The Connection Between Back Pain & Arthritis
Back pain is one of the most common medical complaints. Its widely reported that about 80% of adults experience low back pain at some point in their lives. Most back pain goes away on its own within a few days to a few weeks and is not due to chronic disease. Most acute back pain is due to a musculoskeletal injury like a muscle strain or sprain and usually lasts one to seven days. Otherwise, its considered chronic and may be caused by arthritis.
Many people do not suspect arthritis as a cause of their back pain. Arthritis in the back can occur in conjunction with other causes of back pain which can make it harder to get the right diagnosis and treatment. Many forms of arthritis and related conditions can cause back pain, stiffness and swelling. The lower back is the most common site of arthritis back pain.
Although back pain is a common symptom, not all people with arthritis in the back have symptoms like pain, even those with advanced back arthritis, said Adam Reinhard, Nurse Practitioner with West Tennessee Medical Group Neuroscience & Spine. On the other hand, some people may experience back pain even before evidence of arthritis can be seen on an X-ray.
The more common types of arthritis that affect the back include:
Back Surgery For Chronic Pain
Surgery is usually a last resort for back pain treatment. Still, it can be very effective in helping to ease chronic back pain.
For example, your doctor may recommend a fusion procedure: This involves cutting out the diseased joint and bonding the vertebrae together, decreasing mobility. In some cases, this will alleviate the pain in that area.
Realigning and stabilizing your spine to ease pressure on your spines nerves is another approach. This can lessen pain and even improve mobility.
What Are The Symptoms Of Rheumatoid Arthritis
Rheumatoid arthritis affects everyone differently. In some people, joint symptoms develop over several years. In other people, rheumatoid arthritis symptoms progress rapidly. Many people have time with symptoms and then time with no symptoms .
Symptoms of rheumatoid arthritis include:
- Pain, swelling, stiffness and tenderness in more than one joint.
- Stiffness, especially in the morning or after sitting for long periods.
- Pain and stiffness in the same joints on both sides of your body.
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Other Rheumatoid Arthritis Treatment Options
Patients can also relieve joint stiffness with low impact exercises like swimming, walking or cycling, Dr. Chi said. I generally prefer low impact, Dr. Chi stated. The more force you apply to the joints, the more damage you could do to the cartilage.
Spinal surgery may be a treatment as well. The most important indications for cervical spine surgery when rheumatoid arthritis is involved are resistant pain, neurologic deficits and/or a need to stabilize the upper cervical spine to prevent spinal cord damage.
References1. Freeman J. RA Facts: What are the Latest Statistics on Rheumatoid Arthritis? Rheumatoid Arthritis Support Network. October 27, 2018. https://www.rheumatoidarthritis.org/ra/facts-and-statistics/. Accessed June 27, 2019.
2. Duarie-Garcia A. Rheumatoid Arthritis. How is rheumatoid arthritis treated? Updated March 2019. https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Rheumatoid-Arthritis. Accessed June 25, 2019.
Scher JU, Malik F, Manasson J. Using the Microbiome to Aid Psoriatic & Rheumatoid Arthritis Diagnostics & Therapeutics. Rheumatology 2018 Year in Review. https://nyulangone.org/news/using-microbiome-aid-psoriatic-rheumatoid-arthritis-diagnostics-therapeutics. Accessed June 27, 2019.
Small Blood Vessel Nerve Symptoms
RA may damage the small vessels that feed the nerves. This damage is known as rheumatoid vasculitis . RV impacts only about 1 percent of those with RA, but the condition may be severe. RV can cause damage to the nerves of the hands and feet, which can disable the person impacted. RV may lead to damage to multiple nerves in the body. Signs of RV may include:2
- Numbness, tingling, burning, or pain in the hands or feet
- Muscle weakness or paralysis
- Muscle wasting, or loss of muscle
Although rare, RV may affect the small vessels in the brain. This may increase the risk of conditions such as stroke.2
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Do I Need A Spinal Fusion
If your spinal compression is at the front, rather than the back of your spine, your doctor might recommend spinal fusion over laminectomy. You might also need this if you have severe compression in multiple spots.
Spinal fusion permanently connects at least two vertebrae in your spine. This eliminates the motion between these vertebrae that may be causing you pain.
Spinal fusion mimics the normal process of healing broken bones. Your surgeon places a bonelike material between two spinal vertebrae, then fuses them together with metal plates, screws, or rods. This prevents movement that irritates or inflames the spinal nerves. The surgery usually takes 3-6 hours. As with laminectomy, youâll stay in the hospital for 2-3 days. You may wear a brace and need physical therapy after surgery.
Spinal fusion comes with a greater risk of complications and a longer recovery than other spine surgeries. But the results of this surgery are always improving, and rates of complications are falling among people with RA.
What Is The Role Of Diet In Rheumatoid Arthritis Treatment
Patients can also control their own gut microbiome by altering their diets. Because there is not enough hard data and because different individuals react differently to a given food, the American College of Rheumatology doesnt promote any diet, Dr. Chi said, other than a heart healthy diet, due to the damage rheumatoid arthritis can wreak on the bodys cardiovascular system. In general, Omega 3 fatty acids that are found in fatty fish like salmon are thought to have anti-inflammatory effects, and there is plenty of anecdotal evidence for turmeric, vegan diets, and eliminating fast food, processed food, dairy or gluten.
Dr. Chi stated that while she doesnt recommend any diet, she doesnt deter her patients from experimenting with diets and supplements as long as patients get the nutrients they need. I dont discourage patients from trying different kinds of diets. And people ask me about supplements all the time. As long as its from a reputable source and not potentially tainted with something, its fine to try, she said. However, it should be noted that supplements are not regulated by the FDA or any other governing body, so safety cannot be guaranteed.
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Effects Of Ra On The Back
RA causes inflammation in joints. The cervical spine has seven vertebrae, or bones. RA inflammation typically affects C1, also called the atlas, and C2, also called the axis.
C1 and C2 are the uppermost vertebrae and they have synovial-lined joints like those of the peripheral joints.
When the immune system attacks the tissue that lines these joints it can lead to an excess of synovial fluid. This causes swelling and pain and joint erosion over time.
Once C1 and C2 are affected, the inflammation can also cause pain in surrounding areas, including the upper back, shoulders, and head.
RA can also affect the facet joints of the spine. You have a pair of facet joints that run along the spine on both sides at the back of the spine. They connect to the bony bumps you feel down your back. The facet joints support the movement and flexibility of your spine.
RA can cause the facet joints to become inflamed resulting in neck and/or back pain. Sometimes, chronic inflammation can cause damage to the facet joints and make the spine less stable.
Instability in the spine causes a vertebra to slip out of their place where an upper vertebra slide over the lower one. This is called spondylolisthesis.
Spondylolisthesis is different from a slipped disc, or correctly named, a herniated disc. A herniated disc is usually the result of injury. C1 and C2 also are unique vertebrae that do not have discs between them.
Causes Of Arthritis In The Spine
Arthritis is generally considered to be a process which comes with aging. The same applies to Spinal Stenosis which is seen more commonly as a person gets older. It may be seen in younger individuals when that person has suffered trauma to the spine, or when they have had repeated injuries to the spine, as is the case in certain athletes.
Determining the cause of arthritis can be difficult because several factors often contribute to an individual developing this common problem.
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Can Lifestyle Changes Make A Difference
Yes. Eat healthy, get exercise, and do gentle stretches, Bose says. Rest when you need to.
A Mediterranean diet filled with fruits, veggies, whole grains, and healthy fats can help control the inflammation of RA.
It may seem odd, but exercise can also help ease your pain. Talk to your doctor or physical therapist before you start working out. They can recommend exercises and stretches that are safe for you. Ask them to suggest a mix of activities that improve your flexibility, range of motion, endurance, and strength.
Avoid high-impact or heavy exercises that could strain or injure your shoulders, Bose says.
What Are The Symptoms Of Spinal Arthritis
Symptoms of spinal arthritis may differ from person to person. In general, they may include:
Back and neck pain, especially in the lower back
Stiffness and loss of flexibility in the spine, such as being unable to straighten your back or turn your neck
Swelling and tenderness over the affected vertebrae
Feeling of grinding when moving the spine
Pain, swelling and stiffness in other areas of the body
Whole-body weakness and fatigue
Pain and numbness in your arms or legs if the nerves are affected
Although back pain is a common symptom, not all people have it, even those with advanced spinal arthritis. On the other hand, some may experience pain even before arthritis can be seen on an X-ray.
In certain types of spondyloarthritis, eye inflammation may occur, causing pain, watery eyes and blurred vision.
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What It Feels Like
Neck pain is a primary symptom of RA in the neck. The severity of neck pain varies from person-to-person. You may feel a dull or throbbing ache in the back of your neck around the base of the skull. Joint swelling and stiffness can also make it difficult to move your head from side to side.
The difference between RA neck pain and a neck injury is that stiffness and pain from an injury may gradually improve over days or weeks. If left untreated, RA in the neck may not get better it can actually worsen. Even if symptoms do improve, inflammation, swelling, and stiffness can return.
RA in the neck also differs from osteoarthritis. RA pain is due to inflammation in the joints, whereas osteoarthritis involves the natural wear and tear of joints.
Osteoarthritis can also affect the neck. However, pain and stiffness with RA can be worse in the mornings or after periods of inactivity. Osteoarthritis neck pain tends to worsen with activity.
What Types Of Lifestyle Changes Can Help With Rheumatoid Arthritis
Having a lifelong illness like rheumatoid arthritis may make you feel like you dont have much control over your quality of life. While there are aspects of RA that you cant control, there are things you can do to help you feel the best that you can.
Such lifestyle changes include:
When your joints are inflamed, the risk of injury to your joints and nearby soft tissue structures is high. This is why you need to rest your inflamed joints. But its still important for you to exercise. Maintaining a good range of motion in your joints and good fitness overall are important in coping with RA.
Pain and stiffness can slow you down. Some people with rheumatoid arthritis become inactive. But inactivity can lead to a loss of joint motion and loss of muscle strength. These, in turn, decrease joint stability and increase pain and fatigue.
Regular exercise can help prevent and reverse these effects. You might want to start by seeing a physical or occupational therapist for advice about how to exercise safely. Beneficial workouts include:
- Range-of-motion exercises to preserve and restore joint motion.
- Exercises to increase strength.
- Exercises to increase endurance .
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Ra Rarely Attacks The Joints Of The Lower Spine
Rheumatoid arthritis causes the bodys immune system to attack the lining of synovial joints. However, it is rare for RA to attack the synovial joints of the lower spine,4 which connect vertebrae to each other and to the pelvis .
Rheumatoid arthritis is more likely to affect the lower spine in other ways.
Read more about Lumbar Spine Anatomy and Pain on Spine-health.com
Lifestyle Changes That Help Ease Ra Symptoms
In addition to treatment with drugs, the following remedies and lifestyle approaches can help alleviate symptoms at any stage of RA:
Occupational or Physical Therapy Rheumatologists frequently refer patients to occupational or physical therapy practitioners to help patients find ways of moving that are less painful, and that strengthen muscles, says Manno. Decreased movement can cause muscles to atrophy and can reduce a persons cardiovascular fitness.
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Can Physical Therapy Help For Shoulder Ra
Yes. Bose says physical therapy can be a great part of your RA treatment plan, whether the disease affects your shoulders or other joints.
A physical therapist can teach you about exercises and devices that help you:
- Improve or maintain how well your shoulders work
- Manage shoulder pain
- Ease strain on your shoulder joints
- Do everyday tasks with less discomfort
A physical therapist may also be able to recommend certain work accommodations that make it easier for you to do your job. They work at places like hospitals, outpatient clinics, nursing centers, and gyms. If you have health insurance, itâs a good idea to find out if your plan covers some or all of the cost of physical therapy before you start.
Why & When Does Rheumatoid Arthritis Happen In The Low Back
Rheumatoid arthritis is just one of many types of arthritis affecting the joints of the body. Osteoarthritis is the most common type of arthritis in the UK, however rheumatoid arthritis is quite common affecting one in every 100 people, with an estimated 400,000 people living with the condition in England and Wales alone. The condition affects three times more women than men and normally develops between the ages of 40 to 50, although it can affect people at any age.
RA has the ability to develop in any joint of the body but most commonly affects the feet, ankles, wrists and hands. Spine RA is slightly less common, as is RA affecting the hips, knees and elbows. One characteristic of RA is that it normally develops symmetrically affecting the same joint on both sides of the body.
There is a lot understood about how RA attacks the joint and manifests, however there is still no understanding of what triggers this autoimmune disease to develop in the first place. There have been relatable links to certain viruses, infections and hormones, and even genetically linked through familial history. Scientific research for these links has so far been inconclusive.
Patients with RA also tend to be more likely to develop other conditions such as osteoporosis, cardiovascular disease, carpal tunnel syndrome, tendon ruptures, high blood pressure levels and inflammation of other parts of your body like the lungs, heart, eyes and even blood vessels.
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Ra Life Expectancy: Does Rheumatoid Arthritis Affect Life Span
The predicted life expectancy of a patient diagnosed with rheumatoid arthritis is problematic to accurately calculate due to the vast amount of unpredictable variables involved. As a chronic disease, RA tends to be progressive. In other words, it is a long-term disease in which symptoms tend to accumulate over time. This accumulation results in an overall worsening of the patients symptoms. Presently, doctors do not know what causes nor triggers the disease. That being said, they suspect it is likely initiated by a combination of factors including genetics and environmental influences.
Because there isnt one specific cause of the disease, there is also no known cure for RA. Todays medical technology and research, however, provide a variety of treatment options, which can prolong the lives of patients, slow the progression of disease, and provide some symptom relief.
These are just some of the factors which make it difficult to predict an exact life expectancy for RA patients. What research has found is that it isnt the disease itself which reduces the life expectancy of patients. Its the varying complications that develop as a result of the disease which cause life expectancy to shorten. For example, RA can cause respiratory and cardiovascular conditions which can compound over time and lead to a shortened lifespan and possibly eventual fatality.
Creating Instability Within The Spine
RA essentially destroys movable joints within the back. Once the joints are compromised, connections between the vertebrae become unstable. This instability causes the upper vertebrae to move forward onto the lower vertebrae of the joints in the spine, resulting in pain due to the pressure from slipped vertebra pressing on nerve roots. Symptoms of RA in the spine may include:
- Back pain
- Difficulty walking
- Blackout spells
- Tingling, weakness and a lack of coordination
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Rheumatoid Arthritis And Low Back Pain
This article describes the connection between rheumatoid arthritis and low back pain, including sciatica. Also discussed are ways to safely relieve low back pain at home when RA is present.
Rheumatoid arthritis is an autoimmune disease that causes painful swelling, stiffness, and deformities of the joints. Watch:Rheumatoid Arthritis Overview Video
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