Article reviewed and approved by Dr. Ibtissama Boukas, physician specializing in family medicine
Back osteoarthritis is a condition that can cause back pain and limit daily activities. If left untreated, it can get worse and lead to potentially serious consequences. Fortunately, it is not always symptomatic, and there are many treatment modalities aimed at relieving symptoms and improving quality of life.
What is back osteoarthritis, and what causes it? How to make an accurate diagnosis based on symptoms? What are the possible treatments for this pathology? The answers in this article.
Definition and anatomy
La dorsal column (or thoracic) is directly connected to the rib cage and helps protect major organs such as the heart, lungs and liver. The vertebrae thoracic do not have the same characteristics as those present at the cervical and lumbar level. Let's start by reviewing certain notions of anatomy that will help to better understand back osteoarthritis.
Dorsal spine and joints
Each vertebrate dorsal is formed in front of a circular bone called vertebral body. The size of each vertebra increases from top to bottom, with the widest vertebrae being at the lumbar level. This progressive increase in size helps to support the trunk and support the surrounding muscles.
A posterior arch is attached to the back of each vertebral body. Made up of pedicles and laminae that come together, this arc forms the spinal canal when the vertebrae are stacked on top of each other. Inside the spinal canal are also the spinal cord and the spinal nerves.
The two blades which meet at the back of the rachis give way to a spinous process. This protrusion can be felt when we run our fingers over a spine and that there are bony prominences. On either side of the vertebrae, transverse processes are also present.
The vertebrae are articulated to each other by articular facets forming the facet joints. These are part of the posterior arch, and there are two facet joints between each pair of vertebrae (one on each side of the spine).
Un intervertebral disc consists of two parts. In the center there is the gelatinous core which is spongy and provides shock absorption. This is held in place by the annulus, a series of fibrous rings that surround it. It is moreover when the annulus is pierced that we speak of herniated disc.
The discs of the dorsal spine are much thinner than those of the cervical and lumbar spine. Consequently, there is generally less movement between the vertebrae of the dorsal spine.
On each side of the vertebrae are small tunnels called intervertebral foramina. It is at this level that the spinal nerves emerging from the spinal cord pass to serve the organs and limbs there.
Dorsal spine nerves primarily control the muscles and organs of the chest and abdomen.
Muscles and ligaments
The dorsal spine muscles are arranged in layers (superficial and deep), extending from the neck and shoulder region to the lower back. Together, the muscles allow the movements of the trunk and contribute to stability.
Ligaments connect bones and ribs to each other.
Role of the dorsal spine
Together, the components of the thoracic spine hold several key roles:
- Spinal cord protection
- Heart and lung protection
- Neck and lumbar support
- Trunk stability
Dorsal osteoarthritis is a condition where there is wear of the protective cartilage covering the vertebrae and facet joints at the dorsal level. This phenomenon is sometimes accompanied by disc degeneration, and can lead to the appearance of osteophytes (bony prominences) sometimes leading to conflict with the surrounding nerve roots.
Back Osteoarthritis Causes
Although the dorsal column is less likely to degenerate compared to the cervical or lumbar regions, it is not immune to degenerative and osteoarthritic phenomena. Whether it is the general wear and tear of the spinal joints over time (normal aging), or certain predisposing factors, it is possible to develop back osteoarthritis.
Here are some potential causes favoring the appearance of this disease:
- heavy lifting
- history of falls
- road accident
- Scoliosis or scoliotic attitude
- genetic factors
Back osteoarthritis is confirmed by medical imaging. Often an X-ray is sufficient, although the doctor may order a CT scan or magnetic resonance imaging to clarify the diagnosis.
It should be noted that the presence of osteoarthritis at the dorsal level is not necessarily synonymous with pain or pathology. Indeed, there are many asymptomatic cases, that is to say people who show degenerative changes on medical imaging without showing symptoms. This comes from the ability of the human body to adapt despite the presence of osteoarthritis. Often, it is said that the pain will appear if there is nerve irritation, or if an inflammatory phenomenon is triggered.
To determine the functional consequences of back osteoarthritis, a health professional will perform a clinical examination to better define the diagnosis. This will include an assessment of trunk movements, reflexes, sensitivity, muscle strength, etc. These elements will make it possible in particular to exclude serious damage to the spine, and to guide the treatment plan.
Symptoms of the disease
People with symptomatic back osteoarthritis may experience the following symptoms:
- Back pain at the location of the affected joint
- Radiation of pain to the rib cage or trunk
- Localized swelling, redness and tenderness
- Muscle spasms
- Difficulty leaning back, standing, and walking
- Difficulty sitting still for long periods
- Morning stiffness
In some rare cases, back osteoarthritis will compress important structures (such as the spinal cord) and lead to potentially serious consequences. This constitutes a medical and sometimes surgical emergency. Therefore, it is essential to consult without delay if you observe any of the following signs:
- Tingling, numbness and/or weakness in the arms, hands, legs or feet.
- Lack of coordination and difficulty walking
- Loss of sensation in the perineum area
- Uncontrollable muscle spasms
- Loss of sphincter control (urinary and fecal incontinence)
- Constant pain not relieved by rest
- Chest pain or severe abdominal
To find out about all the situations where back pain is the result of a serious injury, see the following article.
The treatment for back osteoarthritis depends on the extent of the symptoms, their intensity and their duration. Healthcare professionals have a wide range of treatments and therapies aimed at relieving symptoms, improving quality of life and preventing the worsening of osteoarthritis. Among the prescribed modalities are:
- heat and ice (video explanation)
- Posture corrector
- Lumbar belt
- Physiotherapy (physiotherapy)
- Alternative medicine (acupuncture, suction cups, acupressure mat, myotherapyEtc.).
- Natural products
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