Vertebral joint osteoarthritis, also known as spondylarthrosis (or spondylarthrosis deformans), is a degenerative disease of the small vertebral joints between the vertebral bodies and often leads to so-called “facet syndrome” – which, in turn, is a common cause of back pain. Facet syndrome can be caused by various injuries or diseases of the spine, however, increased wear is usually the cause.
What are vertebral joints?
The vertebral bodies of the spine are not only connected by the intervertebral discs, but also at two additional points, the vertebral arch joints (also known as intervertebral joints, or vertebral joints). These are small, paired and in particular flat joint surfaces (hence they are also known as facet joints). Per vertebral body, two joint surfaces located next to the spinous process point upwards and two point downwards, so that they meet the joint surfaces of the adjacent vertebral body, which are also arranged in the same way. When moving, the joint surfaces slide parallel to each other, which is why they are also called “sliding joints”. While the intervertebral discs and spinal ligaments mainly limit the range of movement, the vertebral arch joints primarily determine the direction of motion. Although the joints are comparatively small, all processes that cause arthrosis can occur:
What causes vertebral joint osteoarthritis?
These factors make facet syndrome more likely to occur
- One sided lifting and overloading (occupation and sport)
- Intervertebral disc damage
- Distortions of the spine
- Hollow back (hyperlordosis)
Painful symptoms in the affecting joints can occur as a result of whiplash injury – then usually in the area of the cervical spine. Increased wear of the vertebral joint is much more common however, and the resulting damage to the joint mechanism is the cause of the pain that arises there: Over the course of our lives, the protective cartilage layer of the vertebral joints gradually wears off, depending on the strain, which leads to a reduced distance between the joint surfaces and thus to increased friction. The body reacts to the damaged cartilage surfaces by widening the osseous parts: The bones under the cartilage become compressed and sclerosed. This wear-related ossification of the vertebral arch joints is known as spondylarthritis; persistent complaints (often chronic back pain) due to irritation of these joints are known as facet syndrome. Since this is a degenerative change, older people are more prone to facet syndrome. In addition, there is a whole range of other factors that can promote the development of spondylarthrosis (see info box).
What are the symptoms of vertebral joint osteoarthritis?
In general, spondylarthrosis with facet syndrome can occur in any area of the spine. Mostly, however, the lumbar spine is affected where symptoms are manifested as pain in the lower back. This symptom worsens through load-bearing and movement; the complaints subside in a resting position. A vicious circle is created when pain caused by facet syndrome leads to further muscle tension and spinal blockages.
Typical symptoms of facet syndrome are:
- Dull pain
- Limited mobility of the affected area
- Pain radiates into the buttocks and legs, mostly on both sides but not very far down
- “Feeling as though I was going to burst”
- “Feeling as though I had a board in my lower back”
- Pain when changing position, e.g. from sitting to standing or from lying to sitting, and an improvement after exercise and activity.
However, if apart from the back pain, accompanying symptoms such as muscle weakness, abnormal sensations, numbness or even paralysis occur, you should consult a doctor immediately!
How is vertebral joint osteoarthritis treated?
Thorough diagnosis is fundamental to discovering the cause of the degenerative disease and combating it in a targeted way. Alongside a physical examination, we have all the necessary imaging procedures such as CAT and MRI available in our four medical care centres – you do not have to arrange any follow-up appointments and, therefore, save time. Based on the diagnosis, we create a treatment concept tailored to your individual needs with our interdisciplinary specialist team of doctors to enable you to live your life free of pain without movement limitations.
As back pain is the primary symptom of spondylarthrosis, the treatment is primarily focused on its elimination. Our primary aim is to use the possibilities of conservative therapies such as pain therapy and physiotherapy.
Conservative therapy also includes medicinal treatment of severe pain. Here we inject analgesics and anti-inflammatory drugs directly into the affected area of the spine, usually achieving immediate pain relief.
In physiotherapy, patients learn how to relax and strengthen their back through targeted exercises. In addition, muscle-relaxing medication is helpful for releasing tension.
How to prevent vertebral joint osteoarthritis
The best way to achieve long-term protection against the development of arthrosis of the joints is through regular exercise as well as sports that do not place too much strain on the back, spine or intervertebral discs and, at the same time, strengthen the back muscles. Swimming is a useful sporting activity for this. Anyone who has to carry or lift particularly heavy loads due to their job should compensate this by doing exercises for a healthy back, because a strong back is far less susceptible to diseases such as facet syndrome.
This helps if you already have vertebral joint osteoarthritis
If you already have spondylarthrosis, you should lose weight if you are overweight and you should also have physiotherapy. Improving your nutrition by regularly eating a healthy mixed diet and drinking plenty of water is a great help here. There are also some exercises that can be helpful if you have spondylarthrosis. Please only carry these out after consulting with your doctor or physiotherapist. Here is an example:
- Adopt an all-fours position on a mat.
- Simultaneously stretch your right arm out to the front and your left leg out to the back. Pull your belly button towards your spine – do not let your back become hollow!
- Change sides. Stretch yourself out as much as possible.
- Hold the stretch for several seconds and repeat the exercise many times.