Article reviewed and approved by Dr. Ibtissama Boukas, physician specializing in family medicine
Lumbar osteoarthritis is a common cause of back pain. Contrary to what one might think, it does not only affect the elderly.
What is osteoarthritis and what are the symptoms? What are the consequences on work and activities? Will activities like walking make it worse or relieve it?
This popular article explains everything you need to know about lumbar osteoarthritis, from the anatomy to the various possible treatments.
Definition and anatomy
Before discussing lumbar osteoarthritis, it is worth reviewing certain notions of anatomy that will allow you to better understand this condition.
La spine is separated into vertebrae cervical, dorsal and lumbar. At the lumbar level, the 5 vertebrae are notably connected together by the intervertebral disc and facet joints.
Lumbar osteoarthritis occurs when the cartilage that protects the joints in the lower back wears down and cracks, irritating the nerves around the bones, as well as the nerve roots nearby.
The wear of the vertebral joints at the lumbar level causes a vertebral compaction over time, as well as the formation of bony prominences called osteophytes.
Osteoarthritis can affect anyone, but it is most common in women and people over 50. The risk factors for osteoarthritis are mainly genetics, but also other factors such as a sedentary lifestyle or being overweight.
It is essential to mention that joint degeneration is part of normal aging, and is not always synonymous with disease.
Indeed, the presence of lumbar osteoarthritis has been observed in several people who have no back pain. This is because the body has adapted to the degenerative changes, and osteoarthritis does not cause inflammation or significant nerve irritation.
On the other hand, in some cases, the process of degeneration is problematic, and leads to significant disorders affecting the quality of life. It is in these situations that lumbar osteoarthritis requires medical care.
Causes of lumbar osteoarthritis
Few people know this, but osteoarthritis is a form of arthritis. It is also called osteoarthritis.
Besides osteoarthritis, there are other forms of arthritis and conditions that can affect the lumbar spine and its surroundings:
• Ankylosing spondylitis
• Psoriatic arthritis
• Enteropathic arthritis
Symptoms: Lumbar osteoarthritis and its consequences
How to recognize lumbar osteoarthritis? Before going through themedical imaging, sufferers observe the consequences of this pathology through the following symptoms:
• Lower back pain. This is the most important symptom. In typical cases, it is increased in extension and reduced in flexion.
• Radiation of pain in the lower limbs, sometimes associated with numbness, tingling and sensation of electric shock.
• Pain on exertion, reduced by rest (except in advanced cases)
• Morning stiffness
• Muscle tension and spasms
• Reductions in range of motion of the lumbar spine
• Possible crackling, crackling or other noises in the lower back
• Feeling of weakness and/or general fatigue
Diagnosis of lumbar osteoarthritis
As mentioned, the causes of lumbar osteoarthritis are multiple.
A doctor will begin the consultation with questions aimed at better understanding your medical history, injury history, symptoms and functional impact.
Then, he will perform a clinical examination where he will observe the movements of your spine, muscle strength, reflexes and other neurological tests.
To clarify the diagnosis, it is not uncommon for it to refer to a medical imaging. Among the tests used are:
• X-ray (to observe the space between your vertebrae)
• To scan
• MRI (to observe soft tissue and nerve integrity)
• Bone densitometry (to determine if osteoporosis is present)
Finally, a blood test may be requested if the doctor suspects systemic involvement or an inflammatory condition.
Treatment: How to relieve lumbar osteoarthritis
Lumbar osteoarthritis should not be synonymous with condemnation. Certainly, it is almost impossible to act on the degeneration, if not via the operation.
On the other hand, there are many modalities aimed at relieving the pain and functional limitations induced by lumbar osteoarthritis:
heat and ice
Heat and ice can help relieve symptoms by reducing inflammation and muscle spasms often associated with osteoarthritis. On the other hand, they do not act directly on the cause of the problem.
To learn more about using heat and ice, see next article.
Massage and manual therapy
A trained therapist (such as an osteo or physiotherapist) can relieve symptoms by performing manual techniques.
Massages can reduce muscle tension. Mobilizations and manipulations can reduce stress on the vertebrae, or increase the range of motion in the lumbar region.
1. Weight control
Overweight and obesity have been related to back pain, although the relationship is not proportional.
So, by maintaining a healthy weight (meaning shedding our extra pounds if that's the case), we can reduce the pressure on the joints and potentially see an improvement in symptoms.
A anti-inflammatory diet can for example make it possible to fight inflammation while losing weight, assuming that a calorie deficit is respected.
Physical exercise has several health benefits. Applied in a specific and gradual manner, it can help reduce the symptoms of lumbar osteoarthritis over the long term, and facilitate the resumption of daily activities.
Un physiotherapist (physiotherapist) is best able to provide an exercise program adapted to your condition. Often, this will include sheathing, strengthening of the lower back and hips, mobility, etc.
3. Lumbar osteoarthritis and walking
Many people with lumbar osteoarthritis wonder if walking is allowed, or if it would aggravate the symptoms.
In general, walking is a cardiovascular activity with several benefits for the joints, the heart and overall health.
In the presence of osteoarthritis, it will depend on the symptoms caused. If walking causes significant pain from the outset, it will either have to be avoided or the parameters adjusted. In general, this occurs when osteoarthritis is in an advanced stage.
Consider this: If walking causes pain, you can try this:
• Reduce walking speed by walking more slowly
• Reduce the distance by taking regular breaks
• Change the walking surface (on grass or a running track)
• Wear walking shoes with support
• Take medication or apply heat beforehand to facilitate walking.
• Apply ice after walking sessions
• Practice exercises of diaphragmatic breathing during walking to facilitate blood circulation and tissue oxygenation.
• Practice meditation techniques (such as mindfulness meditation) during walking to modulate symptoms.
• Practice dynamic stretching before the walking session
As you have seen, there are several solutions to try before definitively stopping walking – despite the incapacitating pain.
4. Natural products and alternative medicine
Although they are not supported by quality scientific studies, many people are turning to alternative approaches to relieve their lumbar osteoarthritis.
Among the methods tried are:
- acupressure mat
- Cupping (suction cups)
- Glucosamine and chondroitin
- Vitamin D
- Just to name a few
In cases where conservative treatments do not offer conclusive results, the doctor usually resorts to more invasive treatments.
Lumbar infiltration can be used to relieve pain and calm inflammation. To learn more (as well as what type of infiltration to consider), check out next article.
The last resort is to resort to lumbar surgery. An orthopedic surgeon is the most qualified to determine the appropriateness of surgery, as well as the type of operation offering the best chance of recovery.
The most common operation islumbar arthrodesis. If lumbar osteoarthritis is accompanied by herniated disc symptomatic, he may also have resorted to a laminectomies or an discectomy.
Can we work with lumbar osteoarthritis?
It was found that the symptoms of lumbar osteoarthritis varied enormously depending on the individual. Sometimes asymptomatic in some cases, it can also cause disabling and limiting pain in some people.
The question of work in the presence of lumbar osteoarthritis should be discussed individually with his doctor. First, you will have to see if your symptoms are a hindrance to the practice of your professional activities.
Then, you will have to analyze the physical demands of your job, and determine if you are able to exercise your profession. A sedentary job is much easier to perform than a job involving the carrying of heavy loads when you suffer from low back pain.
Disability rate for lumbar osteoarthritis
The other frequently asked question is related to the disability rate for lumbar osteoarthritis.
A disease is said to be occupational if it results from direct exposure to a physical, chemical or biological risk. It must also result from the conditions in which a worker exercises his professional activity, and must appear in one of the tables of the general or agricultural Social Security system.
Fullerenes tables of occupational diseases 97 and 98 relate to back pain, and define a number of criteria which must all be met to allow recognition of the disease.
Here are the conditions that must be met for back pain to be recognized as an occupational disease:
- It must be a chronic condition (defined by a duration of at least 3 months)
- If the pain radiates into the leg: the sciatica or radiculalgia femoral crural must be caused by a herniated disc with a topography consistent with the root involvement. For sciatica, the herniated disc must be level L4-L5 or L5-S1. For crural radiculalgia, the herniated disc must be level L2-L3, or L3-L4, or L4-L5.
- The herniated disc must be explicitly qualified in the report of the radiological examination via a scanner or MRI.
- The duration of exposure to the risk is 5 years, and the period of coverage must be a maximum of 6 months.
It can therefore be seen that at present, lumbar osteoarthritis alone does not meet the above criteria, and therefore cannot be recognized as an occupational disease.
On the other hand, if you really think that your condition results from your professional activity, it is possible to make a declaration of illness called excluding tables.
In accordance with law 93-121 of July 27, 1993, a disease not mentioned in a table can be recognized as being occupational:
- if it is directly attributable to the professional activity of the victim.
- and if it results in incapacity for work of at least 25%.
Lumbar osteoarthritis is due to the degeneration of the joints in the lumbar region. It may be the cause of your lower back pain.
To be sure, it is advisable to consult a doctor who will carry out a clinical examination, and will refer to medical imaging examinations if necessary.
Once the diagnosis is made, it will be possible to establish a treatment plan taking into consideration your medical history, your symptoms, and your goals.
Good recovery !