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How can I manage the pain of arthritis in the spine?

Q) I have been diagnosed with arthritis in the spine. This is as a result of muscle spasms in my upper back (which I have had on and off for the last 11 years), sometimes left side and sometimes right. It is now occurring more frequently, and has occurred six times in the last eight months, which last for four to five days, and the pain is quite excruciating. Codeine, diazepam and paracetamol do not ease the situation at all. I have about 30 seconds to do anything before I need to place my hand on my back to help relieve some of the pain. I have had two osteotemies and two total knee replacements and also have arthritis in my hands, so I am quite used to pain, but this is something else and is quite wearing me down. I am wondering if you could throw any light on the situation for me on how to manage the pain?
Sandra, Wiltshire (Spring 2012)

A) I wonder if the severe pain and muscle spasms are due to ‘something getting caught’ or becoming misplaced in the spine. Sometimes, malalignment can cause such severe episodes, and gentle manipulation (by physiotherapists, chiropractors or osteopaths) can solve the problem relatively quickly. Sometimes little bits of tissue called plica can get caught up between the small facet joints of the neck. The facet joints allow your head to turn and they depend on the smooth movement of the two surfaces of the joint. If something gets in between the surfaces, then movement stops and pain starts, usually quite dramatically. Again, physical treatments such as gentle manipulation can be of help.

This answer was provided by Dr Philip Helliwell for the Spring 2012 edition of our magazine, Arthritis Today, and was correct at the time of publication.

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