When dealing with spinal arthritis, it is more complicated than extremities such as the hip, the knee or the ankle. It might not be intuitive to think about arthritis in one joint being more difficult to treat than another since they both result from the loss of cartilage ending up in a painful situation.
There are four reasons why spinal arthritis is simply more complicated and difficult to treat than that of the extremities.
1. There are many more spinal joints. At every level of the spinal column from the skull all the way down to the sacrum, there are spinal joints on each side and then at every level of the spinal column. These joints are called facet joints, and contain cartilage just like any other joint in the body including the knee or the hip.
They are prone to arthritis as they are weight-bearing joints, and they end up causing significant pain in any one of the facet joints. The pain emanating from one of these tiny joints may be just as severe as that coming from the much larger knee or hip joint in the case of severe arthritis. So the concise answer is there are many more facet joints than extremity joints and lots more chances for pain from spinal arthritis.
2. Surgery for spinal arthritis is not as successful as extremity surgery. According to surveys done around the world on the most successful operations performed for quality of life, both hip replacement and knee replacement rank in the top five. The same simply cannot be said for spinal arthritis surgery.
A spinal fusion procedure has a success rate anywhere from 50% upwards to 80%. Hip and knee replacement surgeries are much more successful and on average get rid of much more of a person’s pain with a joint replacement. No joint replacement procedure exists for facet joints, so the current gold standard is a fusion procedure. Due to the fact that if a person has arthritis in one facet joint they often have it in quite a few, is unreasonable the fuse multiple levels of the spine for good old wear and tear spinal arthritis.
Spinal arthritis procedures are often performed for scoliosis that results from arthritic degeneration, or instability that may end up with a condition called degenerative spondylolisthesis. But by and large, spinal arthritis surgeries are not as successful as your typical joint replacement procedures done for extremity arthritis.
3. The joints are much smaller than the hip or the knee. The reason this makes treatment difficult is that it is harder for a pain management doctor to get a needle into the joint for injection. When a spinal joint suffers from arthritis, bony overgrowth occurs and it can be very difficult to enter it with a steroid injection. Pain management doctors use fluoroscopy to do these injections and are typically successful, but not always.
Thankfully, there are multiple pain management procedures that can bring relief to spinal arthritic joints which do not involve a needle into the joint. The medial branch block involves an injection around the arthritic joints which can stop the transmission of pain from the surrounding nerve endings. A radiofrequency ablation procedure can also deaden the surrounding nerve endings and allow for pain relief in arthritic spinal joint. So it does make treatment slightly more difficult, but pain management doctors in Florida are often very successful in achieving the goal of pain relief without surgery.
4. It is often very difficult to delineate the exact source of a person’s pain in the spine. When you have just one knee joint that is arthritic, and a doctor does an injection that provides immediate pain relief, it makes it fairly straightforward. However, when the pain doctor has to inject multiple levels of the spine in order to figure out exactly which arthritic levels are causing the pain, the diagnosis is often much more difficult to specifically achieve. So spinal arthritis is more of a diagnostic quandary, and it takes considerable thought process and diligence for the pain management doctor to work through.
Despite these four reasons for making spinal arthritis more difficult to diagnose and treat then your typical chili arthritis, pain management doctors are often very successful at achieving nonsurgical pain relief for their patients.
If you live in Florida and are having significant neckk, mid back or low back pain, let the Florida Pain Network help you. The network connects those in pain with pain relievers including pain clinics in Florida, chiropractors and physical therapy practices.
For instance, there are pain clinics in Orlando, pain management Fort Myers clinics, Tampa pain management clinics, Port St. Lucie pain management practices, pain management Ocala Fl clinics, and many more. Simply go to this page and the pain clinics closest to you will show up first, or you may call 877-877-8556 for assistance.