Osteoarthritis
Wear of the cartilage in the small joints of the spine that can cause back or neck pain, stiffness, and, when bone spurs form, nerve compression.
Quick Answer
Osteoarthritis of the spine is wear of the cartilage in the facet joints that connect the vertebrae. As cartilage thins, the joints can become painful and stiff, and the body may form bone spurs that narrow the space around the nerves. It commonly causes back or neck pain and stiffness, often worse with activity. Most cases are managed with exercise, therapy, and medication; procedures are considered when nerve compression or joint pain persists.
Key Takeaways
- Spinal osteoarthritis is cartilage wear in the facet joints of the spine.
- It commonly causes back or neck pain and stiffness that varies with activity.
- Bone spurs from arthritis can narrow the canal and compress nerves.
- Most cases respond to exercise, therapy, and anti-inflammatory care.
- Injections or, less often, surgery are used when symptoms persist.
At a Glance
| What it is | Cartilage wear in the spinal facet joints |
|---|---|
| Common symptoms | Back or neck pain and stiffness, often activity-related |
| Can contribute to | Bone spurs, spinal stenosis, nerve compression |
| Who it affects | More common with increasing age |
| First-line treatment | Exercise, physical therapy, anti-inflammatory medication |
| Further options | Facet joint injections; surgery if nerve compression persists |
Symptoms
Spinal osteoarthritis typically causes back or neck pain and stiffness. Pain is often worse in the morning or after inactivity, may loosen with gentle movement, and can increase again with prolonged activity. Some people feel or hear grinding in the joints, and the affected area may feel tender.
When arthritis leads to bone spurs that narrow the space around the nerves, it can produce radiating symptoms such as pain, numbness, or tingling in an arm or leg, or the walking-related leg symptoms of spinal stenosis. These nerve-related features, rather than the joint pain itself, often prompt further evaluation.
Common Warning Signs
- Back or neck pain and stiffness
- Pain worse after inactivity that eases with movement
- Grinding or tenderness in the spine
- Pain that increases with prolonged activity
- Reduced flexibility of the spine
When to Seek Care Promptly
- Radiating pain, numbness, or weakness in a limb
- Leg symptoms brought on by walking
- Progressive weakness or hand clumsiness
- Loss of bladder or bowel control
- Severe pain after injury
Diagnosis
Diagnosis is based on the history and examination, supported by imaging. X-rays can show joint space narrowing, bone spurs, and other arthritic changes. MRI is used when nerve compression is suspected, since it shows the nerves and any associated stenosis.
Because arthritic changes are common on imaging in people without symptoms, findings are interpreted together with the clinical picture. In some cases a diagnostic facet joint injection is used to confirm that a specific joint is the source of pain.
Treatment
Most spinal osteoarthritis is managed without surgery. Regular low-impact exercise, physical therapy to build supporting strength and flexibility, weight management, and anti-inflammatory medication improve pain and function for most patients. Heat, activity pacing, and posture strategies also help.
When pain is localized to specific arthritic joints, facet joint injections or related procedures can provide relief and confirm the pain source. Surgery is uncommon and is reserved for cases where arthritis causes nerve compression, such as spinal stenosis, that does not respond to conservative care. At Atlantic Brain and Spine, those cases are reviewed through the spine board.
The Diagnosis-to-Treatment Pathway
1. Clinical evaluation
History and exam characterize pain, stiffness, and any nerve symptoms.
2. Imaging
X-ray shows arthritic changes; MRI assesses nerve compression if needed.
3. Conservative care
Exercise, therapy, and anti-inflammatory medication are the foundation.
4. Targeted injection
Facet joint injection relieves and confirms joint-related pain.
5. Surgical review
Persistent nerve compression prompts spine board evaluation.
6. Decompression if needed
Surgery relieves stenosis or nerve compression when present.
7. Long-term management
Ongoing conditioning maintains mobility and controls symptoms.
Frequently Asked Questions
It is arthritis affecting the facet joints of the spine, where cartilage wears down over time. This can cause pain and stiffness, and the body may form bone spurs that narrow the space around the nerves. It is a common part of spinal aging.
Degenerative disc disease affects the discs between the vertebrae, while osteoarthritis affects the facet joints. They often occur together as part of general spinal degeneration and can both contribute to back pain and, at times, nerve compression.
There is no cure for the arthritic changes themselves, but symptoms can be managed effectively for most people with exercise, therapy, and medication. The goal is to control pain, maintain mobility, and address any nerve compression that develops.
Rarely. Surgery is considered mainly when arthritis leads to nerve compression, such as spinal stenosis, that causes limiting symptoms unresponsive to conservative care. The joint pain of arthritis alone is usually managed without surgery.
Facet joint injections can relieve pain from arthritic joints and also help confirm which joints are responsible. Relief varies in duration and the injections are often combined with therapy for lasting benefit.
Low-impact activity such as walking, swimming, or cycling, combined with stretching and strengthening guided by a physical therapist, generally helps. Staying active reduces stiffness and supports the spine, while your care team can tailor a program to your symptoms.
Specialists Who Treat Osteoarthritis
Your care is provided by Atlantic Brain and Spine's spine team, including fellowship-trained neurosurgeons and orthopedic spine surgeons.
Related Articles
View All Articles
Back on the Field: How Pediatric Pars Repair Helped a Teen Athlete Return to Soccer
After months of back pain threatened his soccer career, 16-year-old Nathan Young found the right diagnosis and a…
He Could Barely Walk. Robotic Spine Surgery Got Him Back on His Feet.
After more than a year of back pain, leg numbness, and temporary fixes, Jeff Bigley could barely walk.…
What Patients Wish They Knew Before Spine Surgery
Lauren Eskuchen, APN, Director of Nursing at Atlantic Brain and Spine, shares what patients should know before spine…
A New Era in Spine Surgery: Preserving Motion, Protecting Quality of Life
Spine surgery is no longer focused solely on relieving pain. Learn how motion-preserving procedures are helping patients maintain…
