CAUSES OF CHRONIC BACK PAIN: Arthritis

Anatomy
Condition: Arthritis
Diagnosis: Arthritis
Treatment: Arthritis
Non-Surgical Spinal Decompression: Arthritis

Anatomy

The vertebrae are the "bony elements" that surround the spinal cord. In an adult human, there are approximately 25 bones that make up the spine. 7 cervical (neck), 12 thoracic (mid-back), 5 lumbar (low back) and 1 sacral ("tailbone"). The vertebrae are composed of several elements: vertebral body, pedicles, lamina, transverse process, spinous process & superior/inferior articular processes (which make up the facet joint). The vertebral body is a "hourglass" shaped bone which we commonly associate with the spine. The pedicles and lamina make up the posterior "ring" of the vertebrae which is responsible for housing the spinal cord. The transverse processes are sites for muscle/ligament attachment and rib attachment (in the thoracic spine). The spinous process is the bony "bump" you can feel on your back, this is also a site for muscle/ligament attachment. The superior & inferior articular processes form the posterior joints called the facet joints. The facet joints help guide motions in our spine such as bending forward/backward, bending sideways and turning from side to side. Like any other joint in your body, the facet joints are covered with a layer of cartilage, surrounded by a joint capsule (made of ligaments) and bathed in a lubricating fluid called synovial fluid. In addition to all the "bony" elements commonly associated with the spine, there are many "soft tissue" elements that support the spine by both restricting motion (i.e. ligaments) and enabling motion (i.e. muscles). Some of these soft tissue elements (ligaments) can calcify ("turn to bone") secondary to arthritis or degenerative disc disease.

Condition: Arthritis

Arthritis of the spine is also called Osteoarthritis (OA), Degenerative Disc Disease (DDD) or Degenerative Joint Disease (DJD). Causes of spinal arthritis include (1) trauma (2) repetitive stress due to occupation, poor posture or other external factors and the (3) natural processes of aging. Osteoarthritis is the most common type of arthritis and is a non-inflammatory degeneration of joint cartilage with secondary effects (such as "bone spurs") on adjacent bone. Usually, the patient will present with local back pain, stiffness, crepitus (joint "popping"), joint deformity and swelling. Osteoarthritis due to trauma usually presents equally in males and females during their 20's - 60's. Osteoarthritis due to "old age" is more common in females and presents in their 50's - 60's and is most prevalent in weight-bearing joints (such as knees and the spine). Arthritis causes a change in the biomechanical structure of the spine such as: a decrease in intervertebral disc space (due to degenerative disc disease), stress osteophytes ("bone spurs"), and joint "loosening" which causes "slippage" of the vertebrae and alteration of the spinal curves. Pain is usually due to biomechanical changes in the spine (decrease range of motion) and pressure on the diseased disc.

Diagnosis: Arthritis

Arthritis is a very common condition and can usually be diagnosed with a thorough physical examination including X-rays. X-rays will typically show: a decrease in disc space(s), bone spurs (osteophytes), joint laxity (loosening), subchondral cysts, loose bodies, subluxation and an alteration of the spinal curves. Usually, pain will be locally in the back but there may be non-specific pain referral in the extremities (arms/legs). In most cases, advanced imaging is not warranted unless severe symptoms are present.

Treatment: Arthritis

Traditional treatment includes pain killers such as: Non-Steroid Anti-Inflammatories (NSAID's), Physical/Chiropractic Therapy or Surgery (in extremely severe cases). NSAID's have an inherent risk of Gastrointestinal ("stomach" and "intestines") disorders such as: ulcers, GI hemorrhage or perforation. In fact, an article in the New England Journal of Medicine reported that it has been conservatively estimated that 16,500 NSAID-deaths occur every year in the United States and conservative calculations estimate that approximately 107,000 Americans are hospitalized every year due to NSAID related GI complications . The number of deaths reported in the same study due to AIDS was 16,685. In addition to Gastrointestinal disorders, drugs such as VIOXX have been known to cause serious Cardiovascular (CV) events such as: Heart Attacks, Stroke and Heart Failure. There have been similar complaints from other NSAID's such as: Bextra and Celebrex.

An article in Spine reviewed the outcomes and complication rates for surgical intervention in Degenerative Disc Disease. Complication rates were as high as 55% and included: hematoma, neurologic, adjacent segment degeneration, infection and hardware/instrument related issues. Another study to determine the effects of single level (2 vertebrae) and 2-level (3-4 vertebrae) spinal fusion success rates reported 53% with "good" and "fair" results with single level fusion and no "good" results with 2-level fusions. This can lead to a loss of range of motion, further pain, further degeneration and a condition known as failed back surgery/post-operative pain syndrome which is a very disabling and troubling reality of surgical intervention.

Now that you have read about the possible side effects of what traditional treatments have to offer, you may want to consider the drugless, non-surgical approach that Non-Surgical Spinal Decompression has to offer.

Non-Surgical Spinal Decompression: Arthritis

The following is the rationale, based on anatomical and physiological principles of Non-Surgical Spinal Decompression. Non-Surgical Spinal Decompression offers to treat the root cause of the disease - compression of the disc. Non-Surgical Spinal Decompression relieves pressure from the disc and can facilitate a healthy exchange of nutrients ("Imbibition") through its "pumping action" which can rehydrate the disc (with the aid of OTC supplements such as Chondroitin/Glucosamine Sulfate), allow proper spinal motion and prevent further deterioration of the spinal column by restoring proper biomechanics. Once the "compressing" force is relieved from the diseased disc, pain decreases and function increases.

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