Nonsurgical Treatment for Osteoarthritis of the Spine

Doctors often recommend physical therapy to help people with osteoarthritis of the spine build strength in the muscles that support the spine, reduce stress on the joints, and relieve pain. Physiatrists and physical therapists at NYU Langone’s Rusk Rehabilitation are specially trained in spinal rehabilitation and can create a customized exercise program for you.

The focus of physical therapy in the lumbar spine, or lower back, is to build strength in the core muscle groups, which include muscles in the thighs, back, buttocks, and abdomen. These muscles work together to support and stabilize the spine, and when they’re strong, they act like a built-in brace that diminishes the impact of the body’s weight on the spine during movement.  

If osteoarthritis affects the cervical spine, or neck, physical therapy focuses on muscle groups in the neck and shoulders. Stretching and strengthening these muscles supports and protects the neck and promotes flexibility. 

Physical therapy usually continues for six to eight weeks, at which time your doctor assesses your progress and determines whether further therapy may benefit you.

Our doctors and physical therapists may also recommend stretching and conditioning exercises you can do at home. Stretching the muscles in your legs, back, neck, and shoulders aids in preserving full movement in the spine. Doctors may also suggest low-impact exercise such as yoga, tai chi, or swimming to keep the circulatory system healthy and muscles toned and flexible. 

Our doctors and therapists also offer therapies to relieve pain and reduce stress. These include acupuncture, in which doctors use very thin needles to relieve tension in various parts of the body; acupressure, a type of therapeutic massage; and meditation. These therapies are available at Rusk Rehabilitation.

Your doctor may recommend an over-the counter pain relief medication to treat discomfort caused by osteoarthritis of the spine. Many doctors recommend acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), which include aspirin, ibuprofen, and naproxen. These medications are taken by mouth and are available at drugstores.

Acetaminophen blocks pain signals that travel from the site of an inflamed joint to the brain. NSAIDs relieve pain and swelling that result as the body’s immune system responds to joint damage caused by arthritis. Many people find that these over-the-counter medications alleviate aching and stiffness in arthritic joints, making movement easier and helping them to remain active.

Although acetaminophen is safe in moderate doses, it has been linked to liver problems with long-term use. NSAID use is associated with side effects such as high blood pressure, headaches, and stomach upset, as well as heart or kidney disease, when taken for an extended period. Your doctor can explain the risks and recommend a safe regimen based on your symptoms, age, and other medical conditions that could affect or interact with these medicines. 

If over-the-counter medications don’t adequately relieve pain and stiffness from osteoarthritis within a number of weeks, doctors may prescribe a stronger medication.

If pain caused by osteoarthritis of the spine doesn’t respond to medication and physical therapy, doctors may recommend an injection of corticosteroids and anesthesia directly into the affected facet joints. The anesthesia temporarily relieves pain, and the corticosteroids reduce inflammation, which may alleviate pain for weeks, months, or even a year. There is no reliable way to predict whether an injection can be effective, or how long pain relief may last, but many people experience significant relief for three months or longer.

Doctors usually recommend a facet joint injection for pain caused by joint degeneration, or an epidural injection if narrowed disc space puts pressure on a nerve as it exits the spinal canal. Doctors administer either type of injection in the lower spine or the neck depending on the location of pain.

You can expect to return home one or two hours after receiving the injection. Most people experience slight tenderness at the injection site for a day or two.

Corticosteroids injected into the spine carry some risk of side effects, including headache and discoloration of the skin at the site of injection. Doctors recommend limiting spinal injections to no more than two or three a year.

Acupuncture is a therapeutic technique in which very thin needles are inserted into various points on the surface of the body. By targeting specific points along “meridians” that correspond to the nerve pathways affected by osteoarthritis of the spine, acupuncture may stimulate healing by increasing blood flow and reducing inflammation, which can improve joint function. Acupuncture may also prompt the body to release endorphins, which are natural pain relievers. 

Licensed acupuncturists administer this therapy in a relaxed setting at NYU Langone. Acupuncture needles are left in place for 20 to 40 minutes. For optimal results, doctors may recommend 6 to 10 acupuncture sessions.

Being overweight stresses the spine and may cause osteoarthritis to progress more quickly. Losing weight and exercising can help reduce stress on the spine, build bone mass, and increase muscle strength, which relieve pain and benefit your overall health. 

Our doctors understand that weight loss is not easy and offer assistance with making healthy lifestyle changes through NYU Langone’s Weight Management Program.