Osteoarthritis in North Texas

Did you know that osteoarthritis (OA) is one of the leading causes of disability in men and women in the United States? Our board-certified spine surgeon, Dr. Kendall Carll, has spent over 15 years of his career treating patients with this slowly progressive, degenerative joint disease of the spine. Also referred to as spondylosis or degenerative joint disease, OA is a slow-developing disease that can be hard to diagnose until it starts to cause painful symptoms in its later stages. If you have a family history and/or have been overweight, you are at greater risk for OA. Dr. Carll works with patients to help them manage the symptoms associated with osteoarthritis and will prescribe an ongoing treatment plan to keep you active and comfortable.

OA can occur in many places in the body, but it usually develops in the hips, knees, and spine. In the back, OA most often arises when the facet joints on either side of the vertebrae become inflamed due to friction along with a natural deterioration of the cartilage on the surface of the facets. As the facet surfaces wear down and create bone-on-bone contact, this can also stimulate the growth of bone spurs on the surfaces of the facets or generalized swelling in tissues near the joint. As the facets meet each other (or as the spurs grow) the nearby nerve branches can be irritated, causing tingling, muscle weakness, and spasms.

The two common places for OA to occur are in the neck (cervical) and lower back (spinal).

Common symptoms of cervical OA are:

• Pain in your shoulder blade, down your arm, or in your fingers
• Muscle weakness
• Stiffness in your neck
• Headaches, mostly in the back of your head
• Tingling or numbness down your arms or legs

Standard symptoms of spinal OA include:

• Stiffness or tenderness in the joints in your back
• Weakness, numbness, or tingling in your arms or legs
• Reduced range of motion

Early onset OA can be diagnosed with an x-ray, but Dr. Carll may use an MRI scan to determine whether the inflamed joints are impacting the nerve branches that cut between the vertebrae, or if there are associated bone spurs causing spinal stenosis. He may also order a blood test to rule out other conditions that cause joint pain, such as rheumatoid arthritis. A joint fluid analysis can also be ordered to determine whether you have gout or some type of infection as the underlying cause of your uncomfortable joint inflammation. The joint damage caused by severe OA is not reversible, but treatment can help reduce symptoms. We will do our best to help you manage this condition through nonsurgical and surgical treatments.

OA is a chronic condition that has no known cure. However, there are easy-to-implement nonsurgical remedies and treatments that can lessen the severity of the symptoms, such as:

• Exercise
  Physical activity to strengthen the muscles in your back may help relieve the stiffness that typically accompanies OA. Generally, this would involve low-impact activities, such as walking or swimming. Yoga may also improve joint flexibility and help with pain management.
• Weight loss
  Being overweight can place a strain on your joints and cause pain. Maintaining a healthy weight can help relieve discomfort in your joints. Your primary care provider can help you decide on a healthy plan for weight loss.
• Heat and cold therapy
  Experiment with heat or cold therapy to relieve muscle pain and stiffness. Apply a cold or hot compress to sore joints for 15 – 20 minutes several times a day.
• Medications
  Oral analgesics and topical analgesics can reduce the pain from the tender joints, but not the swelling. Nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen will reduce swelling as well as pain. Several new antidepressants have been shown to provide OA pain relief. Corticosteroids, either injected or taken orally, can reduce the inflammation in the joints.
• Natural treatments
  Some supplements have been shown to relieve some OA symptoms, but always discuss your use of supplements or herbs with Dr. Carll to make sure they won’t interfere with your prescription medications.
• Diet
  Eating foods high in Vitamin C and D, beta-carotene, and omega-3 fatty acids can be highly beneficial to patients with OA.

In most cases, facet joint osteoarthritis does not require surgery. If you opt for surgery, Dr. Carll will more than likely perform a spinal fusion procedure to eliminate movement in the affected vertebrae. After removing the intervertebral disc, he will insert bone graft material and screws so that the vertebrae can grow together. This will limit your range of motion in the affected area to reduce the friction and irritation caused by facet joint movements.

If the OA affected joints are pinching or squeezing the spinal cord or nerve branches, Dr. Carll might perform a laminectomy and remove a section of the vertebra called the lamina. OA can cause the spinal canal to narrow, but the laminectomy procedure creates more space for the spinal column and the nerve branches nearby by removing the part of the lamina (and sometimes the entire spinous process section) in one or more vertebrae. This creates more open space around the spinal cord and gives the Dr. Carll the opportunity to slightly shift the nerve branches, so they will no longer meet the spinal vertebrae.

Board-certified and fellowship-trained spine surgeon Dr. Carll is passionate about providing his patients with immediate and long-term relief from back pain due to OA. Using proven nonsurgical and surgical techniques, he strives to help patients renew their ability to engage with life. If you have neck or lower back pain, we invite you to call Spine Care of North Texas to schedule your appointment today.