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.
Warm painful joints
Fever
Deformity of the spine
Swelling and tenderness
Trouble walking
Ankylosis (abnormal joint fusion)
Fatigue
Morning stiffness
Doctors are unsure of the causes of spinal rheumatoid arthritis. There appears to be a genetic factor involved. After proper diagnosis by a GP, referral to a rheumatologist is suggested. The rheumatologist may begin treatment conservatively with rest, stress reduction, gentle massage, light chiropractic work and anti-inflammatory and specific immunosuppressant medications.
As the symptoms of this disorder become more severe, conventional treatments could prove less effective. In this case, surgery may be required to address bone spurring and spinal stenosis in order to achieve significant symptom reduction. If you are considering surgery, Mr Torrie offers patients minimally invasive procedures that could help you recover daily function.
