Is Your Back Pain Osteoarthritis? Interview with Dr. Alessio Mattei
Osteoarthritis represents one of the most prevalent diseases in the world, affecting 15% of the world's population over the age of 40. Forecasts indicate that by 2050 nearly one billion individuals will face this condition (source: Global Burden of Disease 2021). This condition can affect any joint in the body, including the spine, in which case it is referred to as spondylosis.
We interviewed Dr. Alessio Mattei, an expert in neuro-motor rehabilitation, manual and neurodynamic therapies, postural rehabilitation, and hydro-kinesiotherapy, who works at UPMC Salvator Mundi International Hospital, about osteoarthritis of the spine, its symptoms, and available treatment options.
Dr. Mattei, could you explain what osteoarthritis of the spine is?
Osteoarthrosis is a condition in which the cartilage that lines and protects the joints undergoes a physiological process of deterioration. This leads the surfaces of the bones involved to rub against each other, causing damage to the tissues and the bones themselves resulting in pain and disability. Osteoarthritis is particularly common in the joints of the spine, involving both the small joints and the large joints found between the vertebrae.
Another common aspect related to aging concerns the intervertebral discs. These act as cushions, mostly consisting of water, between the vertebrae increasing the possibility of movement and providing good load distribution. Over time, these can lose fluid and you can, develop small cracks and flatten, reducing the space between the bones. This process can not only exacerbate osteoarthritis, but also compress nerves located near the spine.
What are the most common symptoms of osteoarthritis of the spine?
Some people with spondylosis may experience nothing, while others may experience a variety of symptoms:
- Pain and stiffness in the neck or lower back.
- Pain radiating to the shoulder or arm, buttock, or thigh.
- Limited back mobility.
- Neuropathic symptoms.
- Difficulty walking.
What treatments are indicated for this type of disorder?
If you have back pain derived from spondylosis, it is advisable to consult your primary care physician or a spine specialist or physical therapist specializing in musculoskeletal and rheumatologic physiotherapy. If spondylosis is diagnosed, usually the first therapeutic approaches are noninvasive and nonsurgical:
- Education and information: essential for health care providers to inform the patient about the nature of the condition, available therapeutic strategies supported by scientific literature, prognosis, preventive measures, and self-management strategies.
- Therapeutic exercise: helps stabilize the spine, develop endurance, increase flexibility and reduce pain.
- Aerobic exercise: the specialist may also recommend low-impact exercises such as swimming, biking or walking. These help flexibility, strengthen the muscles that support the spine, and contribute to a reduction in pain through general vascularization of the body.
- Manual therapy: specific therapeutic treatment the prerogative of the physical therapist, characterized by manual techniques that aim to reduce pain and stiffness.
- Pharmacological therapy: in cases of intense pain in the first few days, the use of NSAIDs, muscle relaxants, or corticosteroids may be prescribed by the physician.
Dr. Mattei, when is surgery necessary?
In most cases, nonsurgical treatments are effective in reducing pain and discomfort. Spinal surgery may be necessary if symptoms are persistent over time and do not respond to conservative treatments. There is also an indication for surgery in the presence of severe neurological symptoms, loss of bowel or bladder control, and inability to walk. It is deferred exclusively to the physician, however, to decide whether or not surgery is necessary.
UPMC Salvator Mundi International Hospital specialists will be available on Saturday, November 4, for a free evaluation of your back health. Book your appointment.