What Can Be Done for Arthritis in the Back?

Arthritis causes inflammation in any part of a joint, including the joint lining (synovium), cartilage, bones, and supporting tissues. Treatment for arthritis in the back can include medication, radiofrequency ablation, lifestyle modifications, weight loss, exercise, physical and occupational therapy, postural training, quitting smoking, being more active if sedentary, surgery, and lumbar disc replacements.

Arthritis describes over 100 different conditions that involve inflammation of any part of a joint, including the joint lining (synovium), cartilage, bones, and supporting tissues. Arthritis may affect one, a few, or many joints throughout the body.

Numerous types of arthritis can affect the back, including:

• Osteoarthritis, which is the most common form of back arthritis
• Spondyloarthritis, which causes inflammation in the spine and includes:
  • Axial spondyloarthritis
  • Psoriatic arthritis
  • Reactive arthritis
  • Enteropathic arthritis
  • Undifferentiated spondyloarthritis
• Rheumatoid arthritis (RA), which is a chronic autoimmune condition

Treatment for arthritis in the back depends on the patient’s age, level of pain, type and severity of arthritis, and any other underlying medical conditions. Joint damage caused by arthritis is irreversible but there are a number of things that can be done for arthritis in the back to manage pain and prevent further damage.

Treatments for arthritis in the back include:

• Medications 
  • Pain relievers, such as acetaminophen (Tylenol) 
  • Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) or naproxen (Aleve)
  • Corticosteroids for inflammation
  • Disease-modifying anti-rheumatic drugs (DMARDs) such as methotrexate and biologic medications 
  • Antibiotics for bacterial joint infections
• Radiofrequency ablation, an outpatient procedure in which nerves are burned with a needle to relieve pain
• Lifestyle modifications 
• Weight loss if overweight or obese
• Regular exercise 
  • Gentle exercise such as stretching in yoga and Pilates may help relieve pain for axial spondyloarthritis
  • Strength training and flexibility exercises help strengthen core and back muscles can help prevent further joint degeneration in osteoarthritis
  • Cardiovascular exercise, such as walking, swimming, or cycling promotes circulation in the spine 
• Physical and occupational therapy
• Postural training 
• Don’t smoke
• Avoid being sedentary
  • If your job keeps you seated at a desk for long periods, take breaks or try a standing desk
• Surgery
  • This is a last resort: only about 5% of patients will need surgery
  • Types of surgery used depend on the type of arthritis and part of the back that is affected
  • Surgery for arthritis in the back includes: 
    • Spinal fusion
      • Fuses two or more vertebrae together permanently
      • May be indicated if there is a danger to nerves or in cases of severe disabling back pain, such as in cases of severe spinal arthritis causing deformity or for scoliosis
  • Lumbar disc replacements
    • A worn or degenerated disc in the lower part of the spine is replaced with an artificial disc made of metal or metal and plastic
    • Good candidates are not overweight, have not had previous spinal surgery, and back pain is mainly from one or two discs in the lower spine