Osteoarthritis refers to chronic inflammation of joint surfaces that limits the physical activity across vertebrae and greatly affects the quality of life. Osteoarthritis of lower back is most commonly reported in elderly individuals (mean age greater than 55 years); however, any person can develop osteoarthritis symptoms at a younger age.
The most common site of inflammation is lumbo-sacral joint followed by cervical vertebrae, knee joint and small joints of hand. Almost 25 million American suffer from varying severity of osteoarthritis each year that increases healthcare cost and disability due to limitation of physical mobility.
What are sign and symptoms of osteoarthritis involving lower back region?
Osteoarthritis of lumbar spine is characterized by following sign and symptoms:
– Joint back and stiffness in the region of lower back that limit physical independence and range of motion. The pain and stiffness is worse in the morning hours or after periods of prolong inactivity and improves as the day advances.
– Tenderness across involved joint that may also be associated with mild to moderate swelling
– Loss of flexibility and range of motion (although movement is mainly gliding in lumbar vertebrae but the stiffness involves sacral and pelvic ligaments also).
– Worsening of back pain towards the end of the day or prolong activity
– Radiation of pain to lower limbs (sciatica) and hip region.
– In cases of nerve involvement or impingement, loss of sensation and severe disabling pain.
– Loss of bladder and bowel control in later stages of illness.
What causes osteoarthritis of lower back?
Degeneration of joint surfaces is the primary inciting event that leads to osteoarthritis of lower back. Degenerative bone disorders affect the integrity of collagen, making all the movements painful and difficult by destroying joint cartilage.
The cartilage content of joint serve many purposes in the body, like:
– In episodes of sudden, excessive pressure at or around axial skeleton (like jumping or running), cartilage acts as shock absorber to prevent bone gliding with eachother.
– Synovial membrane around the cartilage produces synovial fluid that helps in reducing friction and rubs during gliding vertebral movements.
After substantial cartilage damage, degeneration process is progressive due to the formation of bony spurs (osteophytes) in the area of friction related injury and leads to full blown inflammation and surrounding tissue damage.
What increases your risk of developing osteoarthritis of lower back?
Osteoarthritis refers to damage to joint surfaces due to degenerative bone disease. Although advancing age is a significant risk factor that increases wear and tear across joint surfaces, following conditions also increase the risk of significant joint injury and inflammation that may lead to osteoarthritis of lower back:
– Family history or hereditary tendency of degenerative bone disorders
– History of moderate to severe injury or trauma in the region of lumbar spinal joints
Certain metabolic diseases and joint disorders can also increase the risk of osteoarthritis.
These include endocrinological abnormalities like Cushing syndrome, Thyroid crisis, long standing and uncontrolled diabetes mellitus, certain bone tumors and metastatic tumors to spine (breast and prostate) and osteoarthritis of other joints.
– Male individuals are at higher risk of developing more severe and debilitating osteoarthritis than females.
– Leg surgery or unequal bone length poses additional pressure on the spinal vertebrae and may lead to osteoarthritis of spine.
What are some treatment methods for osteoarthritis of lower back?
Most treatment modalities are focused at decreasing pain and stiffness around spinal joints and improving range of motion. The progression of degeneration process can be minimized by certain behavioral and lifestyle modifications.
– In order to reduce pain symptoms, pain killer and anti- inflammatory medications are most commonly employed.
– Steroid injection at the site of inflammation is helpful in aborting acute pain attack, refractory to other pain relief medications.
To improve range of motion and limit the degenerative process, following interventions are extremely helpful:
– Maintain regular physical activity (mainly static exercises like yoga) that strengthen your muscles, joints and ligaments
– Physical therapy is one of the most promising treatments available today for the management of osteoarthritis of lower back. It is also helpful in improving blood supply to the inflamed joints to hasten recovery.
– Chiropractic therapy like electrical nerve stimulation is mainly used to alleviate pain symptoms and improve disability due to stiffness.
How can you prevent osteoarthritis of lower back?
– Vitamin D supplementation is helpful in strengthening bones and joints.
– Regular intake of diets rich in calcium and other nutrients strengthen the immunity to fight disease process.
– Occupational therapy.
– Maintenance of appropriate posture.