Post: Osteoarthritis and Your Lower Back: Signs, Symptoms, and Care

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Introduction:

Osteoarthritis is a common condition that affect millions worldwide. As we age, the likelihood of developing osteoarthritis increases. As such, it may be of interest to you, to understand this condition even if you may not be experiencing the effects of osteoarthritis yet. Osteoarthritis is also sometimes referred to as degenerative joint disease. It is the gradual wearing down of your cartilage and bone, which leads to discomfort and limited mobility. Understanding its risk factors and adopting healthy habits can help mitigate its impact. In this blog, we will explore the facts about osteoarthritis, from its causes to practical ways to manage and prevent it. Whether you are starting to notice joint stiffness or simply want to be proactive about your joint health, join us in learning more about osteoarthritis and how to live with this condition.

Elderly lady sitting at computer desk, wearinga light blue jumper. Holding her lower back region, showing pain on right side. right side lower back pain

About Osteoarthritis:

Osteoarthritis is a condition that affects the joints in the body. As you may already know, joints are structures in the body where two or more bones meet and articulate. At the ends of your bones are protective cartilages. These protective cartilages can wear down either over time or as a result of overuse. 

As the cartilage wears away, the space between the end of your bones narrows, and bones may begin to rub against each other, causing further damage and inflammation. This leads to significant pain, stiffness, and reduced mobility in the affected joints. Weight-bearing joints like the knees, hips, and spine, tend to be affected first, but it can also occur in other joints such as the hands, wrists, shoulders, and ankles.

Anatomy of the Lower Back:

In this post, we will explore how osteoarthritis can become an issue, specifically in the lower back. To do so, we need to first understand the anatomy of the lower back.

Deep in your lower back is the lumbar spine, which consists of five vertebral segments (L1-L5) stacked one on top of another. Between each vertebral segments are intervertebral discs that act as shock absorbers. Vertebral segments are connected to other segments directly above and below via facet joints, which also allow for spinal movement. Within each vertebral segment is a space to allow the spinal cord to pass through while being protected within the spine. This is known as the central canal, or the spinal canal. There are also openings on either sides of the spine between adjacent vertebral segments through which spinal nerves exit the spinal cord and travel to other parts of the body. These are called lateral canals, or the neural foramina.

Anatomy of spine in plastci model. Depiciting lower back. Pain at lower disc shown in red. Can be caused by osteoarthritis
Lumbar spine, plastic model. Nerves are shown by yellow plastic. Osteoarthritis effects this part of spine.

How Osteoarthritis Affects Your Lower Back:

In the lower back, osteoarthritis can affect both the intervertebral discs and the facet joints.

  1. Intervertebral DiscsThe intervertebral discs serve as shock absorbers, providing cushioning between the vertebral segments and allowing for flexibility and movement of the spine. With age and wear-and-tear, these discs can degenerate, losing their elasticity and height. This degeneration can lead to conditions like disc herniation or spinal stenosis, contributing to lower back pain
  2. Facet Joints: The facet joints allow for smooth movement of the spine and help stabilize it during activities like bending and twisting. Osteoarthritis can affect these joints, causing inflammation, stiffness, and pain. As the cartilage within the facet joints wears away, bone-on-bone contact can occur, resulting in further discomfort and reduced mobility.

Both disc degeneration and facet joint arthritis can contribute to lower back pain, stiffness, and reduced range of motion.

How Osteoarthritis May Lead To Nerve-Related Symptoms:

In addition, osteoarthritis-related changes in the spine can sometimes result in narrowing of the passages where nerves run, including the central canal and the lateral canals, leading to nerve compression, causing symptoms such as sciatica (pain radiating down the leg) or numbness and weakness in the lower extremities.

  1. Central Canal: Osteoarthritis-related changes such as the thickening of ligaments, the formation of bone spurs (osteophytes), and the degeneration of intervertebral discs can lead to a condition called spinal stenosis. Spinal stenosis involves the narrowing of the central canal, potentially causing compression of the spinal cord. This compression can result in symptoms such as pain, numbness, weakness, or tingling that radiates down the legs, a condition often referred to as neurogenic claudication.
  2. Lateral Canals: Osteoarthritis-related changes, such as bone spur formation, thickening of ligaments, and facet joint hypertrophy (enlargement), can lead to narrowing of these neural foramina. This narrowing can compress spinal nerves as they exit the spinal canal, resulting in symptoms such as radiating pain, numbness, or weakness in the arms or legs, depending on the location of the affected nerves.

The narrowing of these spinal passages due to osteoarthritis can lead to various neurological symptoms and contribute to the overall pain and dysfunction experienced by individuals with lumbar spine osteoarthritis.

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Diagnosis and Tests for Osteoarthritis in Your Lower Back

Diagnosing osteoarthritis in the lower back typically involves a physical examination, medical history review, and imaging tests such as X-rays or MRI scans. These tests can help determine the extent of osteoarthritis-related changes within your lumbar spine and rule out other possible causes of your symptoms.

  1. Physical Examination: A physical examination involves assessing the range of motion, flexibility, and tenderness of the lower back. Your healthcare provider will look for stiffness, and reduced range of motion, and may also check for any signs of inflammation or swelling around the affected joints.
  2. Medical History Review: Understanding your medical history is crucial in diagnosing osteoarthritis. Factors such as previous injuries, occupation, lifestyle, and family history of arthritis can influence the likelihood of having osteoarthritis-related changes earlier or later in life.
  3. Imaging Tests:
    • X-rays (Plain Film Radiography): X-rays can reveal changes in the bones, such as bone spurs, narrowing of joint spaces, and the presence of osteophytes (bony outgrowths).
    • MRI (Magnetic Resonance Imaging): MRI scans provide detailed images of the soft tissues, such as the cartilage and ligaments, as well as the bones. This helps in assessing the extent of joint damage and identifying any other underlying conditions.

Causes of Osteoarthritis:

Various factors are known to contribute to the development of osteoarthritis-related changes:

  • Aging: As people age, the cartilage that cushions the joints tends to wear down gradually. This natural degeneration can lead to osteoarthritis over time.
  • Genetics: There’s evidence to suggest that genetics play a role in the development of osteoarthritis. Certain genetic factors may predispose individuals to this condition, making them more susceptible to joint damage and degeneration.
young lady running down a garden path in active wear has stop an is clutching lower back. Lower back arthritis can cause this reaction to the pain.
  • Joint Overuse: Repetitive stress or strain on the joints due to activities such as heavy lifting, bending, or participating in high-impact sports can accelerate the wear and tear of cartilage, increasing the risk of osteoarthritis.
  • Previous Injuries: Traumatic injuries to the joints, such as fractures, dislocations, or ligament tears, can disrupt the normal structure of the joint and contribute to the development of osteoarthritis later in life. These injuries may lead to altered biomechanics or instability in the joint, hastening the degenerative process.
  • Obesity: Excess body weight puts added stress on the joints, particularly weight-bearing joints like the knees, hips, and lower back. This increased mechanical load can accelerate the degeneration of cartilage and contribute to the onset or progression of osteoarthritis.
  • Joint Alignment: Abnormalities in joint alignment or biomechanics can also predispose individuals to osteoarthritis. For example, conditions like bowed legs or unequal leg lengths can alter the distribution of weight on the joints, leading to increased wear and tear over time.

Management Strategy for Osteoarthritis:

Here are some strategies to manage osteoarthritis:

  • Pain Management: Over-the-counter pain relievers such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) can help manage pain and reduce inflammation.
  • Physical Therapy: A chiropractor or a physiotherapist can develop a customized exercise program to strengthen the muscles supporting your lower back and improve flexibility.
  • Weight Management: Maintaining a healthy weight can reduce stress on your lower back joints, which may help alleviate symptoms.
  • Injections: Corticosteroid injections into the affected joint can provide temporary relief from pain and inflammation.
  • Surgery: In severe cases where conservative treatments have not been effective, surgery such as spinal fusion or artificial disc replacement may be considered.
chiropractor treating lower back for back pain. Osteoarthritis and lumbar pain. Patient is lying on the side and chiropractor is rolling him to the left side. Pateint is wearing a grey singlet. Chiroractor is wearing a blue button up shirt.

How chiropractic care can help:

At Five Dock Osteopathic and Chiropractic Centre, we tailor our treatment to reduce your pain and improve your mobility by addressing changes to your musculoskeletal system as a result of osteoarthritis. This means spending time working on your muscles and your joints separately. 

We provide hands-on soft tissue massage to alleviate muscle tension and pain that builds over time as the body compensates for reduced mobility in your joints. Where appropriate, we use spinal manipulation techniques and traction technique to improve joint space and joint mobility, to reduce stiffness, increase flexibility, and relieve pressure on affected joints. We will also have a look at your posture and movement. Poor posture and movement pattern can put unnecessary stress on your joints which may lead to osteoarthritis-related changes taking place earlier than they should. We will provide you with stretches and exercises to correct issues that we find, and maintain your joint health. We will teach you how to reduce the amount of wear and tear that you subject your joints to, and in doing so, maintain your quality of life for longer. 

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Consequences of Not Seeking Treatment:

Failure to seek diagnosis and treatment for osteoarthritis in the lower back can lead to worsening symptoms, decreased mobility, and reduced quality of life. As permanent structural changes in your joints become more extensive, conservative treatment may no longer be enough to manage your condition. Physical therapy cannot reverse structural changes including loss of cartilage and development of bone spurs. Surgery in the lower back may become the only option remaining that can provide relief. Common surgical options include spinal fusion, laminectomy, and discectomy. Early intervention is crucial for managing this condition effectively. 

Living with Osteoarthritis in Your Lower Back:

Living with osteoarthritis in your lower back may require making lifestyle changes to manage your symptoms. This may include the following:

    • Exercise Regularly: Low-impact exercises such as swimming, walking, or yoga can help improve flexibility and strengthen muscles.

    • Maintain Good Posture: Proper posture can reduce strain on your lower back joints and help alleviate pain.
    • Use Ergonomic Furniture: Using ergonomic chairs and desks can help support your lower back and improve comfort.

People standing in a park with arms above head, wearing active wear. Picture show full shoulder movement. Patient has no rotator cuff injuries.
Health span elderly couple walking together smiling in the afternoon sun. Avoiding back pain and arthritis, headaches by keeping active.

Importance of Treatment to Stop Long-Term Degeneration:

Improve Mobility

Seeking early treatment for osteoarthritis in the lower back is important for preventing further joint degeneration and improving mobility. Treatment can help manage symptoms and improve your quality of life.

Improving Strength and Stability

Building strength and stability in the muscles surrounding your lower back can help support your spine and reduce the risk of injury. Physical therapy exercises can help improve muscle strength and flexibility.

Importance of Staying Active:

Staying active is important for maintaining joint mobility and overall health. Low-impact exercises such as walking, swimming, or yoga can help improve flexibility and reduce pain.

Conclusion:

Osteoarthritis in the lower back can be a challenging condition to manage, but with the right approach, you can reduce pain, improve mobility, and maintain a good quality of life. By working closely with your healthcare team and adopting healthy lifestyle habits, you can effectively manage osteoarthritis and its impact on your lower back.

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Five Dock Osteopathic and Chiropractic male chiropractor wearing a light blue shirt performing a stretch on the neck of a young female patient. The doctors right hand is placed on the head of the patient and the left hand on the shoulder of the female patient

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