There Is No Holy Grail In Dealing With Back Arthritis

The question of how to deal with arthritis in the back is not an easy one. Arthritis in the back comes from numerous potential causes most of which stem from degeneration of the intervertebral disk. Once the disk starts to dehydrate and degenerate, then ensuing arthritic changes occur in that level of the spinal column.

The other elements in the spinal column include the facet joints of which there are one joint on each side at each level of the spine. By and large the major problem when dealing with arthritis in the back is facet joint arthritis. These joints are about the size of a thumbnail and they are symmetrically situated at each level of the spine.

When dealing with facet joint arthritis unfortunately if you have arthritis at any one particular joint most likely you also have arthritis at multiple others. So it's much more complicated than dealing with simply a hip joint. Isn't this great?

So if you were to have spine surgery on all of the arthritic joints, you would have a spinal fusion at multiple levels which is not a good idea unless there is associated scoliosis or instability to address.

There are some very good answers for treating arthritis in the back that are non-surgical. One of those for example would be spinal decompression therapy. These treatments consist of about six weeks worth of intermittent spinal traction which can be very effective in decreasing the pain from facet arthritis.

Another option for treating arthritis in the facet joints is physical therapy. Strengthening the muscles around the spine can take pressure and stress off of the facet joints and it's the movement and pressure and stress which create and increase the pain. So strengthening one's core and doing lumbar stabilization exercises can decrease the pain from back arthritis.

One of the best options that we have for treating arthritis in the facet joints are facet injections, also called facet blocks. The injections into the facet joints consist of steroid medication which is currently the gold standard. Another injection that may be of benefit are medial branch blocks, which are injections around what's called the medial branches which are the tiny little nerves that supply sensation to the joints. These injections may include simply numbing medicine or also steroid medication too.

Assuming you want to achieve some sort of relief for back pain from arthritis with either medial branch blocks or facet injections, but potentially a combination of the two, and this wears off, the next step that may be of significant benefit is called radiofrequency ablation.

Radiofrequency ablation is a treatment that involves burning the small little nerves that supply sensation to the facet joints, and that is what actually causes the pain from arthritis. So if one can eliminate that pain with radiofrequency ablation, the objective has been achieved. The reduction of pain from radiofrequency ablation, also called rhizotomy, can be achieved for upwards of two years but typically it's around 6 to 12 months.