Arthritis of the Spine

A common thing I hear from patients who have chronic back pain is that a have been told they have arthritis in their spine. For several reasons, hearing this never sits right with me. First, descriptions such as degeneration and arthritis suggests an incurable condition. Arthritis is a more fitting description for joint degeneration in the hands, which do have limited treatment options. However, this is not the case of for low back pain, as many treatment options exist. Second, it is more of a description and then a diagnosis. The condition is called facet arthropathy, a vertebrogenic spinal disorder. Third, most studies have shown that MRI and other studies are inaccurate in aiding the diagnose such conditions. Therefore, whether or not an MRI truly shows vertebrogenic changes, it may or may not be the cause of the condition. However, patient’s are left feeling that there’s nothing that can be done.

The lumbar facets joints are true joints with a synovial fluid and joint capsule as with all of the joints in the body. They exist from the top of the neck down to the sacrum. Pain from the facet joints are as common as pain disk emanating from the intravertebral discs. And as all of the joints of the body, they can degenerate over time. A patient may have pain from the facet joints but have little or no MRI findings, or conversely a patient may an MRI which shows significant changes of the facet joints, but which are not symptomatic.

Treatment of facet arthritis similar to any back condition.

If conservative treatment fails then a diagnostic nerve block can confirm the condition. One or two treatments can lead to permanent benefit; or if necessary more definitive treatment options include Facet Rhizotomy or Radiofrequency ablation

In conclusion, if you are told you have arthritis in your spine, you should get a second opinion from a well trained interventional pain specialist. Certainly vertebrogenic back conditions, of which facet arthritis is one, is common. However the connotation of the word arthritis suggests an incurable condition, and this certainly is not the case. I have successfully treated thousands of patients with such conditions in my over 20 years of practice.

Author
Dr. Todd Koppel

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