Definition

Vertebral osteoarthritis (OA) is a condition that causes damage to the cartilage and discs in the spine, specifically in the neck and back. It is also known as degenerative joint disease because it worsens over time. In this condition, the protective cartilage that cushions the bones in the joints gradually degenerates or breaks down.

Causes

Vertebral OA is primarily associated with aging, but younger individuals can also develop this condition due to:

• Joint injury
• Genetic disorders affecting the cartilage

Risk Factor

Vertebral OA is more common in men under 45 years of age. After this age, it tends to occur more frequently in women. The condition is also more common in individuals who are overweight or those who engage in physical activities or occupations that put repeated stress on the spinal joints.

Symptoms

Vertebral OA is more common in men under 45 years of age. After this age, it tends to occur more frequently in women. The condition is also more common in individuals who are overweight or those who engage in physical activities or occupations that put repeated stress on the spinal joints.

In addition to its physical effect, someone with an OA vertebra can also experience social and emotional disorders. For example, someone with an OA vertebra that is impaired in their activity and ability to work can feel depressed or helpless.

Diagnosis

The diagnosis of vertebral osteoarthritis (OA) is confirmed through a combination of a medical interview, physical examination, and additional diagnostic tests.

Medical Interview

The medical interview is conducted between the patient and the doctor, during which the doctor will inquire about:

• Current symptoms

• Personal medical history

• Family medical history

• Any relevant past medical conditions

Physical Examination

Following the interview, the doctor will perform both a general and a specific physical examination. During the general examination, the doctor will check your blood pressure, respiratory rate, pulse, and body temperature. The specific examination focuses on evaluating the condition of your spine, checking for signs of pain, tenderness, or restricted movement in the neck or back.

Diagnostic Tests

To confirm the diagnosis of vertebral OA, a radiological examination such as an X-ray is often the best method. The doctor will review your medical history and perform a physical examination to look for pain, tenderness, or limited movement in the neck or lower back. They may also check for nerve involvement by testing for weakness, reflex changes, or numbness.

Several tests may be recommended to further diagnose vertebral OA:

• X-rays: These can detect bone damage, bone spurs, and any issues with cartilage or discs. However, X-rays may not detect early cartilage damage.

• Blood tests: These help rule out other conditions that may cause similar symptoms.

• MRI: This scan can reveal disc damage or any narrowing of the spinal cord.

Management

Treatment for vertebral OA primarily focuses on alleviating pain and improving daily functioning. The goal is to help the patient maintain a healthy lifestyle and manage symptoms effectively.

Initial treatments may involve weight management, if necessary, and ensuring a healthy weight through regular exercise. In addition to weight management, exercise can also help:

• Increase flexibility

• Enhance mood and outlook

• Strengthen the heart

• Improve blood circulation

• Make daily tasks easier

Effective exercises for vertebral OA include swimming, walking, and water aerobics. Exercise can be categorized into the following types:

• Strength training: Exercises aimed at strengthening the muscles that support the joints, using weights or resistance bands.

• Aerobic exercise: These activities improve the strength of the heart and circulatory system.

• Flexibility training: Exercises designed to increase body flexibility.

While rest intervals between therapy sessions are essential, prolonged bed rest or the use of splints, braces, or traction is not recommended.

Non-medication therapies for vertebral OA include:

• Massage
• Acupuncture
• Heat or cold compresses: Applying ice or heat to the affected joint for relief.
• Transcutaneous electrical nerve stimulation (TENS): A small device that delivers electrical pulses to the affected area.
• Nutritional supplements

Pain management is an important aspect of treatment. Over-the-counter medications like acetaminophen or paracetamol can help control pain.

Non-steroidal anti-inflammatory drugs (NSAIDs), available over the counter in certain doses, such as aspirin, naproxen, and ibuprofen, can also be effective. However, these medications come with potential side effects, including the risk of heart attack, stroke, stomach irritation, bleeding, and, in rare cases, kidney damage.

Topical ointments and creams are available for pain relief, though they tend to be less effective compared to other treatments.

Doctors may recommend prescription medications to manage the symptoms of vertebral osteoarthritis (OA), but these medications will not cure the condition. The options include prescription pain relievers, mild narcotics, or corticosteroid injections into the spine, known as epidural steroid injections. It's essential to understand that these injections do not cure the condition and are sometimes used without clear long-term benefits. Oral steroid medications are generally avoided for this purpose.

While surgery is not typically required for vertebral OA, there are instances where it may be necessary. Vertebral OA can contribute to vertebral stenosis, which is the narrowing of the spinal canal. Surgery is usually recommended in cases where there is bladder or bowel dysfunction, nerve damage, or increasing difficulty walking.

Complications

Vertebral OA is a chronic, progressive disease that can worsen over time. Although some people may only experience mild discomfort, if untreated, it can interfere with daily activities and lead to long-term disability.

Prevention

Although some factors contributing to vertebral OA are beyond your control, such as past injuries, genetics, and aging, there are several measures you can take to reduce your risk:

• Maintain a healthy weight: Obesity is a significant risk factor for developing vertebral OA. Maintaining a healthy weight through a balanced diet and regular exercise can help prevent vertebral OA. In addition, it offers numerous other health benefits and reduces stress on your joints.

• Exercise regularly: Regular physical activity is not only good for weight management, but it can also strengthen the muscles around your joints. Stronger muscles offer added protection against joint damage, which is often the cause of vertebral OA.

• Avoid injuries: Joint injuries that don’t heal properly or cause long-term damage can contribute to vertebral OA. Always wear protective gear during sports or activities with a higher risk of injury. It’s also important to stretch before and after exercise and learn proper techniques to avoid injury.

When to See a Doctor?

If you experience persistent neck or back pain or stiffness for more than two weeks, it is important to seek a medical evaluation.

You should seek immediate medical attention if you experience:

• Urinary incontinence

• Bladder or bowel control issues, such as an inability to control urination or bowel movements

• Tingling or numbness in the genital area or buttocks

• Weakness in the legs

• General weakness, fever, or cold sweats

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