Lumbar Osteoarthritis

What is lumbar osteoarthritis?

It is a normal wear and tear of the joints in the lower back vertebrae. Osteoarthritis is often described as the wearing away of cartilage between our vertebrae. While this is true, it involves more than just cartilage. Cartilage is a tissue that acts like a cushion between the surfaces of our vertebrae, allowing them to glide smoothly and move with ease.

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With the development of osteoarthritis, it is true that the cartilage will be more worn. However, all the structures that form the joint of the vertebra can be affected by osteoarthritis. Therefore, there can be degenerative changes in the cartilage, bone, ligaments, discs, capsule, synovial membrane, and muscles around the joint.

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What are the symptoms of lumbar osteoarthritis?

It is important to understand that osteoarthritis does not always cause symptoms. Many people live with osteoarthritis and feel absolutely nothing.

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Does this seem surprising to you? Read our blog article to learn more

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When osteoarthritis is symptomatic, here is what people may experience:

• Lower back pain
• Back stiffness that is often worse in the morning or after a period of inactivity
• Back stiffness that generally improves with movement
• Decreased flexibility of the back
• You may feel crackling or popping in the back with movement

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What are the causes and risk factors of lumbar osteoarthritis?

Aging is the main factor that causes osteoarthritis, regardless of the joint in the body. From the age of 50, 90% of people have lumbar osteoarthritis. However, osteoarthritis does not develop overnight. It is a process that occurs gradually over several years.

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Here are some risk factors that increase the chances of developing lumbar osteoarthritis more quickly or severely:

• A back injury in the past (fracture, sprain, car accident)
• Women are more at risk than men
• Obesity
• Inactivity
• Having a job in a static position throughout our lives (office work)
• Certain inflammatory diseases

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How to diagnose lumbar osteoarthritis?

Lumbar osteoarthritis can be diagnosed just with the history of symptoms and the clinical examination. An X-ray of the back can also show signs of lumbar osteoarthritis, but is not mandatory to make a diagnosis of lumbar osteoarthritis.

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It's important to know that what we see on X-rays or other types of imaging isn't always relevant. Did you know that 48% of healthy young adults aged 20-22 have arthritis in their back when they undergo magnetic resonance imaging (MRI) and have no pain? Yes, even at 20! Yet, they have no pain!

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When should you see a physiotherapist for lumbar osteoarthritis?

You should see a physiotherapist if you have back pain or stiffness that prevents you from doing your daily activities or hobbies as you would like.

You do not need to see a doctor before consulting a physiotherapist. If your condition requires you to see a doctor, your physiotherapist will be able to tell you.

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What are the physiotherapy treatments for lumbar osteoarthritis?

Your physiotherapist will perform an assessment to determine why your osteoarthritis is causing you pain. To do this, they will assess the following elements:

• Your joint mobility
• The gliding of your nerves
• The quality of your movements
• Your strength and stability

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Based on the assessment results, your physiotherapist will:

• Mobilize your spine and nerves to reduce pain and improve your movement
• Give you specific exercises to re-educate the control of your back movements
• Give you exercises to regain mobility, reduce pain and regain your muscle strength.
• Teach you how to properly manage your daily activities and hobbies to optimize healing
• Give you advice for your posture and movements.

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It is important to note that osteoarthritis itself cannot be cured, as it is a wear and tear process that is irreversible. However, the symptoms associated with lumbar osteoarthritis can be completely eliminated with treatment, even if the osteoarthritis is still present in the joints.

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What can you do at home for lumbar osteoarthritis?

The best thing to do is to be active.

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If you are sedentary, start by taking regular walks and doing mobility exercises for your back every day, while respecting your pain. If you are already active, continue your activities that do not cause too much pain.

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Here are some other tips that may help at home:

• Temporarily stop doing the movements that cause too much pain, and then gradually start doing them again.
• Limit the time spent in the same position for more than an hour (computer, television, reading). Get up often for several minutes to move your back and legs.
• Do physical activity every day. This remains the best remedy for the symptoms of osteoarthritis.

If you are a runner, refer to the blog article on running (link to come) for concrete tips for running.

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How can I reduce my chances of developing back osteoarthritis later in life?

If you are still quite young, you have the power to reduce your risk of developing osteoarthritis later in life.
If you are older, these tips will certainly help you reduce your chances of having symptoms, even with your osteoarthritis.

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Here are the best tips to follow from a young age and to continue throughout your life to reduce your chances of developing osteoarthritis:

• Be active regularly throughout your life. This is certainly the most important factor. Your joints are nourished by movement and become stronger through movement.
  
  • Here are some targets to aim for regarding physical activity, according to Canadian recommendations:
    
    • 150 minutes per week of moderate to high intensity cardio activity
    • Stand as often as possible (this counts as light activity)
    • Do strength training with exercises that include large muscle groups 2x/week
    • Limit sitting time to 8 hours/day
• Maintain a "healthy" weight (this will vary greatly from person to person)
• Avoid accumulating multiple joint injuries such as sprains, fractures, and surgeries
• Adopt healthy eating habits (refer to a nutritionist or the Canadian Food Guide)

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Did you know?

• 90% of lower back pain episodes heal in 6 to 12 weeks
• 50% of lower back pain episodes heal in 1-2 weeks
• 40% of people under 30 already have osteoarthritis in their back. It's very normal!

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To learn more...

You can listen to the podcast "Parle-moi de santé" (Let's Talk About Health) created by one of our physiotherapists, Alexis Gougeon. Episode #7 discusses lower back pain and episode #15 talks about osteoarthritis more specifically.

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Episode #7

Find the episode on YouTube :

Click below to listen to episodes on podcast platforms:

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‍Episode #15 ‍

Find the episode on YouTube :

Click below to listen to episodes on podcast platforms:

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Sources

• Alexander CE, Varacallo M. Lumbosacral Radiculopathy. InStatPearls [Internet] 2019 Mar 23. StatPearls Publishing.
• Lindsey T, Dydyk AM. Spinal osteoarthritis. InStatPearls [Internet] 2020 Jan 7. StatPearls Publishing.
• Goode AP, Carey TS, Jordan JM. Low back pain and lumbar spine osteoarthritis: how are they related?. Current rheumatology reports. 2013 Feb 1;15(2):305.
• Takatalo J, Karppinen J, Niinimäki J, Taimela S, Näyhä S, Järvelin MR, Kyllönen E, Tervonen O. Prevalence of degenerative imaging findings in lumbar magnetic resonance imaging among young adults. Spine. 2009 Jul 15;34(16):1716-21
• Chou D, Samartzis D, Bellabarba C, Patel A, Luk KD, Kisser JM, Skelly AC. Degenerative magnetic resonance imaging changes in patients with chronic low back pain: a systematic review. Spine. 2011 Oct 1;36:S43-53.
• Canadian Society for Exercise Physiology (25-01-2021). Canadian 24-Hour Movement Guidelines for Adults ages 18-64 years : An Integration of Physical Activity, Sedentary Behaviour, and Sleep. https://csepguidelines.ca/adults-18-64/

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