Vertebral joint arthritis is a wear and tear disease of the spine. Also called facet syndrome, the condition affects the articular processes (“facets”) located on each vertebra, through which the vertebrae are connected.
What is vertebral joint arthritis?
With vertebral joint arthritis, it is not uncommon to experience severe back pain. Vertebral joint arthritis is characterized by wear and tear of the small vertebral joints. Because the articular processes have nerve fiber endings that pick up pain stimuli and transmit them to the central nervous system (pain receptors), back pain can occur with vertebral joint arthritis. However, not all vertebral joint arthritis results in pain. Although facet syndrome can also affect the entire spine, in many cases the condition occurs in the lower lumbar spine. Because it is a wear-and-tear disease, vertebral joint arthrosis becomes particularly noticeable, and with particularly severe symptoms, at an older age. It is also possible for vertebral joint arthrosis to be combined with a degenerative change in the intervertebral discs or with so-called spondylolisthesis (spondylolisthesis), in which vertebrae shift against each other. Vertebral joint arthritis can also lead to narrowing of the spinal canal (spinal cord canal).
Causes
Vertebral joint osteoarthritis represents a wear and tear disease of the spine triggered by the aging process. The intervertebral discs, which are made of cartilage fibers and connect the individual vertebrae, lose fluid with age, so their height gradually decreases. As the spacing between the vertebrae decreases, the vertebral ligaments lose strength, allowing the individual vertebrae to shift and thus altering the position of the vertebral joints. The resulting overloading of the vertebral joints leads to accelerated wear of the cartilage, which is the basis of vertebral joint arthrosis. In particular, overloading of the spine during work (frequent bending and heavy lifting) or sports contributes to vertebral joint arthrosis, as does obesity and, in some cases, rheumatic disease. Herniated discs also lead to disruption of the interplay between vertebral bodies, vertebral joint and ligaments, which can eventually trigger vertebral joint arthritis.
Typical symptoms and signs
- Back pain, especially during physical activity
- Spondylolisthesis (spondylolisthesis)
- Movement restrictions of the spine
- Sensory disturbances
Diagnosis and course
The various symptoms of vertebral joint osteoarthritis can not always be clearly attributed to a spinal disease, but may also be signs of other diseases. However, x-rays also show pathologic changes in the vertebral joint processes in people who do not experience symptoms of disease. Sensitive symptoms often appear only when the muscles of the trunk are not sufficiently developed. With vertebral joint arthritis, there is often pain in the lumbar vertebrae that occurs over a wide area and cannot be assigned locally. There is often an increase in pain during the day and after physical exertion. Furthermore, the pain increases when the upper body is bent backwards, whereas relief of the pain is observed when the patient is lying down. Radiation of the pain to the legs, lower abdomen, groin or buttocks may also be a sign of vertebral joint arthritis. Imaging techniques such as an X-ray examination, computed tomography or magnetic resonance imaging can be used to visualize changes in the bony structures, as well as in the spinal canal and spinal nerves, and to diagnose vertebral joint arthritis.
Complications
First and foremost, those affected by vertebral joint arthrosis suffer from very severe pain in the area of the back. This pain often spreads to the neighboring regions of the body, so that pain can also occur in the pelvis or neck. This pain occurs not only during movement, but often also at rest, which can be accompanied by sleep problems. In the long term, this can lead to depression or irritability of the affected person. Restrictions in movement and everyday life can also occur due to the disease. The patient’s quality of life is considerably reduced by the disease. Furthermore, paralysis or sensory disturbances may also occur.If these are not treated, they can also occur permanently. Due to the numbness, some affected people are also dependent on the help of other people in their daily lives and cannot easily perform many activities on their own. The treatment of vertebral joint arthrosis is usually carried out by means of various therapies and exercises, whereby massages can also alleviate the symptoms. Complications do not occur. The patient’s life expectancy is also not negatively affected by vertebral joint arthrosis.
When should one go to the doctor?
A doctor is needed as soon as impairments in movement or irregularities in mobility become apparent. If the affected person suffers from pain in the back area, this is a sign of a health disorder. If the discomfort occurs after intense physical activity, sufficient rest and relaxation should be provided. If there is significant relief or freedom from symptoms within a few minutes, hours or after a restful night’s sleep, a doctor is not required in most cases. However, if the restrictions or pain persist or increase in intensity, a clarification of the cause should take place. A warning signal and characteristic of the disease is a gradual increase in the symptoms described. Over several weeks or months, there is a worsening of the state of health, a feeling of indisposition or a decrease in physical performance. A physician should be consulted so that a diagnosis can be made and a treatment plan developed. Sensory disturbances or irregularities in sensitivity should also be investigated and treated. If daily responsibilities or usual sports activities can no longer be performed, the help and support of a medical professional is recommended. If existing symptoms radiate to the hip or leg area, action is needed. A physician should be consulted to prevent long-term damage or secondary diseases.
Treatment and therapy
The treatment of vertebral joint osteoarthritis depends on the symptoms, especially the degree of pain, from which the patient suffers. Since joint degeneration cannot be reversed, the treatment focuses on managing the pain and restoring spinal function. The mildest appropriate treatment procedure is used. Most vertebral joint arthrosis is therefore treated conservatively, i.e. without surgery. Surgery is usually performed only in the case of severe symptoms and numbness. Conservative therapies include physiotherapeutic measures such as gymnastics and massage. Physiotherapy exercises are used to build up the back and abdominal muscles so that the spine is relieved and strengthened as much as possible. Hydrotherapy, in which water is used to treat complaints, relies primarily on temperature stimulation and also on the buoyancy and pressure forces of water. Electrotherapy involves passing finely dosed electric current through the patient’s body. Relaxation exercises can also be helpful. Since physical exercise is one of the most important therapeutic measures for vertebral joint arthrosis, regular exercise such as cycling, Nordic walking or backstroke is particularly important, as these forms of activity are gentle on the back and have a stabilizing effect on the spine. In the case of acute, particularly severe complaints, temporary painkillers are helpful. In individual cases, wearing a corset can help stabilize the spine, but permanent use of a corset is more likely to weaken the muscles. The next strongest step in the pain therapy of a vertebral joint arthrosis is the so-called facet blockade or facet joint infiltration, in which a puncture of the pain-triggering vertebral joint takes place and painkillers are injected into the joint area. A minor surgical procedure is performed in radiofrequency lesioning, in which the nerves located at the vertebral joint are rendered insensitive under local anesthesia. Surgery can also be used to widen the spinal canal to take pressure off the nerves. Spondylodesis (blocking of vertebral bodies) is used to stiffen vertebral bodies in order to stabilize the spine. In this procedure, vertebral bodies are fitted with screws that are firmly connected to each other using metal plates or rods to prevent painful movement of the vertebral joints in cases of vertebral joint arthritis.
Prevention
As measures for the prevention of vertebral joint arthrosis, compensatory sports such as running (especially Nordic walking) and swimming, as well as gymnastics serving to stabilize the spine, are suitable. But even with already existing vertebral joint arthritis, regular exercise helps to strengthen the muscles around the spine and thus prevent or at least inhibit further progression of vertebral joint arthritis.
Aftercare
Vertebral joint osteoarthritis is caused by wear and tear on the vertebrae. The bone tissue breaks down as a result of this wear and tear. The disease is progressive and mostly affects older people. Due to its chronic nature, vertebral joint arthrosis requires follow-up treatment. The complaints should be alleviated and the patient’s quality of life optimized. Overexertion, a pre-existing spinal deformity or rheumatic diseases are among the risk factors. During follow-up care, the orthopedist treats pre-existing complaints. This can mitigate or even prevent vertebral joint arthrosis. An early start of treatment is crucial for a favorable outcome. The affected person must ensure that the spine is adequately protected. Painkillers curb the symptoms, and physiotherapeutic exercises also contribute to relief. With regular follow-up care, vertebral wear and tear can be reduced. The specialist adapts the treatment to the individual course of the disease. If unexpected signs of paralysis, numbness or similar neurological symptoms occur, an immediate visit to the doctor is necessary. In severe cases, the doctor will consider surgery. Here, depending on the severity of the arthritis, there are different approaches, such as nerve sclerotherapy with heat or the insertion of artificial vertebrae. Surgical vertebral fusion is another option. During follow-up care, the healing process is monitored by a doctor.
What you can do yourself
In case of severe symptoms, medical treatment of vertebral joint osteoarthritis is indispensable. Beyond its recommendations, however, the patient can do a few things to alleviate his pain and mobility restrictions, even if age-related wear and tear is not reversible. For one thing, the patient can reduce any excess weight. It does not matter which diet he decides to follow, because studies show that all diets are similarly successful if they are really followed through consistently. Stimulation current therapy, also called electrotherapy or TENS therapy, can also relieve pain and has no side effects. For this purpose, two to four electrodes are attached to the painful areas of the body, through which the stimulation current is then conducted. Since only 80 to 120 hertz are used, there is only a gentle tingling sensation on the skin, but this can mask the pain. The body now releases endorphins, which attach themselves to the pain receptors. When used regularly, this mechanism can relieve pain. Orthomolecular medicine also recommends a high daily enzyme dose for vertebral joint arthritis. Under several weeks of enzyme therapy, inflammation and swelling can decrease permanently, which simultaneously relieves pain and promotes mobility. Massages and relaxation exercises can also help minimize the symptoms of vertebral joint arthritis. Progressive muscle relaxation according to Jacobson is recommended here, as are Reiki, yoga and Pilates.
