One of the most common side effects of aging is the phenomenon of arthritis. It is a situation where a person continues to make cartilage to cover the joints, but starts to lose it at a rate faster than production.
The joints of the spine, called facet joints, are no exception to this situation. Similar to an extremity joint such as the hip or the knee, the facet joints can experience degeneration from arthritis and chronic back pain as a result.
The decision to have a total joint replacement with hip or knee degeneration is an elective one that usually works very well for patients. In fact, hip and knee replacements are two of the top operations for improving a person’s quality of life.
What it comes to spinal arthritis however, spinal surgery is typically not such a fantastic idea. If a person has an associated degenerative scoliosis then it may be indicated, or if significant nerve root compression is present that could be an option. Additionally, if one has spinal instability then fusing those levels may provide significant pain relief and a great outcome. But typically, if a person has spinal arthritis at multiple levels then putting that person through a spinal fusion of all those levels does not produce the great outcomes like a hip or knee replacement. There is no satisfactory facet joint replacement that exists yet.
Here are 10 nonoperative methods of achieving pain relief when dealing with spine arthritis.
1. Over-the-counter medications. These include Tylenol and nonsteroidal anti-inflammatories such as ibuprofen. They may help with mild to moderate pain and should always be taken according to the manufacturers dosing recommendations. As long as a person makes sure not to mix too many anti-inflammatories along with steroids, they can usually be taken on a regular basis.
2. Physical therapy. When it comes to arthritis treatment, treatment for spinal arthritis conceptually is not different than that of an extremity such as the knee. The objective is to strengthen up the muscles around the spine as well as in a person’s core, which includes the abdominal muscles. What this will do is take pressure off of the arthritic joints and help to relieve pain in the process. Along with the strengthening, having the patient go through a stretching regimen can also relieve pain.
3. Chiropractic treatment. Chiropractic manipulations will not cure arthritis or provide permanent pain relief. However, when done on a regular basis, spinal manipulations can achieve significant pain relief. in addition, chiropractic offices often perform electrical stimulation along with spinal decompression therapy.
4. Spinal decompression therapy. While on the subject of chiropractic manipulations, another treatment often seen in chiropractic offices is spinal decompression therapy. It is an intermittent form of spinal traction that tricks the spinal musculature into not going into spasm while decompressing the arthritic joints and disks. This can provide relief of pain and allow oxygen and nutrients with the increased blood flow to come into the damaged areas. It has been shown to provide spinal arthritis relief for months at a time.
5. Short-term narcotic medications. Taking narcotics chronically for spinal arthritis is a bad idea as the risks starts to outweigh the benefits such as with addiction and tolerance. However, in acute exacerbation phases, the short-term narcotics can help the patient significantly to perform the activities of daily living.
6. Neurologic modifying medications. Often times when a person has spinal arthritis they often have associated spinal stenosis. This is when bone spurs and overgrown soft tissue pinch on spinal nerves and cause pain to be referred down into the buttock area, the hip region, and into the lower extremities. Medications such as Lyrica or Neurontin can provide excellent pain relief for spinal stenosis. It is not known exactly how these medications work, but they are non-narcotic and non-addictive.
7. Medial branch blocks and facet injections. This is when numbing medicine is injected around the arthritic joints where the tiny little nerve endings (medial branches) bring sensation to the arthritic area. If pain relief occurs from the injection, it diagnoses that joint as a problem. It also may provide pain relief for a few months at a time. Facet injections are when the pain doctor puts numbing and steroid medicine right into the arthritic joints. They can provide excellent pain relief similar to the same type of injection going into an arthritic painful knee.
8. Radiofrequency ablation. This is one of the most technologically advanced procedures in pain management today. If a medial branch blockworks well and then wears off, radiofrequency ablation entails heating up the area around the arthritic joints and deadening the medial branch tiny nerve endings to provide pain relief. This may provide
pain relief for a few months upwards of two years. it can then be repeated if necessary.
9. Activity modification. This is when a patient avoids activities that exacerbate the person’s pain. For instance if jogging is a typical activity and exacerbates the back pain, then that person could switch to swimming or cycling as cross training to avoid that painful result.
10. Spinal bracing and Tens Units. Spinal bracing is not a good chronic answer for the pain of spinal arthritis. Studies have shown that it tends to make the muscles inactive around the spine and they can get atrophied as a result. Therefore, only short-term spinal bracing use is indicated for spondylarthritis. TENS units have been shown to be a noninvasive mobile device that has small pads over the painful areas. the device itself is about the size of an iPod and can fit on a person’s belt while the wires attached to foam pads on the skin emit small electrical impulses for pain relief. They can provide excellent pain relief and also decrease the amount of opiate medications or anti-inflammatory medications necessary.
Interestingly, all are provided by Arizona Pain Specialists with options customized to each patient’s needs. The Arizona Pain doctors are Board Certified and Fellowship Trained, serving the entire Valley out of multiple AZ pain center locations.
Call (602) 507-6550 today for more information and scheduling.