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Osteoarthritis of the vertebral joints
Degenerative processes that lead to osteoarthritis can affect not only the knees, hips and fingers, as is often known, but all joints. If the small joints on the spine are damaged, it is a spondylarthrosis (spondylarthrosis deformans), which can lead to pain and restricted movement. Often these are phenomena of the natural aging process, which are treated with medication as well as targeted exercises and manual forms of therapy.
Spondylarthrosis is a degenerative change in the vertebral joints on the spine. These joints are also called facet joints, which is why osteoarthritis in this area with corresponding symptoms is also known as facet syndrome (facet joint syndrome).
The small joints are located on both sides between the articular processes of two vertebral bodies and carry about a fifth of the load on the spine in an upright position or in motion. Together with the intervertebral discs, the vertebral joints provide the necessary mobility and stability of the spine. Damage to these joints, or to the articular cartilage, can restrict the movement function and lead to pain.
Degenerative spinal disorders are among the very common and natural signs of aging (wear), but they do not always lead to (permanent) complaints. Spinal wear and tear usually occurs on several structures at the same time or different pathological processes are mutually dependent.
Age-related changes to the intervertebral discs (chondrosis), including the adjacent vertebral bodies (osteochondrosis), or spondylosis (bony changes to the vertebral body edges) are diseases that often result in spondyloarthritis.
The vertebral bones protect the spinal cord, which consists of nerve fibers and passes the information on from the brain to the body. The small vertebral joints are in close proximity to the exit areas of the nerve fibers. If there are changes and, above all, narrowing due to osteoarthritis, this causes pressure on the nerve roots and corresponding pain in the affected spine segment.
This often leads to back pain or lower back pain (lumbar facet syndrome, lumbar pain), which not only express itself locally but can also radiate into other areas. If this is the case, those affected also report, for example, flank pain, sciatica pain or neck pain that also radiates from the cervical spine to the shoulders and arms (cervico-brachial syndrome).
Most of the time, the pain subsides in resting positions and becomes more pronounced especially when sitting and walking or under stress. Stiff joints (especially in the morning after getting up) or a feeling of being broken through can also be signs of damage to the vertebral joints.
However, these symptoms do not always occur, which depends in principle on the individual expression and position of the arthrosis. In the case of severe complaints, however, advanced arthrosis is not always found. The symptom pattern of each individual affected is very different.
In the vast majority of those affected, spondylarthrosis is only diagnosed from the age of fifty, an age from which degenerative processes in our body progressively progress and various signs of wear and tear occur, including osteoarthritis.
In addition, incorrect stress (e.g. due to joint misalignment due to congenital malformations or previous illnesses) or overloading can damage the back. Certain sports or professional activities can overwhelm the resilience of the spine or corresponding segments and cause increased joint wear. Even overweight (obesity) has a negative effect on the musculoskeletal system and can favor spinal joint arthrosis.
Other causes of damage to the facet joints include inflammatory arthritis (such as rheumatoid or reactive arthritis and ankylosing spondylitis).
In addition to the patient's medical history and clinical examination, which is usually carried out with precise orthopedic expertise, various imaging diagnostic methods (X-rays, computed tomography and magnetic resonance imaging) are suitable for displaying the changes in the vertebral joints.
Typical signs are visible narrowing of the joint space and altered bone structures. However, these are not always recognizable, especially in the early stages of the disease. The exclusion of other diseases that can cause joint problems is often an important part of the diagnosis.
As with arthrosis of other joints, conservative symptomatic therapy is of great importance. Medicines for pain relief and muscle relaxation are used in combination with physiotherapy and manual therapy. Targeted exercises for muscle strengthening and back stabilization can also cause therapy and thus achieve long-term improvement.
If such measures are not sufficient, risky and controversial treatments with thermocoagulation or radio frequency therapy can also be considered for lumbar facet syndrome with low back pain. It is about so-called denervation, a destruction of sensory nerve fibers to combat pain.
In particularly severe cases and persistent severe complaints, surgical therapy can also be the last option. This always requires individual consideration and careful consideration of the respective risks.
In addition to physiotherapy, manual forms of treatment from the fields of naturopathy and osteopathy can help to alleviate the symptoms of vertebral joint arthrosis. In this context, for example, fascia therapy (fascia distortion model) or trigger point therapy can achieve good results. Massages can also help relax muscles and reduce pain. (tf, cs)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dr. rer. nat. Corinna Schultheis
- German Society for Orthopedics and Orthopedic Surgery (DGOOC): S2k guideline for specific low back pain, as of 12/2017, published online by AWMF (access: June 17, 2019), awmf.org
- Rüther, Wolfgang and Lohmann, Christoph H .: Orthopedics and trauma surgery, Urban & Fischer, 20th edition, 2014
- Jerosch, Jörg & Heisel, Jürgen: The lumbar facet syndrome, Springer-Verlag, 2nd edition, 2006
- Reith, Wolfgang: Diagnostics of degenerative spinal diseases. in: Der Radiologe, Issue 51/09 (2011), pp. 761-762
- von Strempel, Archibald (ed.): The spine, Georg Thieme Verlag, 2001
ICD codes for this disease: M47ICD codes are internationally valid encodings for medical diagnoses. You can find e.g. in doctor's letters or on disability certificates.