Can Arthritis Cause Back Pain?

Arthritis is a joint disorder causing pain, tenderness, swelling, and limited movements of one or more joints. The most common types of arthritis are osteoarthritis and rheumatoid arthritis, while there are many other forms too. One of the questions commonly asked is can arthritis cause back pain? Well, the answer to this is yes, arthritis can be a cause of your back pain in various ways. Let us understand this in detail.

Around 80% of Americans have an episode of low back pain during their lifetime. Low back pain is one of the most common causes of healthcare visits in the United States, accounting for over 45 million trips in 2006.¹

Arthritis commonly affects the hands and the legs but can also affect the spine. Moreover, there is also a chance that arthritis of the other joints or other types of arthritis can cause back pain. It is important to understand the conditions related to arthritis that can cause back pain, associated factors, and what studies say about the correlation.

Arthritis can be inflammatory or non-inflammatory, related to wear and tear or a result of inflammation, infection, or other disease processes. The causes can be many, but if the type of arthritis affects the neck, back, or the spine, it can result in back pain, stiffness, and restricted movements of the back.

Some types of arthritis that can cause back pain include osteoarthritis of the spine, axial spondyloarthritis, reactive arthritis, enteropathic arthritis, spinal stenosis, fibromyalgia, polymyalgia rheumatica, Paget’s bone disease.² A report on arthritis details its physical distribution and states the conditions related to arthritis that can affect the spine and cause back pain. Osteoarthritis is the common form of arthritis with axial or spine involvement. Non-inflammatory axial arthritis named diffuse idiopathic skeletal hyperostosis (DISH) is another cause. Of the inflammatory types, ankylosing spondylitis, reactive arthritis, IBD-associated arthritis, psoriatic arthritis, undifferentiated seronegative spondyloarthritis, and non-radiographic axial spondyloarthritis. Other causes of inflammatory types with axial involvement include juvenile idiopathic arthritis (JIA) and SAPHO syndrome.³

The commonest cause is spinal arthritis due to degenerative changes or osteoarthritis of the spine. Arthritis can affect any articular surface and is more likely to affect weight-bearing joints, including the joints of the spinal column. The spine protects the spinal cord, sustains weight-bearing, and provides mobility. Degeneration forms vertebral osteophytes, facet joint osteoarthritis, and disc space narrowing.¹ This often causes back pain, and stiffness in the back and increases the risk of further injury to the area.

A report on whether osteoarthritis of the lumbar spine causes chronic low back pain reported that osteoarthritis of the lumbar spine can cause low back pain. Patients who do not have osteoarthritis of the facet joints on magnetic resonance scans do not have back pain.⁴

Spinal arthritis is inflammation of the facet joints in the spine or sacroiliac joints between the spine and the pelvis. It may be related to wear and tear, autoimmune disorders, infection, and other conditions.⁵

Let us look at some ways in which the common types of spinal arthritis can cause back pain:

• Axial spondyloarthritis or ankylosing spondylitis affects the hips and causes damage to the sacroiliac joint causing pain and stiffness in the back.
• Osteoarthritis, a degenerative form of arthritis results from the breakdown of cartilage and affects the facet joints. Rubbing of bones irritates, spur formation and can result in nerve compression and pain.
• Reactive arthritis that occurs after certain infections can cause joint inflammation and affect the spine causing back pain.
• In spinal stenosis, the bony overgrowth of the vertebrae causes narrowing of the spinal column and compresses the nerves. This can result in back pain and numbness in the lower body.

Spinal osteoarthritis being the most common cause of back pain, it is important to know the signs and symptoms. The complaints can range from the neck to the lower back and pain in one area can gradually affect the muscles and tissues in the surrounding area as well.

• Pain and Stiffness – Neck and back pain with stiffness are usually more in the morning that lasts for about half an hour after waking up. The pain usually subsides once you start moving around or carrying on your daily activities. Pain and stiffness are often experienced again after exertional activities or towards the end of the day. Sometimes, pain can also disturb sleep at night.
• Tenderness – The affected area or joint is tender to touch and very sensitive. Surrounding muscles may feel tenser and sometimes difficult to maintain an erect posture due to a lack of muscle strength. Weather changes may cause more pain and stiffness in some cases.
• Limited Range of Motion – With stiffness and pain in the region, the movement of the back is affected. There is the inability to bend or twist the back which can cause pain if performed.
• Numbness and Tingling – If degenerative changes or muscle spasms irritate nerves, it can cause back pain along with numbness and tingling sensation in the limbs.

A study reports hip osteoarthritis as a possible cause of low back pain. Hip osteoarthritis is common in the aging population and symptomatic hip osteoarthritis has been reported in 9.2% of adults aged more than 45 years, significantly limiting their activities and quality of life.5 Some of the possible causes for low back pain in such cases include abnormal sagittal spine-pelvis-leg alignment, reduced range of motion of the hip joint, limited hip flexion, reduced hip abduction, and asymmetric hip rotation.⁶ Proper diagnosis can help plan appropriate treatment to help in the restoration of alignment and improve hip range of motion, which can control low back pain.

Arthritis can cause back pain, particularly if the spine is affected. However, other forms of arthritis that affect the hips, knees, and neck too can contribute to back pain, due to affected muscles and tissues connecting to the back, limited movement of the affected joints, and postural changes. Identify the symptoms and seek timely medical advice to get a proper diagnosis and begin appropriate treatment.

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