Q: I have osteoarthritis in my lower back and get back pain. I have never heard of this type of arthritis in the back. Can it occur there? What can I do about it?
A: Osteoarthritis is generally referred to as a ‘wear and tear’ sort of ailment, a breakdown of protective cartilage in joints as we age and live life. Many people associate osteoarthritis with major joints like the knees and shoulders, but it can also affect the spine and cause lower back pain.
The spine consists of individual bones, each called a vertebra, which are cushioned by discs. A disc is a tough gelatinous pillow of sorts. There are also two joints built for movement between each vertebra called facet joints. In a healthy spine, the discs of the low back take on 90% of the weight bearing and the facets only take 10%. As the discs wear down over time, they become thinner and can cause a loss of motion and compression to the facets. The weight bearing distribution becomes more 50/50 in the disc:facet ratio. This is bad for the disc and even worse for the facet. Think of the arthritic knee of a person that compresses it more than needed because of being overweight.
Discs in the lower back, in what’s known as the lumbar spine, are particularly susceptible to this wear. As they compress, the facets become less fluid, making the spine less flexible, tight and more vulnerable to injury from things like a sudden, unexpected movement, physical exertion or lifting. As the spine compresses, it can also squeeze nerves, causing pain in the lower back and other parts of the body. All the while, the cartilage and bone wears down like two rocks rubbing on each other. Sometimes the vertebra will develop bone spurs as a result of compression.
Once the process starts, as it eventually will with all of us who live long enough, the only thing we can control is how quickly it progresses to severe arthritis. Basic lifestyle habits affect it the most. So keep a healthy weight, exercise and keep moving. Your choices for relief are below and the list is not all inclusive.
Medications, usually anti-inflammatory, that may have adverse side effects and usually cannot be used long term. Chiropractic adjustment can improve spinal mobility and unlock the facet joints if not too advanced. Even in cases of very severe and advanced degeneration, a gentle traction and mobilization of the spine on specialized chiropractic table can reduce pain and increase range of motion. Chiropractic is best used in conjunction with physical therapy for this condition. Home traction – like inversion therapy can slow it down. Back braces may help. Surgery is often not an option for this condition until it is extremely advanced and anything else is no longer helping. Talk with a chiropractor about the potential to help your osteoarthritic spine.
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