Spinal rheumatoid arthritis is a type of arthritis that affects the joints of the spine, more specifically sliding joints called facet joints. Two facet joints are located posteriorly on each vertebra behind the central spinal canal. Facet joints allow flexion and extension of the spine while inhibiting spinal rotation. Rheumatoid arthritis is an autoimmune disorder. The body’s defense system attacks its own health joint lining (synovium) as though it were a foreign invader such as a bacteria or virus. Synovium under attack ceases production of synovial fluid, the natural lubricant which keeps joints moving smoothly.
In cases of spinal rheumatoid arthritis, the body’s immune system attacks the synovium in the facet joints, causing the membrane to become inflamed and thick. As the facet joints swell and stop lubricant production, damage of cartilage on the joints occurs. Without the lubrication and protection of synovial fluid and cartilage, facet joints become stiff, swollen, painful, and damaged. Spinal muscles and ligaments also might weaken as the arthritis progresses. Bone spurs often form as joints become deformed.
As spinal rheumatoid arthritis progresses, joints enlarge. This leads to spinal stenosis, meaning the open spaces in the spinal column that allow nerves to travel to other parts of the body become constricted, exerting painful amounts of pressure on the nerves.
Spinal rheumatoid arthritis is not as common as another type of spinal arthritis called osteoarthritis, but rheumatoid arthritis is generally said to be more debilitating. Women over the age of 40 with a specific genetic makeup are especially vulnerable.
Symptoms of spinal rheumatoid arthritis include:
- Warm painful joints
- Deformity of the spine
- Swelling and tenderness
- Trouble walking
- Ankylosis (abnormal joint fusion)
- Morning stiffness
Physicians are unsure of the causes spinal rheumatoid arthritis. There appears to be a genetic factor involved. After proper diagnosis by a primary care physician, referral to a rheumatologist is suggested. The rheumatologist will begin treatment conservatively with rest, stress reduction, gentle massage, light chiropractic work, and anti-inflammatory and specific immunosuppressant medications.
Unfortunately, as the symptoms of this disorder become more severe, conventional treatments will prove less efficacious. Surgical correction of bone spurring and spinal stenosis may be required to achieve significant symptom reduction. If you are considering surgery, let the experts at Laser Spine Institute (LSI) introduce you to our state-of-the-art, endoscopic procedures that may be able to help you recover daily function. Contact us now to find out more, and to receive a complimentary review of your MRI or CT scan.