Back Pain? 5 Signs It's Arthritis

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If you think arthritis is a disease of older adults only, think again. That persistent backache that you've attributed to pulled muscles or neck strain may very well be osteoarthritis, the most common kind of arthritis no matter what your age. In fact, osteoarthris of the spine, also called spondylosis, affects 15 percent of all American adults. While it's most common in those over age of 45, it affects many younger adults as well, often triggered by a work-, accident-, or sports-related injury. For reasons experts don't yet understand, women typically experience more severe chronic pain from spinal arthritis than do men.

According to doctors, X-ray screening of the spine will uncover degenerative arthritic changes in 95 percent of people over the age of 50 -- yet not all will have back pain, at least not right away. That's because it depends on where and how the wear and tear affects the structure of the spine and whether the nerves and the discs between the vertebrae become involved.

When spinal arthritis does affect the nerves and disks, the result can be persistent, excruciating pain that profoundly affects mobility and quality of life. And when your back hurts, you'll do just about anything to feel better: In 2005, the Journal of the American Medical Association reported that Americans spent $85.9 billion dollars seeking relief. Luckily, if you do have arthritis, new treatment options are becoming available. Here are five telltale signs that your back pain is caused by arthritis:

1. Pain that comes on gradually and worsens over time

Typically, back pain that's not osteoarthritis comes on suddenly and results in an excruciating attack that may leave you immobilized but gradually improves as the underlying problem heals. Osteoarthritis, on the other hand, may start with a twinge here, a twinge there, and before you know it you have a backache almost every day.

What it feels like: Acute pain or overall achiness in one or more parts of your back. Pain due to osteoarthritis may come and go; you may feel better for a few weeks or months, and then the pain comes back worse than before.

Why it happens: The cartilage between the vertebrae wears down, causing the bones to rub against each other. With less cushioning between the vertebrae, the joints become inflamed. Often, as the components of the spine wear down, the intervertebral discs wear down too. For this reason, patients with osteoarthritis often also have degenerative disc disease, and a compressed disc can cause a sudden onset of pain. Many people don't experience pain until the bones or other structures of the back put pressure on or pinch the spinal cord or the nerve roots that emerge from the spinal cord, which is why the pain may come and go.

2. Stiffness and limited range of motion

If you feel stiff and achy when you get out of bed in the morning, it's often a sign of osteoarthritis rather than sore muscles or a disc problem.

What it feels like: Your back feels stiff and unbending but becomes more flexible as the day goes on. When you bend over or arch your back, it may trigger more severe pain. Certain activities, such as sports, yoga, or dance may become more difficult. You may notice that the stiffness is less and range of motion improves with stretching and exercise. You may also notice "migrating" sore muscles that recur in different areas. It may feel like one shoulder is sore one day, your neck the next, the other shoulder a week later.

Why it happens: Over time, degeneration of the joints of the spine causes inflammation around the joints. Your body doesn't want the joints to move, because when they move they rub against each other, so your back compensates by stiffening. One of the factors that can lead to a missed diagnosis of arthritis of the spine is that people often compensate for the stiffness by using different muscles, which can in turn become sore from overuse.

More signs that back pain is arthritis

3. Neck pain that radiates into the head and shoulders

A pulled muscle in the neck or shoulder typically affects one localized area -- you may even be able to touch or pinch the muscle and feel that it's swollen. Osteoarthritis, on the other hand, may affect the cervical or thoracic spine, causing pain to be felt upward and outward.

What it feels like: Upper back or neck pain that radiates upward into the neck and base of the skull. Some people begin to experience chronic headaches that they attribute to tension headaches. It may hurt in one specific area, or the pain may recur throughout a large area, moving from spot to spot. You may notice that your neck feels tingly or numb.

Why it happens: Two things may be happening here: Both your muscles and nerves may be affected. Increased stiffness and reduced range of motion may cause you to use different muscles than you typically would, causing tension, muscle strain, and soreness throughout the neck and shoulders. Nerves may also be irritated by pressure from bony spurs, called osteophytes, that form along the cervical spine, which is the uppermost third of the spine that includes the neck. Nerve pain can cause severe pain and stiffness of the shoulders and neck and can move upward into the base and back of the skull.

4. Numbness or tingling in the arms, hands, and fingers

Some people confuse carpal tunnel syndrome with arthritis of the spine because some of the symptoms can be similar. A loss of sensation or stiffness in the wrists, hands, and fingers may make it feel like you're losing control of your fine motor movements.

What it feels like: Twinges, tingling, or numbness that radiates down from the shoulder through the arm. Depending on where nerve compression is occurring, you may feel pain all the way down your arm or in one specific place, such as your wrists, and it may come and go.

Why it happens: Inflammation and bony overgrowth of the cervical and thoracic spine can impinge upon and irritate spinal nerves, causing numbness, stiffness, and tingling and reducing sensation and motor control in the arms, hands, and fingers.

5. Pain, numbness, or weakness in the legs

A feeling of numbness or tingling that radiates down the buttocks and into the legs is typical of osteoarthritis of the spine as it progresses.

What it feels like:You might notice a lack of sensation in your legs, as if they're numb or asleep. Your legs might also feel weak or as if they're cramping or buckling. In worst-case scenarios, people develop balance problems or have trouble walking. Loss of bladder control is also possible, though less common.

Why it happens: Over time, wear and tear can cause the spinal canal -- the opening inside each vertebra where the spinal cord passes through -- to become narrower. When this narrowing becomes significant (a condition known as spinal stenosis), it can pinch or compress the spinal cord or the nerve roots that emerge from the spinal cord, leading to pain and numbness that radiates down the hips, buttocks, legs, and feet. Disc compression or injury, often occurring at the same time or as a result of arthritis, can also cause pain, known as sciatica, that radiates down the legs.

Melanie Haiken

Melanie Haiken discovered how important it is to provide accurate, targeted, usable health information to people facing difficult decisions when she was health editor of Parenting magazine. See full bio