Osteoarthritis (OA) of the spine

Osteoarthritis(os-tee-o-arth-ri-tus) is the most common type of arthritis, and the spine is one of the most commonly affected parts of the body. Osteoarthritis of the spine affects the back and neck.

颈部骨关节炎有时称为颈脊椎病。脊椎病的意思是“脊柱中的关节炎”，颈椎是颈部的医学术语。

您体内的关节在您的一生中经历了正常的损害和修复周期。但是有时您的身体修复接头的过程可能会改变其形状或结构。当这些变化发生在一个或多个关节中时，称为骨关节炎。

有回来或颈部疼痛doesn’t mean you have osteoarthritis. Most cases of neck and后退pain只有一小段时间才能自行改善，而无需治疗。

关节是两个或多个骨头相遇的地方。您有许多刻布接头，它们位于脊柱的两侧，并指导背部和颈部骨骼的运动。

There are 33 vertebrae in your spine – these start at the top of your neck and run all the way down your back, to your tailbone.

The spine is sometimes called the vertebral column or spinal column. Its purpose is to protect your spinal cord, carry the weight of your body and help you move around. The spine is split into five sections – cervical, thoracic, lumbar, sacrum and coccyx.

The ends of your facet joints are covered in a smooth and slippery surface, known as cartilage. There are also discs of cartilage between each of your vertebrae. The cartilage and discs allow your spine to move with as little friction as possible.

Strong ligaments surround your spine and support the vertebrae, to help keep them in place.

Osteoarthritis means that the cartilage of your facet joints and discs has got thinner and the surfaces have become rougher. This can mean that your back or neck don’t move as smoothly as they used to, and they might feel stiff or sore.

Osteoarthritis can affect anyone at any age, but it’s more common in women and people over 50. Injuries or other joint problems, such as痛风和rheumatoid arthritis, can make people more likely to get osteoarthritis.

那些不太活跃，没有健康饮食或超重的人更有可能患上脊柱骨关节炎。人们从父母那里继承的基因也会影响骨关节炎的风险。

The first sign of osteoarthritis of the spine is usually pain and stiffness in your back or neck.

这种情况可能很难诊断，因为很难说出哪些症状与骨关节炎有关。甚至很难在脊柱X射线上发现背部和颈部问题，因为骨关节炎引起的变化并不总是会引起疼痛。

Symptoms of osteoarthritis of the spine will vary from person to person. The most common symptoms are:

• pain in your back or neck
• stiffness, especially first thing in the morning or after resting
• crunching or grinding noises when moving your back or neck.

People who have osteoarthritis in their neck might also have headaches or feel pain in their shoulders and arms.

It’s normal for the cartilage in our joints to get thinner, especially as we get older. But in people withosteoarthritis，这是人体修复对关节损害的正常过程，可能导致疼痛和僵硬。

当人体开始修复软骨的损害时，整个关节可能会受到影响 - 包括骨骼，肌腱和韧带。

在维修过程中，脊柱中的骨骼边缘可以向外生长，形成骨马刺。这些被称为骨植物（发音为OS-TEE-OH-FITES）。脊柱中椎骨之间的椎间盘也会变得更薄。

疼痛可能会在早晨，一天结束时或以某种方式移动背部或颈部时会感到更糟。有些人的痛苦在晚上唤醒他们。您可能会发现自己的好日子和坏日子混合在一起，并且您的痛苦数量改变了。

Are there any complications?

有些脖子上有骨关节炎的人可能会吞咽或说话时会出现问题，但这不是很常见。这可能是由影响脊髓血液供应的骨刺引起的。

If you have osteoarthritis of the spine, you may have other problems that may need treating. Let your doctor know urgently if you:

• 难以获得wee，或者觉得您不需要时就需要一个wee
• 你的bladd失去控制er or bowel – the organs that control wee and poo
• 在生殖器或底部有麻木或刺痛感
• lose power in your legs
• 感到不适 - 像发烧或出汗。

Spinal stenosis

Spinal stenosis is a condition that happens when the spinal canal, which contains the spinal cord, gets narrower. The most common symptoms are pain and weakness or numbness in the area linked to the affected part of the spine – such as the legs, arms, neck, back or shoulders.

Spinal stenosis is often caused by osteoarthritis, as the bony spurs that form on the edge of the vertebrae can irritate the nerves in your spine. It can usually be treated with exercise, over-the-counter drugs and类固醇注射s.

Sometimes surgery will be needed to remove the spurs and make space in the vertebral column.

您可以为自己做的各种不同的治疗方法和事情可以帮助您的痛苦和僵硬。

Exercise

保持运动is an important way to reduce the pain caused by yourosteoarthritis. Many people with joint pain worry that moving more could make things worse, but this isn’t true. Keeping your muscles and bones strong will support your joints.

锻炼还将帮助您实现和保持健康的体重，从而减少脊椎和腿部的压力。

您可能会在锻炼时听到紧缩或刺耳的声音，但这无需担心，并不意味着关节正在损坏。如果您的脖子上有骨关节炎，这些噪音似乎很大，但这仅仅是因为它们离耳朵很近。

There are three types of exercise you should try to do:

• 伸展运动 - 可以帮助维持和改善关节的运动范围。
• 加强锻炼 - 有助于保持肌肉和关节的强大和支撑。
• Aerobic or fitness exercises, which just means anything that increases your heart rate. These are great for your heart and can also help with back pain.

You should try to do at least two and a half hours of aerobic exercise each week to keep yourself healthy. This is about 20 minutes a day. Start off slowly and gradually build up how much you do.

You should also try to do strengthening exercises two days a week. Try to include the:

• 武器
• 后退
• legs
• 胸部
• tummy
• 后退
• 肩膀
• 臀部。

If you’re at risk of falls, it’s important to do exercises to improve your balance and coordination at least two days per week.瑜伽和tai chican improve your balance and help your后退pain.

You might need to avoid high-impact exercises such as running and lifting weights at times. These can put more strain on your joints, and you may feel stiff or sore. Swimming and cycling can be good alternatives, as your joints are supported while you exercise.

YourGPcan talk to you about exercises, or they might be able to refer you tophysiotherapy用于量身定制的运动计划。物理治疗师可以根据自己的享受和感受建议最好的运动类型。

Depending on what’s available in your area, your GP may also be able to arrange for you to have水疗, where exercises are done in a warm-water pool with a physiotherapist. Hydrotherapy can also be called aquatic therapy.

It’s a good idea to talk to your doctor or physiotherapist before you start any new exercises. Here are some脖子运动和后退您可能想尝试。

Diet

超重会给脊柱的骨骼带来更多压力，尤其是下背部，因此保持健康的体重很重要。保持平衡也很重要饮食，使用所有维生素和营养，您需要保持健康。

You can try to lose weight by doing more exercise and eating a healthier diet, but make sure you speak to your doctor about this first, so they can give you advice. There’s nothing to suggest that a specific diet will help with osteoarthritis, so it’s important that you don’t avoid any food groups entirely.

Helping your joints

节奏活动可能有助于减轻您的背部和脖子上的压力。这可能意味着将任务分为阶段，或者每天做一些事情。在休息和活动之间找到自己的平衡，并确保休息一下，然后才能感到疲倦，无法继续或痛苦。

改变你的姿势可以减少肌肉紧张。Awkward positions can affect the muscles and tissues that support your spine, and this could lead to more pain. Try to change position and posture regularly, and consider your posture when working, watching TV, sitting, texting and walking.

举起东西时避免扭曲脊椎。相反，保持背部伸直并弯曲膝盖。保持您所携带的物质的重量，例如购物，靠近身体，不要抬起超出您的管理。

Aphysiotherapist or anoccupational therapist可以为您提供姿势并节奏活动的建议。职业治疗师也可能会为您提供可以帮助您在家中的辅助和设备，例如长柄伸手和袜子艾滋病。

舒适和支持shoes可以帮助减少脚部的压力以及臀部，膝盖和脊椎。尝试选择鞋子厚实的鞋底，脚趾上有足够的空间。

Coping with low mood and sleep problems

疼痛生活会影响您的心情和睡眠，并且不时感到沮丧是正常的。如果这是影响您的事情，请尝试前往疼痛诊所，在那里您可以学习如何manage your pain. They’ll usually take place at outpatient clinics, and you can be referred to them by whoever is treating you.

Pain can be affected by different things, including feeling low or stressed. There are a number of talking therapies and techniques you can learn, which can help you manage your pain, support your情感福祉并应对您可能会有的任何低迷感。正念和认知行为疗法（CBT）可以帮助骨关节炎。

Learning to relax your muscles can also help, particularly if you have neck pain and are feeling stressed, as this can cause your muscles to become more tense.

Apillow that’s too firm or thick can make neck pain worse. Try tosleepwith your head level to the rest of your body. It’s important to have a mattress that gives your head and spine proper support.

Try having a hot bath, reading a book, or listening to the radio or a relaxation CD to wind down before bed. If pain is waking you during the night, try taking paracetamol or anotherpainkiller睡觉前。与您的医生或睡眠专家交谈以获取更多建议。

有许多不同的药物可以用来帮助管理脊柱骨关节炎的症状。但是，与所有药物一样，可能会有一些副作用。最好与医疗保健专业人员讨论最佳选择。

止痛药和非甾体抗炎药

Many people withosteoarthritiswill find that止痛药可以在柜台上或从商店和化学家（例如扑热息痛）上购买，这可以帮助疼痛。

有些人可能需要服用更强的止痛药，例如复合镇痛药或阿片类镇痛药。但是，这些仅在短时间内有效，并且对于某些类型的脊柱问题而言不可用。化合物镇痛药包括共二莫和阿片类镇痛药包括吗啡和曲马多。

非甾体类抗炎药（NSAIDS）can help with pain and inflammation. Ibuprofen can be bought from supermarkets and chemists, but some stronger NSAIDs, such as naproxen and celecoxib, are available on prescription.

一些NSAID也可以作为奶油或凝胶可用，可以在受影响的区域摩擦以帮助疼痛。如果您已经服用了NSAID的平板电脑或液体版本，请先与您的医生讨论面霜和凝胶，因为您可能无法同时使用这两者。

Drugs for nerve problems

如果背部或颈部的骨关节炎会导致您的神经问题，那么有些药物可能会有所帮助。它们不会减轻骨关节炎引起的疼痛，但它们可能会帮助您的神经被压制或捏住。

阿米替林can help relax your muscles and improve your sleep, while drugs such as gabapentin or pregabalin work to reduce the effects on your nerves. These drugs are only available on prescription and will only be given if you’re having symptoms of nerve problems.

与所有药物一样，它们对某些人可能会有所帮助，但对每个人都不起作用。

Injections

如果您患有某些脊柱骨关节炎症状，则可以使用两种类型的注射。

A类固醇注射, either in the neck or the tailbone, can help with the problems caused by any of your nerves in your spine being irritated. They’re also used sometimes to treat pain caused by arthritis in other joints in the body. These should work for a few months.

射频改造可用于治疗由小相接头变化引起的疼痛。它涉及通过针尖通过针头的电流来阻止脊柱中的神经末端，从而向大脑发送疼痛信号。

在射频神经区神经上，您将首先给您注射称为局部麻醉剂，以使皮肤麻木。然后，当医生看脊柱X射线时，您会躺在前面，以便它们可以注入正确的位置。如果有效，您可以期望它可以持续两年，并且您可能会在以后再做一次。

Warmth on the affected joints has been shown to reduce pain and stiffness. This can be a bath or shower in warm water, or a heat pack applied to your skin. Different heat packs are available – many of which are reusable and can be heated in the microwave.

有些人发现，使用冰袋，冷垫或冰冻蔬菜包装可能会舒缓。在皮肤上涂热或冷包时，请确保将它们包裹在茶巾中，而不是将其放在裸露的皮肤上，并且切勿将其放置超过20分钟。

Transcutaneous electrical nerve stimulation (TENS)是缓解疼痛的一种方法，涉及通过连接到皮肤的垫子发送电脉冲。Aphysiotherapist或药剂师应该能够为您提供有关可用的不同TENS机器的建议。如果您患有下腰痛或起搏器，请与医生交谈，以了解数十个，因为这种治疗可能不适合您。

TheAlexander Technique是一种改善姿势的疗法，并通过教授新的坐，站立和移动的方式来减轻脊柱的压力和张力。

Massage和针刺can sometimes provide pain relief, alongside exercise. The healthcare professionals treating you should be able to give you information on how to access these treatments.

Osteoarthritis of the spine can often be treated without surgery. But if you’re struggling to manage your symptoms, you might be referred to a surgeon, who will discuss your options with you.

Spinal stenosis that is irritating your nerves could lead to pain, numbness and weakness, which could affect your legs and arms. If this is happening, or if it’s affecting your bladder or bowel, you may benefit from surgery.

外科手术could involve a small piece of bone or a disc being removed from your spine. In some cases, two or more of the vertebrae are fused together, to give the spine more stability.