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Lumbar Osteoarthritis


Presentation

  • Abstract The aim of the present study was to determine the association between abdominal muscle strength and quality of life among older adults with lumbar osteoarthritis.[ncbi.nlm.nih.gov]
  • The presence of Osteoarthritis changes on an X-Ray does not mean that pain has to be present. Which part of the spine is affected by Osteoarthritis? Osteoarthritis can affect any part of the spine.[medicalmediaimages.com]
  • But when symptoms do appear, they can present as pain ranging from mild to severe, initially presenting as stiffness in the mornings lasting for more than 30 minutes.[belmarrahealth.com]
  • A limitation of the present study is that a cross - sectional rather than a prospective design was applied.[bmcmusculoskeletdisord.biomedcentral.com]
Prolonged Immobilization
  • OA can result from a wide variety of conditions such as history of faulty posture, occupational tasks, prolonged immobilization, obesity, or repetitive mircotrauma. 4, 7 Some evidence shows that there is a genetic component to osteoarthritis.[pivotalphysio.com]
Back Pain
  • Low back pain is responsive to therapies that are effective for osteoarthritis in other locations. Osteoarthritis of the lumbar spine does cause low back pain.[ncbi.nlm.nih.gov]
  • Up to 80% of people experience low back pain at some time. Osteoarthritis , a common cause of low back pain, involves breakdown of cartilage (tissue covering the joint surfaces at the ends of bones).[jamanetwork.com]
  • Lower back pain is one of the most common reasons why adults seek medical attention, with 15-20% of adults reporting lower back pain each year 9 .[pivotalphysio.com]
Low Back Pain
  • Table 1 Associations between low back pain and spine radiographic features Study (year) Ref.[ncbi.nlm.nih.gov]
  • Up to 80% of people experience low back pain at some time. Osteoarthritis , a common cause of low back pain, involves breakdown of cartilage (tissue covering the joint surfaces at the ends of bones).[jamanetwork.com]
Spine Pain
  • Epidemiology and risk factors for spine pain. Neurology Clinical. 2007;25:353-71[pivotalphysio.com]
  • Here are some common symptoms of OA in the spine: Stiffness of the spine Spine pain that is worse after standing or sitting Pain in the low-back which spreads to the hips, buttocks or legs Pain, numbness or weakness in legs Difficulty with gait How is[medicalmediaimages.com]
  • pain caused by degeneration, including but not limited to osteoarthritis Regardless of the term used, spinal osteoarthritis is common in older adults.[arthritis-health.com]
Acute Low Back Pain
  • The first stage is significant dysfunction caused by acute low back pain. The second stage is the longest phase where there is relative instability at the degenerated segment 7. The patient in this stage is susceptible to intermittent bouts of pain.[pivotalphysio.com]
  • Evaluation and treatment of acute low back pain. Am Fam Physician 2007; 75: 1181-8. PubMed Hill JC, Whitehurst DGT, Lewis M, et al.[nhi.no]
  • Efficacy of paracetamol for acute low-back pain: a double-blind, randomised controlled trial. Lancet. 2014;384(9954):1586–96. Google Scholar 105. Chou R, Huffman LH.[link.springer.com]
Spine Stiffness
  • History A history of spine stiffness and aching which has progressed slowly over the years and is relieved by rest is often suggestive of Osteoarthritis of the spine. 2.[medicalmediaimages.com]
  • Pelvic Tilt Use this movement to gently release lumbar spine stiffness caused by arthritis, advises Pilates expert Lynne Robinson, author of “The Official Body Control Pilates Manual.” Lie on your back with your knees bent and your feet flat.[livestrong.com]
  • The symptoms which result include: pain in the back or spine stiffness of the spine loss of flexibility in the spine Osteoarthritis can occur in the cervical (neck), thoracic (mid-back), or lumbar (lower back) regions of the spine.[verywellhealth.com]
Paresthesia
  • In more severe cases, it may cause pressure on nerve roots with subsequent sensory and/or motor disturbances, such as pain, paresthesia, or muscle weakness in the limbs.[davidrobertsphysio.co.uk]
  • Paresthesias (abnormal sensations) may develop, such as numbness or tingling. As mentioned earlier, spondylosis is often associated with aging.[spineuniverse.com]
  • This could lead to neck and/or low back pain, arm and leg pain, paresthesias (needles and pins), and muscle weakness.[njspinespecialists.net]
  • If severe, it may cause pressure on the spinal cord or nerve roots with subsequent sensory or motor disturbances, such as pain, paresthesia, imbalance, and muscle weakness in the limbs.[en.wikipedia.org]
Meningism
  • More rarely, post-lumbar puncture syndrome can occur or an epidural haematoma, nerve damage or infection (epidural abscess, meningitis).[arthrolink.com]

Workup

Increased Bone Density
  • These are irreversible and can be identified on X-Ray as narrowing of the joint space, osteophyte (bone spur) formation and subchondral sclerosis (increased bone density beneath the cartilage).[back-in-action.com]

Treatment

  • The difference between the pain scores in two active treatments arms was not statistically significant at the Vf whereas the differences between the pain scores of two active treatment arms vs the placebo arm were statistically significant validating[ncbi.nlm.nih.gov]
  • Spinal Osteoarthritis Treatment If you are seeking the most advanced treatment for Spinal Osteoarthritis in Atlanta, you can count on the caring team from Ortho Sport & Spine Physicians.[orthosportandspine.com]
  • Treatment is directed at managing pain, maintaining joint mobility, and slowing progression. A treatment plan, which could include exercise, medications, and measures to protect joints, should be developed.[jamanetwork.com]
  • If the anticoagulant treatment was prescribed in cardiology, the cardiologists' agreement is necessary before interrupting the treatment. An epidural injection is not recommended during treatment with an antiplatelet drug.[arthrolink.com]

Prognosis

  • Prognosis of Lumbosacral Spondylosis without Myelopathy If treated early then the prognosis for Lumbosacral spondylosis without myelopathy is good for the patient and they can live a healthy life-style.[epainassist.com]
  • Use of proper mechanics, proper posture, body mechanics and awareness of the do’s and don’ts for a healthy back is necessary for a good long-term prognosis.[twinboro.com]
  • For a positive prognosis, don’t ignore symptoms and talk to your doctor if you have pain, numbness, weakness, or swelling in your back — or in any part of your body.[healthline.com]
  • What Is the Prognosis of Spondylosis? Generally, the prognosis of spondylosis is favorable. Many people with spondylosis do not have any symptoms.[emedicinehealth.com]

Etiology

  • Etiology (cause): OA is most often atraumatic in nature, which means there was no specific trauma which caused the condition.[pivotalphysio.com]
  • To address prevention and treatment, understanding the etiology of LBP is important, because it may differ within the large majority of patients in whom we describe the etiology as mechanical or non-specific origin.[ncbi.nlm.nih.gov]
  • Reiter’s syndrome Reiter’s syndrome is a relatively uncommon arthropathy of uncertain etiology with the classic triad of urethritis, arthritis, and conjunctivitis.[rad.washington.edu]
  • In cases where there is a confusion regarding infective etiology i.e. pyogenic infections of spine , routine blood tests may be performed.[boneandspine.com]

Epidemiology

  • CONCLUSION: This study established epidemiological baseline data for degenerative lumbar osteoarthritis in adults, especially for people younger than 45 years.[ncbi.nlm.nih.gov]
  • Epidemiology and impact of low-back pain. Spine. 1980;5(2):133–42. PubMed Google Scholar 29. Fujiwara A, Tamai K, Yamato M, An HS, Yoshida H, Saotome K, Kurihashi A.[link.springer.com]
  • Epidemiology and risk factors for spine pain. Neurology Clinical. 2007;25:353-71[pivotalphysio.com]
Sex distribution
Age distribution

Pathophysiology

  • Intervertebral disc: anatomy-physiology- pathophysiology-treatment. Pain Practice. 2008;8(1):18-44. Rubin, DI. Epidemiology and risk factors for spine pain. Neurology Clinical. 2007;25:353-71[pivotalphysio.com]
  • Findings such as these suggest the pathophysiological course of degeneration in the spine differs, depending on the radiographic feature, from that of hip, knee, and hand OA.[ncbi.nlm.nih.gov]
  • An x-ray of the lumbar spine with spondylosis Pathophysiology of Lumbar Spondylosis When the annular ligament is put to stress body responds by forming new bone i.e. osteophytes which results in lumbar spondylosis.[boneandspine.com]
  • Lack of physical exercise or daily activity (questionably) Pathophysiology [ edit ] 55% of facet syndrome cases occur in cervical vertebrae, and 31% in lumbar.[en.wikipedia.org]

Prevention

  • Instead treatment is normally aimed at reducing pain levels and preventing further degeneration.[clinic-hq.co.uk]
  • Prevention It is possible to limit the effects of osteoarthritis by treating directly at the onset of symptoms. Taking care of joints that have a risk of osteoarthritis should done as early as possible.[health.ccm.net]
  • Outside the flare-ups, the therapist will give advice on preventive care for the joints and recommend joint physiotherapy exercises with the essential aim of strengthening the abdominal muscles.[arthrolink.com]
  • Furthermore, there are few secondary prevention intervention techniques specifically aimed at treating symptomatic spine degeneration.[ncbi.nlm.nih.gov]

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