types of daily activities on the joints - and is thus subjected to considerable wear and tear during life.
Indeed, heavy work, sports, repeated injuries, and obesity take a heavy toll on the joints of the limbs and spine. To be healthy, all joints should be exercised, but if this is excessive, joint damage may accumulate slowly.
In addition to the hips, knees, and lower back, arthritis commonly occurs in the neck, small finger joints, the base of the thumb, and the big toe. In the fingers, nodes (masses of bone and cartilage) can form on either side of the nail bed or the margins of joints to become reddened, tender, and swollen.
Cartilage breakdown in the hips and knees can be severe enough to require joint replacement. Osteoarthritis found in other joints, such as the hinge of the jaw, is often due to injury or stress.
In This Article:
Osteoarthritis of the Spine
Spinal arthritis is one of the common causes of back pain. Spinal arthritis is the mechanical breakdown of the cartilage between the aligning facet joints in the back portion (posterior) of the spine that quite often leads to mechanically induced pain.
The facet joints (also called vertebral joints or zygophyseal joints) become inflamed and progressive joint degeneration creates more frictional pain. Back motion and flexibility decrease in proportion to the progression of back pain induced while standing, sitting, and even walking.
Over time, bone spurs (small irregular growths on the bone also called osteophytes) typically form on the facet joints and even around the spinal vertebrae. These bone spurs are a response to joint instability and are nature's attempt to help return stability to the joint.
The enlargement of the normal bony structure indicates degeneration of the spine. Bone spurs are also seen as a normal part of aging and do not directly cause pain, but may become so large as to cause irritation or entrapment of nerves passing through spinal structures, and may result in diminished room for the nerves to pass (spinal stenosis).
Osteoarthritis in the spine is anatomically divided into:
- Lower back (lumbar spine) osteoarthritis, sometimes called lumbosacral arthritis, which produces stiffness and pain in the lower spine and sacroiliac joint (between the spine and pelvis).
- Neck (cervical spine) osteoarthritis, sometimes called cervical spondylosis (spondy- implies the spine, and -osis is an abnormal condition), which can cause stiffness and pain in the upper spine, neck, shoulders, arms, and head.