Three Reasons Why Spinal Arthritis Is More Difficult To Treat Than Hip or Knee Arthritis

The joints of the spine are called facet joints. They are located on both sides of the spine at every level up and down the spinal column all the way from the skull down to the sacrum.

Each of these joints combines to allow humans an incredible range of motion of the spines, permitting bending and twisting to an exceptional degree. Unfortunately though, each of these joints has cartilage and it has the potential for arthritis either due to age with loss of cartilage or trauma with damage to cartilage and subsequent arthritis pain.

Spinal arthritis is more difficult to treat than that of an extremity such as the hip or the knee. Here are the three main reasons why this is the case.

1. The number of joints in the spine is much higher. When you're dealing with hip or knee arthritis, there is one on each side. When you're dealing with spinal joints, there is one on each side at every level. Each of them is prone to developing arthritis and pain. even though the joints are considerably smaller, arthritis at any one facet joint can cause just as much pain as arthritis in a knee or a hip joint.

Typically when a person develops arthritis in a facet joint, he or she has arthritis in multiple facet joints which would need to be treated. Figuring out which is causing the pain and treating appropriately is much more difficult in a spinal arthritis situation than for the hip or knee.

2. Figuring out the source of the pain is more difficult. Even the best trained spine doctors who are board-certified can only tell people 50% of the time exactly why their back hurts. This is one of the shortcomings of back pain treatment, that the world of modern medicine is simply farther along when it comes to hip or knee arthritis than for that of the spine.

What this means is that if a pain management doctor does an injection into one of the facet joints of the lumbar spine, it may relieve part of a person's back pain, but a decent amount of the time they will still have significant residual pain. Pain management doctors have developed some more specific techniques to delineate the source of a person's pain, including facet joint injections and medial branch blocks as diagnostic tools. This will continue to improve, however, currently it makes spinal arthritis more difficult to deal with than that of the hip or knee.

3. Surgical outcomes for spinal arthritis treatments are not as good as that of total joint replacement for the hip or knee. Out of all the surgeries done for quality-of-life in the world, total hip and total knee replacement are in the top five overall. They are unbelievable game changers when it comes to decreasing pain and increasing function.

The same cannot be said for surgery for spinal arthritis. Although artificial disc replacement has been in existence since 2004, it has not been shown to be as good of a procedure as extremity joint replacement. In addition, there is no FDA approved procedure for replacing the facet joints in the back of the spine. What this means is that if a person undergoes surgery for facet arthritis, it will involve a spinal fusion. Satisfactory results after these treatments are in the 50 to 75% range, whereas knee replacement surgeries are typically over 90% satisfactory with outcomes.

The hope is that with modern medical techniques advancing, diagnosing the exact areas of spinal arthritis will become more exact and the results will be better with surgery. For now, nonsurgical pain management treatment is actually very good at reducing pain. it just takes more diagnostic tools and thought-provoking maneuvers to make sure the proper levels are being treated with the appropriate procedures.