Have you been told by your doctor that you have arthritis of the spine, spondylosis, bone spurs, or degenerative disc disease (DDD)? Each of these terms means basically the same thing and are very commonly used by doctors to describe what are mostly natural changes in the joints and spine that occur over time. Typically, the term “arthritis” is used when pain is present and imaging studies (such as an MRI or X-ray) indicate degenerative changes. The medical term for this is osteoarthritis.
Arthritis of the spine describes a host of changes in and around the joints of the spine as a result of lost disc height between the vertebrae. It’s present in some degree in most people after 40 years of age. Note: this article is about osteoarthritis, by far the most common form of arthritis and the type commonly referred to as just “arthritis. This is very different from inflammatory arthritis, which is much rarer and includes conditions such as rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis. See articles specific to those conditions for further information.
Spinal Discs–Small but Essential
The spine is made up of a group of bones called vertebrae that are stacked on top of each other with shock-absorbing discs between each bone. The discs are made of a fibrous outer layer and jelly-like inner layer. The jelly-like inner layer of the disc, called the nucleus, has no direct blood supply and needs alternating compressing (think: sitting) and decompressing (think: physical activity such as walking) forces to receive nutrients from the body and stay healthy.
The Degenerative Disc Process
As people age, the compressing forces tend to greatly outnumber the decompressing forces placed on the discs. The forces of gravity and muscle contractions press the vertebrae together and compress the discs. Years and years of pressure dehydrate the discs and they shrink and wear down. In this degenerative condition the discs’ ability to absorb shock is compromised. As one part of the spine deteriorates, it directly affects nearby regions. Hence, as you lose disc height and function, the vertebral facet joints take on more of your body weight. Because these joints are constantly involved with spine motion, they wear down and lose cartilage, a process that is quickened as the joints take on additional weight loads—work that was intended for your discs. This deterioration process often results in bone spurs called osteophytes, and when the bone spurs cause pain, it’s often referred to as arthritis.
What Causes Arthritic Pain?
Pain can result from ongoing irritation caused by putting pressure on structures that have worn down. One common area for irritation, and therefore pain, is the facet joints. It’s important to note that just because you may have findings of arthritis, spondylosis, bone spurs or degenerative disc disease on an MRI or X-ray, it doesn’t mean that the condition will cause pain or be the cause of the pain that you’re experiencing. Many people with findings of arthritis on their imaging studies have pain that’s caused by the muscles that surround the joints, not the joints themselves. When muscles are trying to stabilize and protect arthritic joints, yet are too weak or out of balance, they can tighten up, causing significant pain. Many people are surprised to find that their muscle pain is a 10 out of 10 on the pain scale.
Treatment for Arthritis
The good news: pain from arthritis can be treated very effectively at home with exercise and behavior modification. All current research and leading doctors concur: healthy movement is one of the most important steps patients can take to treat pain from arthritis. It is very rare for someone to need surgery or drugs for arthritis pain if they follow the right exercise plan.
Written by Dr. Jeremy James. Dr. James founded and was director of the Aspen Club Back Institute in Aspen, Colorado, is the coauthor of the bestselling The Younger Next Year Back Book and earned his Doctor of Chiropractic from the University of Western States. Learn more about Dr. James here.