FAQs on Arthritis Treatment in Philadelphia

Degenerative arthritis affects the extremities and spine. Osteoarthritis is the most common type of arthritis, and it affects people 50 years of age and older. This condition is characterized by cartilage breakdown of the joints. Regarding the spine, degenerative arthritis is caused by wear of the cartilage in the facet joints, which are tiny connectors between the vertebrae that assist with back movements.

What causes degenerative arthritis of the spine?

The facet joints lose their smooth cartilage covering from wear and tear. When this occurs, the bones rub against one another, which leads to the formation of bony protrusions (bone spurs and osteophytes). Bony protrusions often impinge on the spinal cord or nerve roots, which leads to pain and nerve problems.

What symptoms are associated with spinal arthritis?

Arthritis of the spine can cause back pain and nerve symptoms. This includes weakness of the extremities, radiating pain, and a pins-and-needles sensation. In addition, patients with this form of arthritis often have limited range of spine motion, decreased flexibility, and tenderness.

What causes arthritis of the joints?

Osteoarthritis affects the hands, elbows, knees, and hips. This disorder occurs when the protective joint cartilage breaks down due to injury or years of use. Rheumatoid arthritis is not as common as OA, but it is worse on the joints. This condition causes joint deformities when the body’s immune system attacks the joint structures. With severe inflammation, the joint lining (synovium) swells and is painful. Another type of arthritis is psoriatic arthritis, which also involves the immune system. With this condition, the body’s own immune system attacks the joint structures, such as the ligaments, tendons, and connective tissue.

How common is arthritis?

According to statistics, around 20% of Americans have some type of doctor-diagnosed arthritis. Around 1 million people in the U.S. have spondylarthritides, and another 1.3 million are affected by rheumatoid arthritis.

What are the risk factors for arthritis?

Common risk factors for arthritis include:

  • Advancing age
  • Female gender
  • Being overweight or obese
  • Having joint surgery
  • Constant joint use
  • Abnormal joint alignment

How is arthritis treated?

The treatment of arthritis depends on the severity of the condition, the joint or site affected, and the health of the patient. Options include:

  • Physical therapy – The patient works with a therapist to improve strength of muscles, as well as increase range of motion. Therapies to alleviate pain include massage, ultrasound, and heat/cold therapy.
  • Medications – For rheumatoid arthritis, the doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs), as well as topical agents (camphor, menthol, and capsaicin). Narcotic analgesics are reserved for severe, debilitating pain.
  • Epidural steroid injection (ESI) – For spinal arthritis with nerve involvement, the pain specialist may recommend ESI. This involves injecting the epidural space with a long-acting corticosteroid. According to a recent clinical study, ESIs have an 80-85% efficacy rate.
  • Facet joint injection (FJI) – Usually given in a series of three, this procedure involves injecting one or more facet joints with a corticosteroid, and possibly, an anesthetic agent. Based on clinical studies, this procedure has an 85% success rate.
  • Joint injections – The doctor may inject hyaluronic acid or a corticosteroid into the joint space.
  • Sacroiliac joint injection – Found to have a success rate of 70% in clinical studies, this procedure involves injecting the SI joint with a corticosteroid and anesthetic agent.

Resources

Liliang PC, Lu K, Weng HC, Liang CL, Tsai YD, & Chen HJ (2009). The therapeutic efficacy of sacroiliac joint blocks with triamcinolone acetonide in the treatment of sacroiliac joint dysfunction without spondyloarthropathy. Spine, 34(9):896-900.

McLain RF, Kapural L, & Mekhail NA (2005). Epidural steroid therapy for back and leg pain: mechanism of action and efficacy. Spine Journal, 5:191-201.

Riew KD, Park JB, Cho YS, et al. (2006). Nerve root blocks in the treatment of lumbar radicular pain. A minimum five-year follow-up. J Bone Joint Surg Am, 88(8):1722-1725.