Back Arthritis is a Royal Pain

Back arthritis is one of the most typical causes of back pain. Degenerative arthritis, also known as osteoarthritis, is the most common form of arthritis affecting the spine. Arthritis of the back does not necessarily mean a lifetime of pain.

The most frequent of many treatment options are non-steroidal anti-inflammatory drugs (NSAIDs). However, increasing numbers of people are seeking safer natural alternatives such as glucosamine, boswellia, fish oil and GLA to treat their painful arthritis symptoms to escape adverse side effects from drugs.

Arthritis can affect any part of the body. The term arthritis comes from "arthros", which means a joint and its attachments, and "-itis" meaning inflammation. Osteo- (meaning bone) arthritis mostly affects the weight bearing joints (hips and knees) plus the hands, ankle/feet and spine.

It surprises some to learn that natural remedies can be as effective, if not more so, than over-the-counter or prescription drugs for arthritis back pain. Plant and herbal substances are extremely well-tolerated in the stomach. As a bonus, they help to regenerate cartilage and can improve joint health, which anti-inflammatory drugs cannot.

My husband and I successfully treat osteoarthritis with natural supplements. We do not have back arthritis, but I've had recurring low back pain since my auto accident in 1991. I know what it’s like to be sidelined with lumbar pain that restricts even the most basic of activities, including getting out of bed, brushing my teeth, or using the rest room.

Because my pain comes and goes, I have not yet been diagnosed with low back arthritis. I am unable to handle painkilling drugs of any kind—they all mess up my stomach and give me more problems than the back pain itself.

Anatomy of the spine and arthritis

Back arthritis can occur in different segments of the spine. Looking at the spine from top to bottom, there are three main segments, plus the sacrum:

  1. The top segment is the cervical spine,
  2. The middle and longest segment is the thoracic spine
  3. The bottom segment is the lumbar spine.
  4. There’s another section below the lumbar, called the sacrum, which includes the coccyx (tip of the tailbone), but the sacrum is actually a group of specialized vertebrae than connects the spine to the pelvis.

Back arthritis can occur in any of these areas and occurs in the joints that connect each spinal segment, or vertebrae. The vertebrae are connected in three places. In front of the spinal cord, the vertebrae are connected by two small joints called facet joints. Together with the cushion-like spinal disc, these facet joints permit normal movements of the spine, such as bending, arching and twisting.

When facet joints become arthritic, spinal movements become painful and stiff.

Back arthritis can appear anywhere along the spine, as follows:

  1. The cervical spine. Arthritis here is called cervical spondylosis, or neck arthritis.
  2. The thoracic spine. Arthritis here is called thoracic arthritis
  3. The lumbar spine. Arthritis here is called lumbar spine arthritis or lumbar arthritis
  4. The sacrum. Arthritis here is called lumbosacral arthritis

What is spondylosis?

Spondylosis is arthritis that affects the spine. Spondy means spine; losis means problem. While spondylosis, then, is a problem with the spine, doctors today use it more specifically to describe back arthritis in the spine.

You can have spondylosis in your neck (cervical spine), mid-back (thoracic spine), or low back (lumbar spine).

Spondylosis is degenerative arthritis of the spinal vertebra and related tissue. It’s a natural part of aging as our body joints tend to “wear out”.

You may hear spondylosis referred to by other names, including spinal arthritis or spinal osteoarthritis.

What is degenerative disc disease?

Degeneration of the discs between the vertebrae along the spine is called degenerative disc disease. Because osteoarthritis and degenerated discs are commonly found together, the two terms may be used interchangeably. They are, however, separate conditions. Technically, degeneration of the disc is medically referred to as spondylosis, which can be noted on x-ray tests or an MRI scan as a narrowing of the normal disc space between adjacent vertebrae, reflecting a loss of water content in the disc.

Degeneration of the disc tissue makes the disc more susceptible to herniation and can cause local pain in the affected area. Any level of the spine can be affected by disc degeneration. When disc degeneration affects the neck, it is referred to as cervical disc disease. When the mid-back is affected, the condition is referred to as thoracic disc disease.

Disc degeneration that affects the lumbar spine is referred to as lumbago, which causes pain localized to the low back and is common in older persons.

What is ankylosing spondylitis?

Ankylosing spondylitis (AS), previously known as Bechterew’s disease and a form of spondyloarthritis is a chronic, painful, degenerative inflammatory arthritis primarily affecting spine and sacroiliac joints, causing eventual fusion of the spine. The most common form of inflammatory arthritis is rheumatoid arthritis.

AS is a autoimmune disease with a strong genetic pre-disposition. The typical patient is young, aged 18 to 30, with chronic pain and stiffness in the joints and ligaments of the lower part of the spine, often with sciatic pain.

Pain is more severe at rest and improves with activity, although movement during active phases of the disease may be severely limited. As with most types, there is no arthritis cure.

Men are affected by AS 3 to 1 more than women. Common side symptoms in 40% of cases, is eye pain and increased sensitivity to light, mouth ulcers, and fatigue. The disease may also cause inflammation and pain wherever tendons and ligaments attach to bones, joints in hips, shoulders, knees and feet, and between ribs and spine.

(Lumbar) lower back arthritis is most common

The most common location for back arthritis is the lumbar spine. The most common lumbar arthritis is osteoarthritis.

The lumbar spine has to bear much more weight than other sections of the spine. That means that its intervertebral discs (in the front) and spinal joints (in the back) are often over-burdened, which can lead to osteoarthritis.

The spinal joints are also called “facet joints” or “vertebral joints.” Most frequently, osteoarthritis affects the lowest vertebra of the lumbar spine, i.e. the 5th lumbar vertebra (also called the L5 vertebra), because it is subjected to more strain than all the others.

Lumbar spine arthritis can be seen in all age groups, but is most commonly seen in patients 50 or older, obese individuals, heavy laborers, overused joints from sports, family history, gender (women are twice as likely to get arthritis), chronic illnesses such as diabetes, cancer or liver disease, and those with previous spinal injury.

Back arthritis symptoms

Generally, the universal signs and symptoms of arthritis include inflammation, stiffness and pain in the joints. In the spine, regardless of the affected spinal segment, these symptoms may also include one or more of the following:

  • Spinal stiffness in the morning such as after getting out of bed or after activity. Often this pain decreases with rest or, for some, after light to moderate exercise. However, symptoms also often become worse with prolonged, strenuous or extreme activity.
  • Pain, tenderness or numbness in the neck
  • Lower back pain that runs down into the buttocks, thighs, or pelvic area, sciatica
  • Pain or tenderness in the shoulders, hips, knees or heels
  • A crunching feeling or sound of bone rubbing on bone
  • Weakness or numbness in legs or arms
  • Limited range of motion, difficulty bending or walking
  • Spinal deformity

When spinal arthritis worsens, the joints form bone spurs, the tissue swells from inflammation, and the nerves around these joints can become pinched. This condition is called spinal stenosis, which is often seen in patients with lumbar arthritis.

The most common symptoms of spinal stenosis are numbness, tingling and weakness. If the narrowing of the spine is in the neck region, the symptoms are felt in the arms. If the narrowing is in the low back area, the symptoms are felt in the legs.

With lumbosacral arthritis, the back pain may be concentrated in the pelvic region or between the lower rib cage and buttocks.

Diagnosis of back arthritis

Arthritis can only be diagnosed by a qualified medical practitioner. If your back pain is severe or is chronic (lasting more than three months) you should make an appointment with a medical doctor.

In addition to finding out about your pain history and treatment, the doctor will examine your back. You may be asked to perform a few simple movements or exercises to determine if your range of motion has been affected. For example, you may be asked to bend forward, side-to-side or backwards. You may be asked to lay down and raise your legs.

Because the symptoms of back arthritis are similar to other spinal conditions, it may be important for the doctor to rule out other possibly more serious problems. To do so, you may need one or more of the following tests:

  1. Blood tests - these will help determine the type of back arthritis.

  2. X-rays - these tests can show the structure of the vertebrae and the outlines of joints and can help determine if there has been any deterioration of cartilage.

  3. MRI (magnetic resonance imaging) - this test gives a three-dimensional view of parts of the back and can show the spinal cord, nerve roots and surrounding spaces.

  4. CAT scan (computerized axial tomography - this test shows the shape and size of the spinal canal, its contents and structures surrounding it. It shows bone better than nerve tissue.

  5. Bone scan - This test uses injected radioactive material that attaches itself to bone. A bone scan can detect arthritis, but may not be able to differentiate it from other disorders. Therefore, bone scans are usually performed along with other tests.

  6. Myelogram - a liquid dye is injected into the spinal column and appears white against bone on an x-ray film. A myelogram can show pressure on the spinal cord or nerves from herniated discs, bone spurs or tumors.

Treatment of back arthritis

While it depends upon the symptoms experienced by each patient, back arthritis treatment most always begins with simple measures and becomes more involved if improvement is not achieved.

The lumbar spine (low back) is the most common site of spinal arthritis, but the following treatments are available to treat all arthritis back pain and other symptoms:

  • Physical Therapy
    Physical therapy is used to strengthen the muscles of the lumbar spine. By better supporting the spine with stronger muscles, less of the burden is placed on the facet joints.
  • Weight Loss
    Losing weight is a difficult task in patients who have worn-out joints. However, losing even a small amount of weight is often a sufficient step to relieving pain from back arthritis.
  • Anti-Inflammatory Medications
    Non-steroidal anti-inflammatory drugs (NSAIDs) can decrease the amount of inflammation around the arthritic joints. By lowering the inflammatory response, pain is often alleviated. Always use anti-inflammatory medications under your doctor's supervision as all have some gastrointestinal side effects, including bleeding, so people with active ulcers or sensitive stomachs should be forewarned.
  • Natural Glucosamine, Cat’s Claw, Boswellia, Safflower and Menthol
    These are natural dietary supplements with the power to produce an effect of decreasing inflammation, swelling and stiffness from back arthritis without side effects or potential addiction like drugs. Because they’re from the plant world, they also deliver nutrients that promote improving overall joint health.
  • Ice & Heat Applications
    Ice and heat applications can be very effective at relieving pain from back arthritis.
  • Chiropractic Treatment
    Chiropractors treat spine alignment, often with a process called manipulation. These treatments do not alter the spinal alignment, but they can provide excellent relief of back pain or back arthritis symptoms.
  • Alternative Treatments
    Alternative treatments include acupuncture, massage, magnet therapy, natural remedies, and others. There is no doubt that many patients find significant relief from these types of treatments.
  • Epidural Injections
    Epidural injections are a way to administer a steroid shot around the area of the arthritis. Cortisone is a powerful anti-inflammatory medication. Using a needle allows the medication to be delivered right to the area of the arthritis.
  • Spinal Fusion Surgery
    Spine fusion is a surgical procedure used to eliminate movement between adjoining vertebrae. When all other treatments fail to provide relief of symptoms, a spine fusion may be a reasonable option for the treatment of severe facet arthritis.

Studies show effectiveness of NSAIDs and COX-2 inhibitors for low back pain but at the cost of statistically significant more side effects

In a systematic updated Cochrane review of randomized controlled trials reported in June, 2007 by PubMed, a service of the U.S. National Library of Medicine and the National Institutes of Health (NIH), a study was published: The objective was to assess the effects of non-steroidal anti-inflammatory drugs (NSAIDs) and COX-2 inhibitors in the treatment of nonspecific low back pain and to assess which type of NSAID is most effective.

In total, 65 trials (total number of patients = 11,237) were included in this review. Statistically significant effects were found in favor of NSAIDs compared with placebo, but at the cost of statistically significant more side effects. The evidence from the 65 trials included in this review suggests that NSAIDs are effective for short-term symptomatic relief in patients with acute and chronic low back pain without sciatica. However, effect sizes are small.

Furthermore, there does not seem to be a specific type of NSAID, which is clearly more effective than others. The selective COX-2 inhibitors showed fewer side effects compared with traditional NSAIDs in the randomized controlled trials included in this review. However, recent studies have shown that COX-2 inhibitors are associated with increased cardiovascular risks in specific patient populations.

GAIT study shows natural glucosamine better than Celebrex for moderate to severe osteoarthritis pain with zero side effects

One of the largest studies on glucosamine for arthritis was a 6-month clinical trial of 1583 patients sponsored by the National Institutes of Health (NIH) named Glucosamine/chondroitin Arthritis Intervention Trial (called GAIT).

The study results were announced Feb. 18, 2006 and showed showed glucosamine and chondroitin supplements were effective for pain relief for people who suffer from osteoarthritis and may also help to prevent cartilage damage.

The study compared the effectiveness of glucosamine hydrochloride (HCL), chondroitin sulfate, a combination of glucosamine and chondroitin sulfate, the COX-2 drug celecoxib (Celebrex), or a placebo. The results:

  • In patients with moderate-to-severe osteoarthritis knee pain, 79.2% taking glucosamine/chondroitin combination experienced pain relief.
  • For patients taking celecoxib, 69.4% experienced pain relief.
  • For patients taking glucosamine hydrochloride alone, 65.7% experienced relief
  • For patients taking chondroitin alone, 61.4% experienced pain relief.
  • For patients taking placebo alone, 54.3% reported pain relief (placebo affect in most studies is approximately 30%)
  • In patients with mild knee osteoarthritis pain, the glucosamine chondroitin combination was not significantly more effective than placebo.

Natural supplements are extremely safe

During the GAIT study, participants reported zero negative side effects from the use of glucosamine and chondroitin supplements.

Perhaps the main lure in using natural products in lieu of drug therapy for relief of back arthritis symptoms is their relative safety. They are easy on the stomach, and they help you feel better overall.

Natural anti-inflammatory products do not work as quickly as drugs, but once they kick in you notice the difference continually, and you stop experiencing and worrying about side effects like you do with drugs.

The choice is yours

As life expectancy continues to increase and people lead active lifestyles into their 80s and 90s, patient education on reducing risk factors and stresses on arthritic joints is critical to maintaining vitality.

There is only one underlying caution about using natural plant and herbal products—know that they’re high in quality. Dietary supplements are not regulated by the Food and Drug Administration (FDA) as stringently as drugs.

This website is devoted to educating the public about the differences in quality of supplements within the industry. Years ago when I was looking for safety and quality, I developed a list of 30 questions that ultimately led me to a 'beyond organic' dietary supplement company with irrefutable standards of excellence. I could feel the difference when using their products and I’m sure you will, too.

Recommended natural supplements for back arthritis

There are natural treatments for back arthritis that can have significant benefits. More and more, people are choosing safer alternatives to treat disc and joint pain due to arthritis.

My husband and I have used three high-quality natural pain products since they first were scientifically developed in 2003. I have neck arthritis from a 1991 lateral whiplash, my husband has osteoarthritis in both knees. I also have recurring back pain.

After extensively researching treatment options for back arthritis, we discovered natural treatments that we've had tremendous success using.

One of the products is a natural complex for chronic pain relief

A second is a natural complex for joint health

A third is a natural pain relief rub that we think is the best found anywhere on the market. We use each daily and can't imagine life without them.

For further details, click on three natural pain relief products, all of which contain natural arthritis-relieving nutrients and other special ingredients to help reduce inflammation, swelling and stiffness as well as protect the joints and provide long lasting pain relief.

From personal experience, I confidently recommend that you try one, two or all three of these natural safe treatments to see if they'll work for you for back arthritis pain, inflammation and stiffness:

The Pain Trio

Disclaimer: Health statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.

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