FAQ’s on Treatment for Arthritis – Extremities & Spine

The spine contains 24 vertebrae that are separated by cushioning discs. These structures support the spine, allowing for movement and proper alignment. Arthritis occur from degeneration of the spinal components. In the joints, arthritis occurs from wear-and-tear of the cartilage. In addition, arthritis of the joints is associated with bone spur formation.

How common is arthritis?

According to research, arthritis affects around 80% of people age 55 and older in America. By the year 2020, more than 60 million people will suffer with some type of arthritis.

What are the most common types of arthritis?

The most common type of arthritis is osteoarthritis. However, other common forms include rheumatoid arthritis, juvenile arthritis, psoriatic arthritis, ankylosing spondylitis, and systemic lupus erythematosus. Cervical spondylosis is a type of arthritis that affects the neck (cervical) vertebrae, and lumbar spondylosis is when arthritis occurs in the lower back (lumbar region).

Who is at risk for arthritis?

Certain people are more at risk for developing arthritis than others. Risk factors that contribute to arthritis include:

Injury/trauma – Such as fractures or severe sprains.

Age – This condition is more common among people age 50 years and older.

Obesity – Excessive weight will cause stress on the joints.

Chronic illnesses – Includes cancer, diabetes, and/or liver disease, as well as certain infections (Lyme disease).

Gender – Females are twice as likely to develop arthritis.

What are the general symptoms of arthritis?

The most common symptoms of arthritis include joint pain, inflammation, and stiffness. Some people report a crunching feeling of the bones. For the spine, arthritis symptoms include pain that comes and goes, stiffness upon rising or after exercise, and lower back pain that radiates to the thighs or buttocks. Limited range of motion of the joints and spine is also a symptom of arthritis, along with problems walking or bending.

How is arthritis diagnosed?

If you suspect you have arthritis, you should mention your symptoms to the doctor. He will assess your medical history and do a physical examination. When examining your spine, the doctor will assess range of motion and mobility with certain exercises. Tests used to assess arthritis include:

Blood tests

X-rays

Magnetic resonance imaging (MRI)

Computed tomography (CT)

What are the treatment options for arthritis?

Intra-articular corticosteroid injection – In a recent study, patients who had injections of bupivicaine and       triamcinolone were found to have significant pain improvement and joint function compared to those who received a placebo injection. With this procedure, success rates are documented as high as 90%.

Medications – For arthritis, medications prescribed include non-steroidal anti-inflammatory drugs (NSAIDs), topical agents (capsaicin, camphor, and menthol), and narcotic analgesics.

Physical therapy – Patients who participate in physical therapy have pain relief, improved range of motion, and strengthened muscles. In addition, alleviation of pain include ultrasound treatments, massage, and heat/cold therapy. According to a recent study, physical therapy improved pain scores and mobility in arthritis patients by more than 50%.

Sacroiliac joint injection – With this procedure, the doctor injects the sacroiliac (SI) joints with corticosteroid, and possibly, an anesthetic agent. According to a recent research article, this procedure has a 70% efficacy rate.

Medial branch block – For pain relief, the doctor can inject the facet joints of the spine with a long-acting anesthetic, followed by use of radiofrequency energy to destroy a portion of the nerve root. In a recent study, use of this procedure proved effective, with pain relief lasting for several months. The success rate is 85-90%.

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