Lumbar Spondylosis (lower back degenerative arthritis) is an age-related degenerative condition affecting the lumbar spine. It is characterized by intervertebral disc degeneration, facet joint osteoarthritis, and osteophyte growth, causing chronic lower back pain, stiffness, and sciatica.
Causes & Risk Factors
- Age-Related Disc Degeneration: Lumbar discs lose water content, shrink, and lose shock-absorption capacity.
- Osteophyte (Bone Spur) Overgrowth: Bony spurs encroaching on spinal canal or neural exit foramina.
- Facet Joint Osteoarthritis: Wear of cartilage lining facet joints in the back of the spine.
- Repetitive Strain & Heavy Lifting: Occupations requiring heavy manual labor or prolonged sitting.
- Obesity & Inactivity: Increased mechanical load on lumbar vertebrae paired with weak core stabilizing muscles.
- Genetics & Previous Spinal Trauma: Inherited susceptibility or past lumbar injuries.
Symptoms
- Chronic lower back pain and stiffness (worse after waking up, prolonged sitting, or bending forward).
- Sciatica (Lumbar Radiculopathy): Sharp, shooting, or burning pain radiating from lower back through buttocks down back of leg into foot.
- Paresthesias: Numbness, tingling, or "pins and needles" in leg or foot.
- Leg muscle weakness or feeling of legs giving out.
- Difficulty standing upright or walking long distances.
- Grinding or cracking sensation (crepitus) in lower back during movement.
Diagnostic Workup
- Physical & Neurological Exam: Straight Leg Raise (SLR) test, checking knee/ankle reflexes, and dermatome sensation.
- Lumbar Spine X-Ray: Detects narrowing of intervertebral disc spaces, vertebral alignment, and bone spurs.
- Lumbar MRI / CT Scan: Evaluates spinal canal stenosis, herniated discs, and nerve root compression.
- Electromyography (EMG): Assesses nerve root damage severity.
Treatment & Management Protocols
- 1. Medications: NSAIDs (Ibuprofen, Naproxen), Acetaminophen, Muscle Relaxants, Epidural Steroid Injections, and Neuropathic medications (Pregabalin / Gabapentin) for radicular pain.
- 2. Physical Therapy & Core Rehabilitation: Core stabilization exercises (planks, pelvic tilts), hamstrings stretching, back extension exercises, and posture re-training.
- 3. Lifestyle Modifications: Weight loss to reduce lumbar load, ergonomic chair lumbar support, proper lifting technique (bending knees), heat/ice therapy.
- 4. Surgical Options: Decompressive Laminectomy or Spinal Fusion reserved for progressive neurological deficit or intractable pain.
