Rheumatoid arthritis is a disorder, which causes the destruction of joints. The disorder can develop in any joint in the body. It is most commonly indicative in the small joints of hands and feet. When rheumatoid arthritis affects the spine, then most commonly neck (cervical spine) is affected than the lower back.
The back pain in rheumatoid arthritis can be the result of the immune system attacking the synovial lining of the small joints in the spine. In complex cases, it can be the result of compression of the spinal cord and nerve roots. This can cause moderate to severe pain.
Symptoms of Spinal Rheumatoid Arthritis Include:
- Warm painful joints
- Deformity of the spine
- Swelling and tenderness of joints
- Trouble walking
- Loss of functions in joints
- Abnormal joint fusion
- Morning stiffness
- Neck and/or back pain
- Headaches and pain at the base of the skull
- Painful and stiff joints
- Loss of flexibility
In progressive types of rheumatoid arthritis, the deterioration of the joints in the spine can lead to compression of the spinal cord and spinal nerve roots. The symptoms of compression depend on the part of the spine affected. Its symptoms may include:
- Loss of coordination
- changes in the walk
- Loss of bowel or bladder function
- Muscle weakness
The cause behind the spinal rheumatoid arthritis is not known but genetic and environmental factors play a big role in the development of rheumatoid arthritis.
Diagnosis of Spinal Rheumatoid Arthritis
The diagnosis of rheumatoid arthritis involves complete history and detailed physical examination. Cervical x-rays and MRI scans are usually required to determine the effects and severity of the disease.
Treatment of Spinal Rheumatoid Arthritis
Medicinal treatment: following medicines may help to provide relief from symptoms and improve the joint function in the spine:
- Non-steroidal anti-inflammatory medications (NSAIDs): these drugs decrease the inflammation.
- disease-modifying antirheumatic drugs (DMARDs): these medicines reduce the inflammation and slow down the progression of rheumatoid arthritis. They include methotrexate, hydroxychloroquine, and
- Biologic agents: these medicines repress certain substances in the body, which cause inflammation and joint damage. They include abatacept, adalimumab, and etanercept.
- Surgery : in the cases of spinal cord compression, surgical treatment can help to prevent severe neurological damage by fixing any unstable part of the spine and removing the pressure from the spinal cord. Fusion surgery can help to do so. Fusion of two or more vertebrae helps to reduce the movement in the neck.