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It occurs when the cartilage of the joints in the lower part of the spine is damaged or degenerated.
Lumbar osteoarthritis causes mild and severe low back pain, stiffness, joint blockage, and muscle spasms.
Occasionally, complications can occur, causing symptoms such as pins and needles penetrating this part of the spine, weakness, and numbness in the leg. It develops gradually, and you have likely had low back pain for a few years.
Characteristically pain and stiffness levels are worst in the morning, relieved by getting up and moving for an hour or two; however, pain and stiffness will start to return at night.
Gentle exercise and movement help relieve pain levels, as do hot or cold packs.
Any prolonged static posture or rigorous activity aggravates pain levels. It most commonly develops in the age group over 50. However, it can occur as early as the age of 20.
What is lumbar osteoarthritis?
Lumbar osteoarthritis is also known as cervical spondylosis or joint degeneration, but you’ve probably heard most people use the term “joint wear and tear.”
Wear and tear encompass precisely what this condition is.
Lumbar osteoarthritis is a chronic degenerative disorder that affects the neck joints’ articular cartilage and subchondral bone. The term “wear” suggests that the degeneration of these surfaces is a gradual and repetitive process.
The joints in your neck are designed to withstand the pressures of wear and tear. The affected joints in the lower back are called facet joints; this is where the vertebrae above and below meet.
The bony surface of a joint is known as the subchondral bone. Both sides of the subchondral bone of the joints never meet, as they are separated by a protective layer of articular cartilage that covers both bone surfaces.
Also, a small amount of thick fluid called synovial fluid cushions the ends of the joint and is enclosed in a capsule that contains the entire joint.
The smooth cartilage, fluid, and capsule allow the joint to move smoothly, flexibly, and stably.
Your lower back relies on your discs and facet joints to join the spinal vertebrae to allow and control the movement of your lower back.
Now consider how much you use your lower back daily and imagine how much stress these joints damage throughout your life.
Your body is designed to repair some of this daily wear and tear on your joints. However, in more pronounced or prolonged injuries, your body struggles to fix all of the damaged joint cartilage.
This abnormal damage begins to erode the surface of the cartilage.
This exposes the sections of the subchondral bone below and leads to further damage.
The exposed subchondral bone outside the joint reacts by developing new bone spurs called osteophytes. This attempts to compensate for the loss of articular cartilage. At the same time, the cartilage breaks down and begins to mix with the synovial fluid.
In motion, these bits of cartilage floating in the joint cause a crackling and crackling noise, which can be painless.
When the cells of the joint capsule begin to try to clean and remove the cartilage fragments, an inflammatory reaction occurs that inflames the joint capsule and synovial fluid.
These new bone growths, mixed with inflammation of the joint capsule, can be both painful and very debilitating.
When the cells of the joint capsule begin to try to clean and remove the cartilage fragments, an inflammatory reaction occurs that inflames the joint capsule and synovial fluid.
These new bone growths, mixed with inflammation of the joint capsule, can be both painful and very debilitating.
When the cells of the joint capsule begin to try to clean and remove the cartilage fragments, an inflammatory reaction occurs that inflames the joint capsule and synovial fluid.
These new bone growths, mixed with inflammation of the joint capsule, can be both painful and very debilitating.
Symptoms of lumbar osteoarthritis
Lumbar osteoarthritis initially presents as mild lower back pain and stiffness. Because it typically involves more than one joint, it is more likely to feel like a generalized low back pain rather than a point of spike pain.
As the joint becomes more and more degenerated, common pain symptoms will couple to severe stiffness leading to a severe loss of motion.
The levels of joint stiffness can result in a painful lock of the joint.
As a result of stiffness and secondary to pain, the lower back muscles may begin to weaken, and the ligaments may become looser. This can lead to unstable and more injury-prone joints.
The surrounding muscles and tendons may begin to spasm, and this contraction is a compensatory reaction to secure and support the joint.
Lumbar osteoarthritis is a slow, gradual condition that occurs over many years. Pain levels can be mild from one day to the next; however, pain levels can be very high; patients are advised to rest during a flare-up.
The pain has been described as a sharp ache, an intense dull ache almost like a toothache, and a burning sensation. Stiffness levels are characterized by worse stiffness first thing in the morning that improves after moving for half an hour.
Pain levels gradually worsen throughout the day, reaching the worst levels at night. Rest provides the most relief, as do gentle movements and heat packs on the affected area.
Prolonged static postures, such as standing or sitting, aggravate pain levels, and some patients also associate cold weather changes with increased pain levels.
The pain does not always remain localized to the lower back and often leads to mid-back pain. It also can radiate down into the buttocks. The muscle spasm that occurs can also be excruciating in and of itself.
Complications can occur if an osteophyte grows close to the nerve from the spinal cord branches to the leg.
If the osteophyte compresses or impinges on the nerve, it can cause severe leg pain, pins and needles, weakness, and numbness, very similar to the symptoms seen in a lumbar disc herniation.
Similarly, if the osteophyte enters the spinal cord, it could lead to cervical myelopathy. In some cases, high levels of degeneration can weaken the joint and lead to cervical spondylolisthesis.
This is when one vertebra becomes unstable and slides forward over another.
Pathology
Normal joints move quickly because healthy cartilage cushions the bones as they move against each other.
In spinal osteoarthritis, the cartilage that lines the facet joints (vertebral joints) wears down, allowing the bones to rub against each other.
Osteophytes (small bony growths, also known as bone spurs) form in the facet joints and around the vertebrae to restore stability to the joint. Little by little, the spine stiffens and loses flexibility.
Osteophytes sometimes become large enough to cause narrowing of the spinal canal or foramen, and irritating or trapping nerves pass through them (spinal stenosis and foraminal stenosis).
Stenosis, while related to osteoarthritis, is a particular medical condition.
Osteoarthritis can also be confused with degenerative disc disease, a gradual deterioration of the discs between the vertebrae, but it is a different medical condition.
Osteoarthritis occurs as a person ages, but it is not a direct result of aging.
It can be due to repetitive use, high mechanical stress, injury, joint infection, obesity, ligament damage, hormonal problems, pregnancy, and other conditions. Heredity also plays a role.
Causes of lumbar osteoarthritis
Mainly, osteoarthritis is considered a chronic degenerative disorder associated with aging. However, some people live well into their nineties without signs or symptoms of the disease.
As we age, we lose some of the protective elements of our joint surfaces.
We also do not retain water, the blood supply to our joints decreases, and our body is not as fast or efficient in repairing worn surfaces, so leaving our cartilage in our joints is more susceptible to injury.
Secondary causes of osteoarthritis have been linked to genetics, and some cases are linked to a hereditary development of the disease.
Our lifestyles can also contribute; obesity creates a more significant load on your joints, particularly the knees and hips. In these cases, osteoarthritis is more prevalent, and the extent of degeneration is more severe.
Occupations and hobbies can lead to repetitive loads such as running, or drilling equipment can lead to an early onset of the condition in the most directly affected joint.
Previous injuries, such as fractures or sprains, can also initiate early cartilage degeneration.
Millions and millions of people suffer from a form of osteoarthritis, which affects more women than men.
The condition can be triggered at any age, occasionally as early as 20; however, in most cases, signs and symptoms begin to appear in people over the age of 50.
Osteoarthritis can develop in any joint in the body but most commonly affects the spine, hands, feet, knees, and hips.
Diagnosis
Your GP will be able to diagnose you by listening to your history and examining you. An x-ray of the affected area is usually recommended to confirm the diagnosis and assess the level and extent of degeneration.
The proper treatment of back pain depends on the cause. To diagnose the cause of your back pain, your doctor will take your medical history, perform a physical exam, and may order X-rays or other imaging studies of the spine.
Treatment is aimed at controlling pain, maintaining joint mobility, and slowing progression. A treatment plan should be developed, including exercise, medications, and measures to protect the joints.
You may also be referred to a rheumatologist (a doctor specializing in diseases of the bones and joints), a physical therapist, a doctor specializing in pain, or a surgeon.
Lumbar osteoarthritis treatment
The proper treatment of back pain depends on the cause.
Lumbar osteoarthritis treatments are generally nonsurgical; however, when osteophytes have affected a nerve or are precariously close to involving the spinal cord, your GP may refer you to a specialist who will restore growth.
Spinal surgery carries high risks, so it is only considered individually if the benefits outweigh the risks.
Unfortunately, there is no cure for osteoarthritis. Instead, treatment is usually aimed at reducing pain levels and preventing further degeneration.
Patients usually opt for a combination of treatments; the essential thing is modifying their lifestyle and avoiding or adapting certain activities to minimize any possible discomfort.
Overweight people need to consider weight loss as part of their treatment, as it has been shown to dramatically reduce pain and stiffness levels in particular cases where the knees and hips are involved.
Rest is essential through severe flare-ups, but it’s just as important to start exercising your back lightly as soon as you feel like you can.
Light exercises provided by your therapist or trainer will strengthen your back and maintain its flexibility and help prevent any additional stiffness.
Many patients find that manual manipulative therapies such as chiropractic, osteopathy, and physical therapy help prevent severe flare-ups. Still, they also help with stiffness and general day-to-day pain levels.
Massage therapies and the Bowen technique have also been found to help loosen muscle spasms around the joint.
Your GP will likely prescribe anti-inflammatory pain relievers to reduce and control the painful inflammation with severe episodes.
Topical creams like capsaicin cream have been said to help relieve pain, the cream made from chili peppers masks the pain by blocking nerve cells and preventing them from sending pain signals to the brain.
It is said to be particularly effective when used on the hands or knees, although not all people find it helpful.
Many patients also chose to take glucosamine and chondroitin supplements as they are components found in cartilage; however, recent studies have questioned the benefits of these supplements for osteoarthritis.
Your GP may use muscle relaxants or even cortisone injections to reduce inflammation and relax muscle spasms in more severe cases.
It can be helped by using heat or ice. Which will depend on the particular person; some sufferers prefer to use a cold or thermal compress.
It is advisable to apply them at night or after any painful activity such as a long day of gardening.
