Dorsarthrosis is arthritis that has settled in the dorsal vertebrae and which results in progressive wear of the intervertebral discs. It can be secondary to an infection of the intervertebral discs, an inflammation of the vertebral joints, a trauma having affected the spine or a scoliosis attitude. It results in “belt” pain in the middle of the back or possibly in the chest. Back osteoarthritis cannot be cured. The objectives of its management are the relief of pain and the maintenance of good joint mobility.

Dorsarthrosis is arthritis that has settled in the dorsal vertebrae, that is to say at the level of the twelve vertebrae located in the middle of the spine. Fairly widespread, it is a condition which results in progressive wear of the intervertebral discs. 

Back osteoarthritis is all the more common as we get older. In fact, osteoarthritis of the spine is the most frequently diagnosed form of osteoarthritis in people aged 65 to 75 years.

This chronic pathology is generally secondary to:

• an infection of the intervertebral discs such as spondylodiscitis;
• inflammation of the vertebral joints, such as Scheuermann’s disease;
• trauma to the spine such as a spinal fracture caused by a fall or shock;
• a scoliotic attitude (slightly deviated spine).

Osteoarthritis increases with age, but osteoarthritis can occur sooner or later and be more or less severe if there are contributing factors. The main factors that can promote back osteoarthritis include:

• aging ;
• frequent excessive exertion resulting, for example, from certain professional or sporting activities;
• bad postures leading to too intense mechanical postural stress;
• overweight ;
• carrying heavy loads;
• smoking;
• excessive alcohol consumption etc.

Back osteoarthritis is often silent because the dorsal part of the spine is a region that takes little part in the rotational movements of the body. 

Symptoms include a gradual onset of joint pain, which gets worse with weight bearing or fatigue and is relieved with rest, and stiffness that reduces activity. Back pain usually manifests as “girdle” pain in the middle of the back, or possibly in the chest, similar to heart, lung or abdominal pain.

Symptoms are mainly manifested by:

• difficulty in sitting correctly (classically, a patient with back osteoarthritis only sits on one buttock);
• pain experienced when breathing or touching the back.

The psyche seems to influence the onset of pain and its intensity. 

As with all types of osteoarthritis, back forms cannot be cured. However, they can be relieved. That is why the management of osteoarthritis includes the prevention and treatment of pain. 

Medical treatment

The treatment of osteoarthritis of the spine is primarily medical. Surgery is very rarely considered. The goals of back osteoarthritis treatment are pain relief, maintenance of good joint mobility and overall correct functionality.

• oral or topical non-steroidal anti-inflammatory drugs (NSAIDs) such as type 2 cyclo-oxygenase inhibitors or coxibs for use in times of crisis;
• analgesics: paracetamol up to 1 g orally 4 times / day, tramadol;
• low dose muscle relaxants such as cyclobenzaprine, metaxalone, and methocarbamol;
• oral corticosteroids.

Re-education

Rehabilitation seeks to stop congestive attacks of osteoarthritis more quickly or to strengthen the spine to reduce pain and daily discomfort.

The objectives of the physiotherapy sessions are to:

• reduce pain through massage therapy or the use of physical therapy (use of electric currents, ultrasound, electromagnetic waves, hot and cold). The physiotherapist can also teach the patient certain movements or exercises to be performed at home and advise him on the positions or attitudes that can reduce pain;
• maintain or partially recover a certain mobility. Performing movements with or without physical assistance and specific massages can improve muscle strength and flexibility in joints affected by osteoarthritis, thereby increasing range of motion;
• strengthen the muscles to stabilize the joints and limit deformities. Exercise that uses physical therapy is important both for maintaining physical fitness and for combating joint instability and strain due to osteoarthritis. 

Changes in daily activities can also help relieve pain:

• avoid sitting on soft, deep seats and sofas, which make it difficult to get up and which lead to poor posture;
• sit on straight chairs without slouching;
• sleep on a hard bed, possibly with a board;
• use a comfortable, forward-tilted car seat;
• practice postural exercises;
• wear shoes with an arch or athletic shoes;
• practice regular adapted physical activity.

Finally, losing about 5% of your weight can improve pain and protect your joints.