Neck + Back

Arthritis in the Back


Neck and back pain can be caused by many things — but is most often related to getting older. Like the rest of the body, the disks and joints in the neck and back slowly degenerate as we age. More than 85 percent of people over the age of 60 are affected. The condition most often causes pain and stiffness — although many people experience no noticeable symptoms.

Cervical Spondylosis (Arthritis of the Neck)

As we age, our intervertebral disks begin to dry out, weaken, become stiff, and begin to bulge. This causes a collapse of the disk space. As the facet joints experience increased pressure, they also begin to degenerate and develop arthritis. The smooth, slippery articular cartilage that covers and protects the joints wears away. If the cartilage wears away completely, it can result in bone rubbing on bone. To make up for the lost cartilage, your body may respond by growing new bone in your facet joints to help support the vertebrae. Over time, these bone spurs may narrow the space for the nerves and spinal cord to pass through (stenosis).

Spondylolisthesis (Arthritis of the Spine)

In spondylolisthesis, one of the bones in your spine slips out of place. This may occur anywhere along the spine but is most common in the lower back. In some people, this causes no symptoms at all. Others may have back and leg pain that ranges from mild to severe. As we age, our intervertebral disks begin to dry out, weaken, become stiff, and begin to bulge. This disk degeneration is the start to both arthritis and degenerative spondylolisthesis. As arthritis develops, the ligament along the back of your spine begins to buckle causing the the vertebrae on either side of a worn, flattened disk to loosen and move forward over the vertebra below it.

Cervical Spondylotic Myelopathy (Spinal Cord Compression)

Cervical spondylotic myelopathy (CSM) is a neck condition that arises when the spinal cord becomes compressed — or squeezed — due to the wear-and-tear changes that occur in the spine as we age. The condition commonly occurs in patients over the age of 50. Because the spinal cord carries nerve impulses to many regions in the body, patients with CSM can experience a wide variety of symptoms. Weakness and numbness in the hands and arms, loss of balance and coordination, and neck pain can all result when the normal flow of nerve impulses through the spinal cord is interrupted.


As spondylosis or spondylolisthesis worsens, the spinal canal begins to narrow and put pressure on the spinal chord. People with spinal stenosis may or may not have back pain, depending on the degree of arthritis that has developed. Physical therapy, anti-inflamatory medications, steroid injections, acupuncture, and chiropractic manipulation can help manage symptoms. Surgery for lumbar spinal stenosis is generally reserved for patients who have poor quality of life due to pain and weakness. Patients may complain of difficulty walking for extended periods of time. This is often the reason that patients consider surgery.


The diagnoses can be made by a physical examination and a gait analysis. Other tests which may help your doctor confirm your diagnosis include X-rays, MRI, CT scans, Myelogram, and Electromyography (EMG).

Treatment Options

As with other arthritic conditions, initial treatment of arthritis of the neck or back is nonsurgical. Your doctor may recommend making a change in posture or some lifestyle modifications to help relieve the pain and slow the progression of the disease. Physical therapy maybe recommended to help increase range of motion and flexibility as well as help strengthen the muscles in your neck and back. A neck collar or back brace may be advised to maintain proper position.

There are several types of medications that are useful in treating arthritis of the neck and back. Because people respond differently to medications, your doctor will work closely with you to determine the medications and dosages that are safe and effective for you. Over-the-counter medications or cortisone injections may be recommended.

If your pain from arthritis causes disability and is not relieved with nonsurgical treatment, your doctor may recommend surgery. As with all surgeries, there are some risks and possible complications with different procedures. Your doctor will discuss the possible complications with you before your operation.

Spinal Fusion

Arthrodesis fuses the bones of the joint completely, making one continuous bone out of two or more bones. The goal of the procedure is to reduce pain by eliminating motion in the arthritic joint.

Artificial Disk Replacement

In artificial disk replacement, worn or damaged disk material between the small bones in the spine (vertebrae) is removed and replaced with a synthetic or "artificial" disk. The goal of the procedure is to relieve back pain while maintaining a more normal motion than is allowed with some other procedures such as spinal fusion.

Physical Therapy

Your doctor may recommend physical therapy to help you regain strength in your back and to restore range of motion. Depending upon your procedure, you may need to wear a brace for a time.