Spinal osteoarthritis (OA) is a condition that affects millions worldwide, causing significant pain and stiffness that can impact your daily life. Globally, an estimated 528 million people endure the pain and limitations of osteoarthritis. If you're dealing with spinal OA, you might be wondering:
How can I manage the relentless pain and stiffness?
What can I do to prevent my condition from worsening?
Is it possible to reclaim my quality of life?
The Good News
The good news is that understanding spinal OA and taking proactive steps can help you regain control over your health. In this article, we’ll explore a conservative approach that has consistently delivered a 90% success rate in reducing pain and improving function. We'll show you how to enhance mobility, decrease discomfort, and live a more active life through manual therapy and targeted exercises.
Article Index
Anatomy of Spinal OA
Anatomy of Spinal OA
Why Antomy Matters: Understanding how spinal osteoarthritis (OA) affects the intricate structures of your spine—leading to pain, stiffness, and reduced mobility—empowers you to manage your condition better and take steps to improve your spinal health.
Spinal osteoarthritis (OA) impacts various critical structures in the spine, leading to pain, stiffness, and reduced mobility. The following are some of the key structures involved:
Vertebrae and Facet Joints: Facet joints connect the vertebrae and allow for smooth spinal movement. However, in spinal OA, the cartilage that cushions these joints deteriorates, leading to painful bone-on-bone contact. This process can also result in the formation of bone spurs, which further restrict movement and increase discomfort. Approximately 85% of people over the age of 60 experience facet joint osteoarthritis, highlighting its prevalence in older adults.
Intervertebral Discs: These discs, composed of a tough outer layer known as the annulus fibrosus and a gel-like center called the nucleus pulposus, function as shock absorbers between the vertebrae. In osteoarthritis (OA), the degeneration of these discs reduces their capacity to cushion the spine, leading to increased stress on the facet joints and potentially causing nerve compression. This compression can result in symptoms such as sciatica, which affects approximately 40% of individuals with lumbar OA.
Ligaments and Muscles: A network of ligaments and muscles supports the spine’s stability and movement. As spinal OA progresses, these soft tissues can become tight and stiff in response to the loss of joint function. This often results in muscle spasms, reduced flexibility, and decreased spinal mobility. Notably, around 80% of adults experience lower back pain at some point, often due to these musculoskeletal changes.
Diagnosis of Spinal OA
Why Diagnosis Matters: Accurately diagnosing spinal osteoarthritis (OA) is essential for identifying the exact causes of your pain and discomfort and differentiating OA from other potential conditions (differential diagnosis). This ensures you receive a tailored treatment plan that effectively addresses your specific symptoms and significantly improves your overall spinal health.
In these video demonstrations, you'll see the key orthopedic, neurological, and vascular tests we use to assess patients with Osteoarthritis. These exams are essential for understanding the spine's structure, the health of the nervous system, and any vascular issues that might contribute to symptoms. Performed alongside diagnostic imaging when necessary, these tests help us ensure a thorough and accurate diagnosis.
Orthopedic Testing
Orthopedic testing plays a crucial role in diagnosing spinal osteoarthritis (OA) by helping to pinpoint the exact cause of lower back pain. This process involves specific examination techniques that differentiate spinal OA from other conditions with similar symptoms, such as herniated discs. By accurately identifying the source of pain, these tests ensure that patients receive the most appropriate and effective treatment tailored to their unique needs.
Lower Limb Neurological Examination
The examination of lower limb neurology plays a significant role in the comprehensive neurological assessment, evaluating the motor and sensory neurons responsible for lower limb function. This assessment is critical for detecting nervous system deficiencies. Neurological testing becomes even more crucial in osteoarthritis patients due to potential nerve compression, resulting in pain, numbness, or weakness in the lower limbs.
Peripheral Vascular Examination: Key Considerations
A peripheral vascular examination is a crucial diagnostic tool to identify signs of vascular-related conditions. Early detection and treatment of Peripheral Vascular Disease (PVD) are vital in preventing cardiovascular and cerebrovascular complications.
Imaging for Spinal OA
Why Imaging Matters: Imaging plays a vital role in spinal osteoarthritis (OA) by providing a clear and detailed view of the spine’s structures. This helps confirm the diagnosis, assess the severity of degeneration, and differentiate OA from other potential conditions. This precision ensures that your treatment plan is accurately tailored to your specific needs, leading to more effective management of your symptoms and overall spinal health.
Key Imaging Modalities for Spinal OA:
X-Rays (Radiographs):
X-rays are typically the first imaging modality used to assess spinal OA. They provide detailed images of the bony structures in the spine, allowing for the identification of key indicators such as joint space narrowing, osteophytes (bone spurs), and subchondral sclerosis (increased bone density beneath the cartilage). These features are hallmark signs of OA and can be easily visualized on standard radiographs.
Magnetic Resonance Imaging (MRI):
MRI is the preferred imaging technique for assessing soft tissues in spinal osteoarthritis (OA), as it can detect early degenerative changes in intervertebral discs, ligaments, and the spinal cord before significant bone alterations occur. Unlike X-rays, MRI effectively identifies issues such as disc desiccation, annular tears, and nerve root impingement, making it especially useful for diagnosing conditions like spinal stenosis and nerve compression, which can lead to symptoms such as sciatica.
Computed Tomography (CT) Scans:
CT scans provide cross-sectional images of the spine with greater detail than X-rays, making them valuable for assessing complex bony structures. CT is especially useful for detecting small osteophytes, assessing the extent of facet joint hypertrophy (enlargement), and evaluating the degree of spinal canal narrowing.
Bone Scans (Scintigraphy):
Bone scans involve injecting a small amount of radioactive tracer, which accumulates in areas of high bone turnover. This technique is sensitive in detecting areas of active inflammation or bone remodelling that may not be apparent on X-rays or CT scans.
Bone scans can be beneficial in detecting early OA or in cases where OA affects multiple areas of the spine, providing a broader view of the condition's impact.
Ultrasound:
Ultrasound is less commonly used for spinal OA but can be beneficial for assessing superficial soft tissue structures and guiding injections or other therapeutic procedures. It provides real-time imaging and is non-invasive, but its use is generally limited to determining accessible areas and is not typically employed for deep spinal structures.
The OA Rating System for Spinal Osteoarthritis
"I don't understand what my doctor told me."
Why the OA Rating System Matters: Understanding it is crucial because it guides the treatment approach and helps you make informed decisions about managing your spinal osteoarthritis. Whether you have mild, moderate, or severe OA, knowing your rating allows you to tailor your treatment plan, ensuring that you take the necessary steps to slow progression, reduce pain, and maintain your quality of life.
Recognizing where you fall on the OA spectrum empowers you to take proactive measures, from exercise and manual therapy to potential surgical considerations, all aimed at preserving your mobility and independence. Here's a breakdown of what each category generally means:
Mild OA
Characteristics: Early-stage OA where cartilage begins to wear down slightly, but joint function remains intact.
Symptoms: Mild stiffness and occasional discomfort, especially after inactivity or by the end of the day.
Impact: OA has a minimal impact on daily activities. While it is not life-threatening, it is progressive—if left untreated, it can worsen over time. Preventive measures like exercise, manual therapy, and lifestyle changes are crucial to slowing its progression and maintaining joint health.
Moderate OA
Characteristics: Noticeable wear and tear on cartilage, often accompanied by bone spurs as the body attempts to stabilize the joint.
Symptoms: Increased pain, stiffness, and reduced range of motion, particularly during physical activity. You may feel discomfort during routine movements like bending or lifting.
Impact: Moderate limitations in daily activities, such as difficulty with prolonged standing or walking. Without intervention, the condition may continue to progress. Exercise remains essential to maintain mobility and strength, while manual therapy and lifestyle adjustments help manage symptoms and support joint function.
Severe OA
Characteristics: Advanced OA, where cartilage is significantly worn away, leading to bone-on-bone contact within the joints.
Symptoms: Persistent pain, significant stiffness, and a noticeable decrease in spinal flexibility. Symptoms may include nerve impingement and severe discomfort, even with minimal activity.
Impact: The severe impact on daily life makes routine tasks difficult or painful. Although OA isn’t life-threatening, its progressive nature can severely diminish the quality of life if not actively managed. In this stage, low-impact exercises are essential to maintain mobility without causing further joint damage, and manual therapy is crucial for the best results. Surgical considerations may be needed to manage symptoms effectively.
Understanding these categories helps tailor treatment strategies to your specific condition, ensuring you receive the most appropriate care to manage symptoms and maintain quality of life.
The Role of Manual Therapy in Managing Spinal OA
Manual therapy is vital in managing spinal osteoarthritis (OA) by addressing the bony structures (skeletal) and soft tissues contributing to discomfort. Picture your spine as a finely tuned machine—when one part isn't working correctly, it can throw everything off balance, leading to pain and restricted movement. Through spinal mobilization and skeletal manipulation, manual therapy helps restore joint mobility, easing the discomfort that limits daily activities and bringing your body back into harmony.
But it doesn’t stop there. Soft tissue treatments, like myofascial release, are equally crucial. These techniques target the muscles, tendons, and ligaments that support your spine, reducing tension, enhancing blood flow, and decreasing inflammation. This comprehensive approach—addressing both the bones and the soft tissues—ensures that your spine can move more freely and with less pain, helping you regain control of your life and stay active in the things you love to do.
Chiropractic Adjustments
This video demonstrates just one type of chiropractic procedure used to treat spinal osteoarthritis (OA). Depending on the specific case, we may also employ mobilization techniques, table drop procedures, and other treatment modalities.
Each approach is tailored to the individual’s condition, ensuring that the treatment is as effective as possible in restoring mobility, reducing pain, and improving overall spinal function. The selection of technique is based on the patient’s specific needs, symptoms, and response to previous treatments, making the approach comprehensive and adaptive.
Fascial Expansion: MSR Low Back Pain Protocol
Fascial expansion techniques are highly effective in addressing low back pain (LBP) from various origins, including spinal osteoarthritis (OA). In this video, Dr. Abelson demonstrates a specific procedure to restore balance and improve joint function, which works particularly well for spinal OA.
This is just one of many techniques we use. Depending on the case, we may employ dozens of myofascial release methods, each tailored to the individual’s needs, integrating fascia research, kinetic chain dynamics, and traditional Chinese medicine principles to reduce pain and enhance mobility effectively.
Treatment Frequency Recommendations
Why Treatment Frequency Matters: The proper treatment frequency is crucial for effectively managing spinal osteoarthritis (OA). An initial intensive phase helps to quickly alleviate pain, improve mobility, and reduce inflammation, while ongoing maintenance care ensures these improvements are sustained over time.
Tailoring the frequency of treatment to your specific needs helps prevent flare-ups, supports long-term spinal health, and maintains your quality of life.
Initial Treatment Phase (3 to 6 Weeks)
Goal: Alleviate pain, enhance mobility, and reduce inflammation.
Frequency: Patients may opt for either two 15-minute sessions or one 30-minute session per week, depending on the severity of symptoms and individual response to treatment. This phase emphasizes joint mobilization, soft tissue therapy, and strengthening exercises.
Transition to Maintenance Care
Criteria: If symptoms improve significantly after 3 to 6 weeks, patients can transition to maintenance care.
Frequency: Maintenance care can be customized based on ongoing needs, with options for either one 15-minute session or one 30-minute session per month. The focus during this phase is on maintaining mobility, managing any recurring symptoms, and adapting the exercise regimen as necessary to prevent flare-ups.
This structured approach allows for an initial focus on controlling symptoms with flexible, ongoing care to maintain long-term health and quality of life.
The Importance of Exercise in Spinal OA Treatment
Why Exercise Matters: Exercise is critical in managing spinal osteoarthritis (OA) because it addresses key areas such as cardiovascular health, mobility, and strength. Regular physical activity helps reduce pain and stiffness and stabilizes the spine, enhances flexibility, and supports overall joint function.
Incorporating targeted exercises into your routine empowers you to take control of your condition, improve your quality of life, and prevent further deterioration of spinal health.
Exercise Examples
The specific exercises we prescribe can vary greatly depending on the case. Below are some common exercises we could prescribe depending on the particular case. What you are seeing is a very small example of possible exercises.
Cat-Camel Stretch for Osteoarthritis
The Cat-Camel Stretch is an essential exercise for spinal mobilization, particularly beneficial for individuals with osteoarthritis (OA). It is highly recommended as the first activity upon waking, even before getting out of bed.
This gentle movement helps reduce the risk of paraspinal muscle spasms by increasing spinal flexibility and improving the spine's biomechanical properties. Integrating this stretch into your morning routine can be a powerful tool in managing OA-related stiffness and discomfort.
Bird Dog Exercise for Osteoarthritis
The Bird Dog exercise is an excellent tool for managing osteoarthritis (OA), particularly in the lower back. This exercise, performed in a four-point kneeling position, promotes neural grooving and is especially beneficial for individuals with low back pain or recent injuries.
The Bird Dog exercise enhances optimal biomechanics and efficient movement patterns by facilitating energy transfer from the lower extremities through the core to the upper extremities. It is crucial in improving proprioception, coordination, and stability, especially in the lumbar and pelvic regions, making it a vital component of an OA management plan.
Swiss Ball Squat for Osteoarthritis
If performing a standard bodyweight squat is challenging, the Swiss Ball Squat is an excellent alternative, particularly for individuals with osteoarthritis (OA). This beginner-friendly exercise effectively strengthens the gluteals, hamstrings, quadriceps, and calf muscles.
The stability ball supports proper alignment and posture. It helps improve balance, making it a safe and effective way to build lower body strength without placing excessive strain on the joints. Incorporating this exercise into your routine can help enhance mobility and reduce OA-related discomfort.
Balance Exercises for Osteoarthritis
Balance exercises are essential for individuals with osteoarthritis (OA), crucial in rehabilitation and maintaining functional mobility. These exercises help stabilize the body during everyday movements, reducing the risk of falls and injuries, which is especially important as OA can affect joint stability.
Incorporating simple balance exercises into a progressive training program can significantly improve balance, enhance joint function, and prevent further complications associated with OA. These exercises should be integral to your routine to support overall joint health and mobility.
Why Choose Our Approach for Spinal Osteoarthritis
When spinal osteoarthritis (OA) disrupts your life, you need a treatment that not only works but also feels personal and empowering. Our approach consistently delivers a 90% success rate in reducing pain and improving spinal function, giving you the relief and mobility you deserve.
You Get Established Expertise: Led by Dr. Brian Abelson, our method is built on over 30 years of clinical experience and the successful treatment of more than 25,000 patients. This extensive experience means you're in the hands of professionals who understand your struggles and are dedicated to helping you regain control of your life.
Experience Thorough Assessments: We take the time to understand your unique situation, thoroughly evaluating all contributing factors, from spinal misalignments to soft tissue restrictions. This comprehensive approach ensures that no detail is overlooked, so you receive a treatment plan that's as unique as you are.
You Experience Powerful MSR Procedures: Our Motion-Specific Release (MSR) techniques precisely target the areas causing your pain, restoring proper spinal function and relieving discomfort. These advanced procedures help you move freely again to return to doing what you love.
Receive Customized Exercise Programs: We know that recovery isn’t one-size-fits-all. That’s why we create individualized exercise plans that focus on strengthening your core and spinal muscles, enhancing joint stability, and improving your overall function. These exercises are carefully selected to support your journey toward a pain-free, active life.
We Take a Logical, Evidence-Based Approach: Our treatment protocols are grounded in the latest research and clinical evidence, ensuring you receive the most effective care. We don’t just treat your symptoms; we empower you with the knowledge and tools to take control of your spinal health.
With our proven, patient-centred approach, you're not just another case but a partner in your recovery. Take the first step toward a more active, pain-free life with confidence, knowing that we’re with you every step of the way.
REFERENCES
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Bijlsma, J. W., Berenbaum, F., & Lafeber, F. P. (2011). Osteoarthritis: an update with relevance for clinical practice. The Lancet, 377(9783), 2115-2126.
Degen, R. M., & Gandbhir, A. (2018). Management of osteoarthritis of the spine: an evidence-based approach to clinical care. Best Practice & Research Clinical Rheumatology, 32(4), 611-622.
Dieppe, P. A., & Lohmander, L. S. (2005). Pathogenesis and management of pain in osteoarthritis. The Lancet, 365(9463), 965-973.
Felson, D. T., et al. (2000). Osteoarthritis: new insights. Part 1: the disease and its risk factors. Annals of Internal Medicine, 133(8), 635-646.
Hunter, D. J., & Felson, D. T. (2006). Osteoarthritis. BMJ, 332(7542), 639-642.
Hurley, M. V., et al. (2007). Exercise interventions and patient beliefs for people with hip, knee or hip and knee osteoarthritis: a mixed methods review. Cochrane Database of Systematic Reviews, 4(4), CD010842.
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Manchikanti, L., et al. (2004). Evaluation of lumbar facet joint nerve blocks in the management of chronic low back pain: preliminary report of a randomized, double-blind controlled trial: clinical trial NCT00035577. Pain Physician, 7(2), 205-213.
McGill, S. M. (2010). Low Back Disorders: Evidence-Based Prevention and Rehabilitation. Human Kinetics.
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Vos, T., et al. (2016). Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet, 388(10053), 1545-1602.
Walker, M. J., et al. (2011). Manual therapy clinical practice guidelines linked to the International Classification of Functioning, Disability, and Health from the Orthopaedic Section of the American Physical Therapy Association. Journal of Orthopaedic & Sports Physical Therapy, 41(4), A1-A57.
Zhang, W., et al. (2008). OARSI recommendations for the management of hip and knee osteoarthritis: part I: critical appraisal of existing treatment guidelines and systematic review of current research evidence. Osteoarthritis and Cartilage, 16(2), 137-162.
Zobel, B. B., et al. (2004). Magnetic resonance imaging and computed tomography evaluation of lumbar disc herniation and spinal stenosis: prospective clinical comparison. European Spine Journal, 13(6), 527-534.
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DR. BRIAN ABELSON, DC. - The Author
With over 30 years of clinical practice and experience in treating over 25,000 patients with a success rate of over 90%, Dr. Abelson created the powerful and effective Motion Specific Release (MSR) Treatment Systems.
As an internationally best-selling author, he aims to educate and share techniques to benefit the broader healthcare community.
A perpetual student himself, Dr. Abelson continually integrates leading-edge techniques into the MSR programs, with a strong emphasis on multidisciplinary care. His work constantly emphasizes patient-centred care and advancing treatment methods. His practice, Kinetic Health, is located in Calgary, Alberta, Canada.
Why Choose Our MSR Courses and MSR Pro Services?
Elevate your clinical practice with our Motion-Specific Release (MSR) courses and MSR Pro services, designed to provide a comprehensive, evidence-based approach to musculoskeletal care. Here’s why you should join us:
Proven Methodology: Developed by Dr. Brian Abelson, an international best-selling author with over 30 years of clinical experience, MSR integrates the most effective elements of osseous and myofascial therapies. With a success rate exceeding 90%, our approach helps set a new industry standard.
Comprehensive Training: Our courses blend rigorous academic content with innovative techniques. You’ll master essential areas like orthopedic and neurological examinations, myofascial treatment, fascial expansions, and osseous adjusting and mobilization.
Extensive Resources: As an MSR Pro subscriber, access a vast library of over 200 MSR procedures, fillable PDF forms, instructional videos, and in-depth articles. From patient intake to tailored exercise prescriptions, our resources equip you for clinical success.
Tailored Support: Refine your diagnostic skills and expand your treatment techniques with ongoing support through over 750 videos, including 200 technique videos, 250 exercise videos, and 160 MSK articles. This extensive library features over 50 musculoskeletal condition articles, all designed to support you in clinical practice. Our resources are dynamic, with regular updates to articles, technique videos, and new additions to our educational curriculum.
Innovation and Growth: We emphasize continuous learning and innovation, giving you the tools to adapt and thrive in complex clinical scenarios. Our courses and resources are designed to foster professional growth, keeping you at the forefront of musculoskeletal therapy.
Unlock your practice's full potential with our MSR courses and MSR Pro services. Achieve outstanding clinical outcomes and join a community of forward-thinking practitioners dedicated to excellence in patient care.
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