Osteoarthritis
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.
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What Is Osteoarthritis?
Osteoarthritis (also known as arthrosis or osteoarthrosis) is a degenerative joint disease characterised by the gradual deterioration of the cartilage that cushions the joints. As the cartilage wears away, the bone surfaces begin to rub against each other, causing pain, inflammation, joint stiffness, and—in more advanced cases—disability.
Osteoarthritis can affect any joint, but it is particularly common in the spine, where it involves both the small facet joints and the intervertebral joints.
Another contributing factor to the condition is the ageing of the intervertebral discs—water-rich structures that act as shock absorbers between the vertebrae. Over time, these discs can dehydrate, lose volume, and develop cracks. The result is a narrowing of the space between vertebrae, which can worsen osteoarthritis and lead to spinal nerve compression, causing radiating pain, tingling, or weakness in the limbs.
What Are the Symptoms of Osteoarthritis?
The symptoms of osteoarthritis can vary from person to person. In some cases, especially in the early stages or in milder forms, the condition may be asymptomatic. In other cases, it can present with more noticeable signs that impact daily life quality.
In the case of spondylosis (osteoarthritis affecting the spine), the most common symptoms include:
- Pain and stiffness in the neck (cervical spine) or lower back (lumbar spine).
- Radiating pain to the shoulder, arm, buttocks, or thigh.
- Limited mobility of the back, especially upon waking or after staying in the same position for an extended period.
- Neuropathic symptoms, such as tingling, muscle weakness, or the sensation of an electric shock.
- Difficulty walking due to spinal nerve compression.
How Do You Treat Osteoarthritis?
In the case of back pain due to spondylosis, it is advisable to consult your primary care doctor or a spine specialist, or a physiotherapist with expertise in musculoskeletal and rheumatologic disorders.
If spondylosis is diagnosed, the initial treatments are typically non-invasive and non-surgical, aimed at relieving symptoms, improving function, and preventing further deterioration.
Conservative treatments for spinal osteoarthritis include:
- 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.
When is surgical intervention necessary?
In most cases, conservative therapy is effective. However, spinal surgery may be considered if:
- Symptoms persist for a long time despite treatment.
- There are significant neurological disturbances.
- Loss of control over bowel or bladder occurs.
- Pain makes walking impossible.
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Reviewed March 2025.