Management of Lumbar Arthritis

Osteoarthritis is also called degenerative joint disease. In the lumbar spine, the disease causes the facet joints to create lumps called osteophytes, also called bone spurs. These can cause reduction in motion and pain in the lumbar spine. In lumbar spinal arthritis, there can be debilitating pain that is located in the lumbar spine or in the leg or legs. The vertebral disc, which cushions the spine can herniate or dry out and can make osteoarthritis worse. On some occasions, the osteoarthritic bone spurs can impinge on the spinal canal or the exit areas for the spinal nerves, causing symptoms from the compressed spinal cord or nerves.

Men get lumbar arthritis more than women among young people, and jobs that put stress on the lumbar spine also make lumbar arthritis more likely. Osteoarthritis generally gets worse with age, however young people can also get osteoarthritis under some circumstances:

  • If they are born with a condition that makes joints lose their normal formation
  • A genetic cartilage defect
  • An injury to the lumbar joint

Symptoms of osteoarthritis of the lumbar spine include stiffness in the low back and pain that gets better when lying flat. It can cause significant discomfort and disability over time. Eventually, symptoms associated with osteophytic pressure of bone onto nerve tissue can produce numbness, weakness, paralysis or tingling of the spine, buttocks or legs.

Osteoarthritis of the lumbar spine is diagnosed with a history and physical examination. X-rays alone can show the osteophytes and an MRI examination can show if the spinal cord or spinal nerve roots have been impinged upon or if a bulging or herniated disc is involved.
The management of osteoarthritis is designed to relieve pain and prevent advancement of the arthritis.

Losing weight helps in many cases. Weight loss can accomplish the following:
Increased ability to exercise

  • Improved mood
  • Better flexibility
  • Less heart disease
  • Better blood flow
  • Improved physical abilities

The best exercises for those who have arthritis include walking, water aerobic activities and swimming. Strengthening activities like gentle weight lifting will support and strengthen the joints. You can also do range of motion exercises in order to decrease stiffness of the lumbar spine. Other non-drug, non-surgical treatments for lumbar arthritis include:

  • Acupuncture
  • Hot compresses alternating with cold compresses
  • Massage
  • TENS Unit—this involves attaching a device to the painful area that emits a small electrical charge which interferes with pain signals.
  • Nutritional aids

Pain medication includes things like Tylenol (acetaminophen), and nonsteroidal anti-inflammatory medication, such as Aleve (naproxen) and Advil or Motrin (ibuprofen). NSAIDs like these medications can be hard on your stomach and can cause abdominal bleeding and sometimes kidney disease. Prescription NSAIDs or narcotics can be prescribed by the doctor and used sparingly for more severe symptoms. Orthopedic surgeons can inject corticosteroids into the arthritic parts with relief generally lasting for months.

Surgery is sometimes necessary, especially if there is bowel or bladder dysfunction or spinal stenosis (narrowing of the spinal cord canal). In such cases, spinal fusion may be necessary to keep bony aspects of the lumbar spine from rubbing against one another, causing pain and nerve damage.