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Rheumatoid Arthritis Affecting the Spine


Rheumatoid arthritis is a very common disease which can provide major discomfort to a person. It is a chronic disease which is primarily characterized by joint pain. This can prove very uncomfortable, but it raises the question whether it can cause back pain or pain along the spine or not. It is very important to know of rheumatoid arthritis can cause back pain or not.

Cervical and Lumbar Affections of the Spine

Rheumatoid arthritis can affect the spine and can especially cause neck pain, back pain and can also cause pain that radiates to the legs or arms which is called radiculopathy. All of these are caused due to the compression of the nerves inside the spinal cord or the nerve roots. When rheumatoid arthritis is causing back pain is due to the fact that it affects the cervical spine situated in the neck region rather than the thoracolumbar spine, also known as the sacroiliac joints. Rheumatoid arthritis usually affects the spine when the disease is very advanced.

The general region affected by rheumatoid arthritis is the cervical spine. Instability at the level of the spine is mainly caused by laxity of the ligament that surrounds the first and second cervical vertebrae, known as C1 and C2.

Patients who suffer from rheumatoid arthritis should have a routine check-up to evaluate the partial dislocation, or subluxation of the spine. If there is compression to the spinal cord as a result of the subluxation then there may also be signs of long tract involvement, more exactly the upper motor neurons, including hyperreflexia, meaning over-responsive reflexes.

The involvement of the intervertebral joints of the cervical spine in rheumatoid arthritis can be explained by two possible mechanisms.

The first involves the extension of the inflammatory process from adjacent neurocentral joints into the discovertebral area.

The second mechanism consists of chronic cervical instability initiated by facet joint destruction, causing vertebral malalignments or subluxation, which can cause microfractures of the vertebral endplates, disc herniation or degeneration of disc cartilage.

The Spine Involvement Associated with Rheumatoid Arthritis.

There are several symptoms that can be usually associated with rheumatoid arthritis in the spine which can be noticeable to the patient.

The first symptom is palpitation of the affected area of the spine which can cause tenderness. The patient can experience stiffness in the affected area of the spine and crepitus, which can especially occur in the neck region. The patient can also experience headaches due to cervical rheumatoid arthritis. He may feel pain that radiates down one or both legs, which is a sign of lumbar nerve root involvement. If the patient has a problem with bowel or bladder control this may be a sign of spinal cord involvement. This symptom requires immediate attention.

If rheumatoid arthritis causes any destruction of the facet joints in the spine it may result in condition known as spondylolisthesis which causes an upper vertebra to slide forward onto the top of the next adjacent lower vertebra. This may result in an extra pressure on the spinal cord or the nerve roots exiting the spine.