2. Lower Back Spinal Arthritis – Diagnosing & Treating the Condition Lower back spinal arthritis is degenerative in nature, which explains why it commonly affects individuals who have reached or exceeded middle age. By definition, a degenerative medical condition gradually develops over time and involves the slow deterioration of the affected body part. In the case of spinal arthritis, it is the facet joints’ cartilaginous lining that slowly wears away, leading to pain and inflammation in the affected segment of the spine. Lower back spinal arthritis (also called lumbar spinal arthritis) is particularly common because this area of the spine plays an important role in supporting the weight of the upper body and helps facilitate a great deal of movement. These weight-bearing and movement-facilitating responsibilities eventually take their toll on the spine, which can lead to the development of spinal arthritis.
3. Symptoms In the early stages of lower back spinal arthritis, the patient may experience sore, painful, and inflamed joints in the lower back. As the cartilaginous lining of the joints continues to deteriorate, patients may have the sensation that bones are rubbing against one another. Popping, crunching, and cracking sounds may also be produced, which is called crepitus and occurs when the non-lubricated bones rub together. In an effort to mitigate bone-on-bone contact and to provide added stability to an arthritic joint, the body may produce osteophytes (bone spurs). These smooth extensions of the body’s natural bone structure can extend into the spinal canal and cause a spinal nerve root to become compressed. When the lumbar spine contains a compressed nerve, patients may have symptoms of pain, numbness, tingling, and muscle weakness that radiate from the lower back, through the hips and buttocks, and into the legs and feet.
4. Diagnosis Many degenerative spine conditions cause nearly identical symptoms, sometimes making it difficult to pinpoint the exact cause of a patient’s back pain and discomfort. However, a physician can employ the following diagnostic techniques to determine whether the patient is afflicted with lower back spinal arthritis or some other condition: Question and answer session – Asking questions regarding the patient’s symptoms and their specific location, duration, and severity can help to steer the physician toward one diagnosis or another. He or she can also ask questions about the patient’s overall level of health, their family members’ medical histories, and the patient’s past and current activity levels, among others, to rule out certain degenerative conditions. Physical examination – Palpating the spine may cause the patient to experience a moderate level of discomfort, but it can also reveal to the physician if there are any inflamed or tender portions of the spine. A neurological exam that checks the patient’s reflexes and muscle strength can determine whether the patient is suffering from neural compression. Diagnostic imaging – An X-ray, MRI, or CT scan can provide the physician with an inside view of the patient’s spine. One or more of these tests should be able to identify whether the source of the patient’s discomfort is lower back spinal arthritis, a herniated disc, spondylolisthesis, or any other degenerative spine condition.
5. Conservative Treatments Once a physician has determined the patient is afflicted with lower back spinal arthritis, he or she will likely formulate a conservative, nonsurgical treatment regimen. The development of the plan will take several variables into consideration, including whether the patient suffers from any other medical conditions, takes any medications, or has any physical limitations. As a result, every patient who suffers from spinal arthritis will receive a slightly different treatment plan. The physician will likely recommend over-the-counter, nonsteroidal anti-inflammatory drugs (NSAIDs) for patients whose level of health does not preclude him or her from utilizing them. These drugs, such as naproxen and ibuprofen, help to reduce inflammation and relieve pain, making them especially beneficial for those who suffer from lower back spinal arthritis. If a patient is unable to take NSAIDs (usually because of a cardiovascular or gastrointestinal condition), the physician may instead recommend over-the-counter analgesics like acetaminophen. Patients whose pain and discomfort are severe may receive a prescription for muscle relaxants or narcotic pain relievers.
6. Physical Therapy Physical therapy can also prove beneficial for spinal arthritis patients. Strengthening and stretching exercises can enable the individual’s back and abdominal muscles to provide more support to the spine while posture modification exercises can help to improve body mechanics. Other techniques that are sometimes employed during physical therapy include: Cryotherapy – applying a cold compress to the affected area; numbs pain and reduces inflammation Thermotherapy – applying a heat source to the affected area; increases blood flow and relieves muscle tension Transcutaneous electrical nerve stimulation – using gentle electrical currents to stimulate the nerves; scrambles nerve signals to relieve pain
7. Alternative Therapies Some patients complement their doctor-recommended treatment regimen with alternative therapies that take a more holistic approach to relieving the symptoms of lower back spinal arthritis. Acupuncture is among these therapies, and involves the insertion of small needles into meridians (or specific points on the body) to relieve pain by inducing the body’s production of endorphins. Chiropractic manipulation, which entails the manipulation of the spine to increase range of motion, is also sometimes utilized by individuals who suffer from chronic back pain. Before attempting any alternative therapy, individuals should consider the risks associated with each of them and perform research to ensure the therapy is being administered by a licensed and insured professional. It is important to note that several alternative therapies are not endorsed by the general medical community due to questions concerning the therapies’ efficacies. However, many patients attribute their pain relief to alternative treatments like acupuncture, chiropractic manipulation, herbal supplements, hypnotics, and Pilates, among others.
8. Surgical Treatment If following a conservative treatment regimen for several weeks or months fails to relieve the pain and discomfort associated with lower back spinal arthritis, the patient may be asked to consider a surgical procedure. Called a facet thermal ablation, this procedure is performed on an outpatient basis and typically requires a recovery period of only about a week. A small incision is made in the patient’s lower back and the muscles and other soft tissues are gently moved to the side. A tube is then fed through the incision and various surgical instruments are funneled through the tube. The surgeon then uses a laser to deaden the nerve in the affected joint’s capsule, thereby preventing any additional pain from occurring. This procedure is very similar to an oral root canal and enables many patients to experience immediate relief. Before undergoing facet thermal ablation, patients should thoroughly research the procedure to ensure it is right for them. It may also prove beneficial to receive a second or third opinion to ensure the condition was properly diagnosed and that no other conservative treatments are available.
