Though we think of arthritis as affecting hands and knees, arthritis in the back is common in older adults. Once spinal arthritis is identified and diagnosed, the right treatment can help you manage this arthritis back pain.

Arthritis back pain is a very common type of back pain affecting older people. In fact, if you take an X-ray to look for spinal arthritis, 95 percent of people over age 50 will have some degenerative or "wear and tear" changes in their spines. This type of arthritis is classified as osteoarthritis.

"Arthritis can affect any joint in the body, including the joints in the back," says S. Christine Kovacs, MD, a rheumatologist at the Lahey Clinic in Burlington, Mass. "Although any part of the back can have arthritis, the lower back is the most common area."

Symptoms of arthritis of the spine are caused when 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. When the spinal canal — the bony canal in which the spinal cord is located — is significantly narrowed by arthritis, it is called spinal stenosis, and wear and tear over time is the most common cause. Spinal stenosis typically causes back pain accompanied by pain or numbness in the legs.

Causes and Risk Factors for Spinal Arthritis

You have 26 bones in your back, stacked on top of each other and separated by disk “cushions”. Your back bones allow you to stand up, and they also protect your spinal cord and spinal nerves.

Osteoarthritis occurs when the bands of tissue that support your spine thicken, the bones and joints change shape, and the surfaces of the bones bulge out as spurs. Any of these changes can put pressure on other structures and cause pain.

Although the majority of spinal arthritis is caused by wear-and-tear arthritis, it can also be from inflammatory types of arthritis, such as rheumatoid arthritis. However, rheumatoid spinal arthritis usually affects younger people and it is not a common cause of arthritis back pain.

Risk factors for osteoarthritis back pain include:

• Being middle-aged or older. Arthritis back pain is most common in people over age 50, but symptoms may start by age 30.
• Being overweight. "Carrying around excess weight increases the wear and tear on your spine," notes Dr. Kovacs.
• Having a back injury. A history of trauma to your spine or a history of spinal surgery can increase your risk for developing spinal arthritis.

Symptoms of Arthritis in the Back

Arthritis back pain symptoms can occur anywhere along the spine. They usually come on slowly and get worse over time. "People who have spinal stenosis from arthritis in their back usually get some relief by leaning forward, and their symptoms get worse while standing. They may need to lean forward and rest on their shopping cart in the store," says Kovacs.

Other symptoms of arthritis of the spine may include:

• Neck pain that radiates into the shoulders and arms
• Back pain that radiates into the buttocks and legs
• Numbness, cramping, or weakness in the arms or legs
• Loss of bladder or bowel control

"Symptoms that would make you think of something other than osteoarthritis as a cause of back pain would include back pain that starts suddenly or starts at a younger age. Spinal arthritis caused by rheumatoid disease is more common in young men and typically causes morning stiffness that gets better with movement," explains Kovacs.

Diagnosis and Treatment for Arthritis of the Spine

Doctors can usually diagnose spinal arthritis by taking your medical history and doing a physical exam, Kovacs says. “A plain X-ray is sometimes the only other diagnostic exam needed. If symptoms persist over time, the next step is usually an MRI,” she explains.

Treatment of arthritis back pain usually starts with rest, but may require medications, physical therapy, and surgery as a last resort. "We used to advise rest for a longer period, but now we know that returning to activity sooner is usually better," notes Kovacs.

Common approaches to ease arthritis back pain may include:

• Physical therapy to strengthen the muscles that support the back
• Medications to relieve pain and reduce swelling
• Weight loss and regular exercise
• Alternative treatments such as chiropractic manipulation or acupuncture
• Surgical treatment to relieve pressure on the spine or the spinal nerves

If you have arthritis back pain or neck pain that radiates into your arms or legs, work with your doctor to find the best treatment. You should always tell your doctor about spinal arthritis symptoms of numbness and weakness. Loss of bladder or bowel control may be a symptom of spinal arthritis which is causing dangerous pressure on the nerves of the lower back. This is an emergency symptom and requires immediate attention.

Arthritis back pain is very common, especially if you are over age 50. Although there is no cure for arthritis of the spine, in most cases symptoms of arthritis back pain can be relieved by conservative treatment and lifestyle changes.