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What Are the Treatment Modalities for Arthritis of the Back?

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Back arthritis occurs due to the gradual wearing away of the cartilage discs present within the spine between the vertebrae. Read on to know more.

Medically reviewed by

Dr. Mohamad Ali Rida

Published At November 29, 2022
Reviewed AtJuly 16, 2023


The vertebrae are the small, interlocking bones of the spine collectively termed a vertebral column. Arthritis occurs due to the gradual wearing away of the cartilage discs present within the spine between the vertebrae. The pain and stiffness can sometimes even radiate to the upper and lower back.

What Are the Components of the Spine?

The entire spine comprises 24 vertebrae beginning at the skull base. The spinal cord and its nerve bundles pass through a tunnel-like structure composed of the foramina of these vertebrae relaying messages between the brain and the body. Each pair of vertebrae articulate at three joints called the intervertebral disk and two facet joints, with cartilages that cushion the ends of the bones to prevent wear and tear by everyday friction. The vertebrae are connected together by ligaments.

What Are the Non-surgical Treatment Modalities for Back Arthritis?

  • Mindfulness and meditation.

  • Diet.

  • Lifestyle modifications.

  • Injection-based treatments.

  • Alternative treatment modalities.

Pharmacotherapy or drug-based treatment modalities:

  1. Analgesics or painkillers, anti-inflammatory drugs such as Ibuprofen and Naproxen, skeletal muscle relaxants, and in extreme cases, opioid-based medications can be used for pain management. However, the adverse effects of the drugs, as mentioned before, should be considered, and prolonged use should be avoided.

  2. Opioid-based medications are not used as the first line of treatment and should be considered only for a long-term line of treatment. Most opioids are addictive and do not address the underlying cause of pain, and the body may build up a tolerance over time. A thorough examination by a specialist and only if other drugs have failed to provide relief should opioid therapy be considered.

Severe cases of back arthritis may require a surgical option to remove and reshape bone spurs, spinal fusion, or laminectomy surgeries.

What Is Spinal Fusion?

Spinal fusion is a surgical procedure where the vertebrae are permanently joined or fused into one single solid bone with no spaces between them. The vertebrae are the small, interlocking bones of the spine collectively termed a vertebral column. Bone grafts fill the naturally occurring space between the separate vertebrae, which is filled up and sealed when the bone heals.

What Are the Postoperative Complications of Spinal Fusion?

As with any major surgical procedure, spinal fusion surgery may also carry risks of certain complications, as follows;

  • Infection of the surgical site.

  • Blood clots in the head and neck or extremities.

  • Dissemination of blood clots to the lungs may be fatal.

  • Bleeding and blood loss may lead to death.

  • Respiratory distress.

  • Increased risk of a heart attack during an ongoing surgery.

  • Increased risk of strokes.

  • Delayed or inadequate wound healing due to systemic diseases such as diabetes.

  • Allergic or anaphylactic reactions to medications or anesthetic agents administered.

Certain rare complications may also be seen, enlisted as follows;

  • Infection in the treated vertebrae.

  • Damage to a spinal or cranial nerve or nerve root leads to weakness, pain, bowel or bladder problems, or neuralgic pain.

  • Stress on the bones adjacent to the surgically treated vertebrae due to loss of flexibility and increased stiffness.

  • Persistent pain at the donor bone graft site if an autograft is used.

  • Allergic reaction caused by synthetic bone grafts.

The most severe complications, as mentioned above, are blood clots, disseminated clots to other sites, and an infection of the surgical site, which have a high chance of occurring during the first few weeks of the postoperative recovery phase.

Removal of the hardware is necessary in case of postoperative pain or discomfort, and emergency help should be sought if one experiences any of the symptoms of a blood clot enlisted as follows;

  • Sudden swelling in the calf, ankle, or foot.

  • Redness or tenderness is seen either above or below the knee.

  • Calf pain.

  • Groin pain.

  • Shortness of breath or difficulty breathing.

A patient should seek emergency help if any of the symptoms of infection are seen, enlisted as follows;

  • Redness or swelling at the edges of the surgical site.

  • Fluid drainage, such as blood or pus from the surgical site.

  • Fever, chills, or elevated body temperature over 100 degrees Fahrenheit.

  • Shaking and malaise.

What Is Laminectomy?

Laminectomy is also known as open decompression. It is a surgical procedure aimed at the treatment of central spinal stenosis. The spinal canal narrowing is also a possible indication of this procedure. The posterior part of the vertebra or lamina is removed to provide more space for the compressed spinal cord or nerve roots. When non-surgical treatments such as physiotherapy, pain medications, and epidural steroid injections fail to improve after 8 to 12 weeks, this procedure may be considered depending on several factors.

What Are the Risks of a Laminectomy Procedure?

Any surgical procedure is not free from the risk of intraoperative or postoperative complications such as;

  • Bleeding from the surgical site.

  • Infection of the surgical site.

  • Blood clots in the legs can disseminate to the lungs.

  • Injury to the spinal cord or nerve root.

  • General anesthesia-related risks.

  • Injury to the local nerve or blood vessels in and around the surgical site.

  • Rarely the pain may either not subside or be aggravated postoperatively.

What Does Postoperative Recovery Look Like After Surgery?

A postoperative hospital stay of one to four days is typically required following laminectomy. The patient is kept under observation by the hospital staff for any complications. In addition, a physical therapist is appointed who works with the patient during the hospital stay to help with a guided rehabilitation program.

Recovery typically depends on the patient's fitness and level of activity before the surgical procedure is conducted. Physical therapy may be advised to improve presurgical activity levels to encourage better postoperative recovery. It typically takes four to six weeks until normal function is established.

Is Back Arthritis Preventable?

Back arthritis is an age-related condition. Thus there are no preventive measures as such. However, preventing repetitive strain from profession or hobbies, using self-help guides, periodic consultations with specialists after the specified age of occurrence, and physical therapies as and when necessary, could likely delay and deter the rate of degeneration and degradation.


Back arthritis usually occurs as a manifestation of the aging process. However, it can also result from prior injuries caused by trauma or repetitive strain. The underlying cause behind some cases of the chronic back is difficult to pinpoint. If the source of the pain is obscure or treatment is not possible, the best option is to reduce the intermittent flare-ups and pain management with non-surgical treatment modalities. When non-surgical and drug-based therapies fail, a surgical option must be sought.

Frequently Asked Questions


What Are the Features of Arthritis in the Back?

Arthritis of the back can cause various symptoms such as chronic pain and stiffness in the lower or upper back, difficulty moving or performing daily activities, limited range of motion, swelling and tenderness in the affected joints, and the development of bony growths known as bone spurs. In some cases, people with arthritis of the back may also experience fatigue, muscle weakness, and decreased endurance.


What Is the Management of Arthritis in the Back?

Arthritis in the back can be managed through a combination of medication, physical therapy, lifestyle changes, and in some cases, surgery. Medications, such as nonsteroidal drugs and painkillers, reduce pain and inflammation. Physical therapy can improve mobility and strength, and exercises such as yoga and swimming can help relieve pain and stiffness. In addition, losing weight, maintaining good posture, and avoiding high-impact activities can help alleviate symptoms. In extreme cases, surgery is recommended.


Is Back Arthritis a Serious Condition?

Arthritis of the back can range in severity and impact a person's daily life. It can cause chronic pain and limited mobility in some cases, and in severe cases, it can greatly affect the quality of life. It is important to consult a physician for proper diagnosis and treatment options. 


In Which Region Does Arthritis in the Back Hurt?

Arthritis in the back can cause pain in various regions of the spine, including the neck (cervical spine), upper back (thoracic spine), and lower back (lumbar spine). The specific location of the pain may depend on the type and severity of arthritis.


What Are the Diagnostic Tests for Arthritis in the Back?

Diagnostic tests for arthritis in the back typically include physical examination, imaging tests such as X-rays, MRI, and CT scans, and sometimes a joint fluid analysis. Blood tests, such as rheumatoid factor and anti-CCP, may also be performed to check for underlying conditions that can cause arthritis. In some cases, a nerve conduction study may be done to check for nerve damage. The doctor may also ask about the medical history and symptoms and perform a thorough physical examination to determine the best course of treatment.


Will X-rays Help to Determine Arthritis in the Back?

X-rays can help in diagnosing arthritis in the back. X-rays show the bones and joints and can help determine if there is any damage or changes to the joint that may suggest arthritis. However, they may not show early signs of arthritis, so other tests, such as MRI or CT scans, may be needed to get a complete picture. 


Is Walking Beneficial for Arthritis in the Back?

Walking can benefit people with arthritis in the back as it can help reduce pain and stiffness, improve mobility and flexibility, and maintain a healthy weight. However, it is important to talk to a doctor before starting a new exercise routine, as the type and intensity of exercise may vary depending on the individual's condition and needs.


What Are the Causative Factors for the Flaring Up of Arthritis in the Back?

Arthritis in the back can flare up for various reasons, such as increased physical activity, overuse, injury, stress, changes in weather, and underlying medical conditions such as osteoporosis or other inflammatory conditions. Flare-ups can also occur when the joint is overstressed or if the surrounding muscles are weak and unable to provide proper support. Poor posture and inactivity can also increase the risk of flare-ups.


Why Does Arthritis in the Back Cause Pain?

Arthritis in the back can cause pain due to inflammation in the spinal joints and surrounding tissues. As the cartilage in the joints wears down, bones can rub against each other, causing pain and reducing mobility.


Is Arthritis in the Back Taken Into Consideration as a Disability?

Arthritis can be considered a disability if it affects a person's ability to perform daily activities and work. However, whether someone with back arthritis specifically is considered a disability would depend on the severity and specific impact of their condition.


What Is the Correct Sleeping Position for Back Arthritis?

For individuals with back arthritis, sleeping on their back with a pillow under their knees is often recommended to relieve pressure on the lower back and spine. Additionally, placing a small pillow under the lower back can help maintain the spine's natural curvature. Avoid sleeping on stomach, as it can strain the neck and back.


What Exercises Are Recommended for Arthritis in the Back?

Low-impact exercises such as swimming, walking, cycling, and water aerobics are great for people with lower back arthritis. These exercises help to reduce pain and improve flexibility without putting excessive stress on the joints. Yoga and Pilates can also be helpful as they focus on strengthening the muscles around the spine and improving posture.


Are Chiropractors Beneficial for Arthritis in the Back?

Chiropractors can help manage symptoms of back arthritis, but they cannot cure the condition. However, chiropractic care can help improve mobility and reduce pain and inflammation in the affected joints. Treatment may include manual adjustments, exercises, and lifestyle changes to support overall spinal health.
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Dr. Mohamad Ali Rida
Dr. Mohamad Ali Rida



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