Nervous System Diseases: Arthritis In Lower Spine
What is this condition?
Arthritis in lower spine is a relatively common spinal condition. Although it can occur throughout the spine the lower parts are preferred including the lumbar and sacral area.
What is arthritis?
This term means the inflammation of the joints. As such any joint in the body may be involved. There are varieties of arthritic conditions, and the most common type is osteoarthritis. Certain other types include rheumatoid arthritis, septic arthritis etc and in this article only the osteoarthritis is discussed, and the other types are discussed separately in other articles.
How does osteoarthritis develop?
It is generally accepted that this arthritis develops as a result of mechanical wear & tear. To support this view this form of joint damage occurs mostly in older people, although it can affect some younger people too. It predominantly involve the weight bearing joints like the large joints of the body including the knee, hip, pelvis, lower spine areas like lumbar spine etc. Joint with more mobility are affected indicating the mechanical wear and tear contribution. For example the thoracic spine is not affected much due to less mobility of that part of the spine.
What is the pathology of arthritis?
Generally the initial damage occurs in the cartilage are of the joint. This invites inflammatory reaction in the joint. As time passes the cartilage destruction progresses and the bony surface of the joint may get exposed and when this happens pain starts manifesting. The destruction of joint may continue if no intervention is done.
When this happens in the lower spine area the intervertebral cartilage destruction takes place. Degeneration of the intervertebral disc is also frequent accompaniment. Osteophytes or bone spurs develop as the erosion of the bony surface of the joint takes place due to deposition of calcium. The deposition of calcium may also occur in the ligaments of the spine. Arthritis of the facet joint is also very frequent.
All these pathological degenerative changes may culminate in conditions like spinal stenosis, pinching of spinal nerve roots, decreased space between the vertebrae, collapse of vertebrae, later may be complicated with vertebral fractures too.
Types of osteoarthritis
The two types are;
• Primary &
Primary osteoarthritis term is used when there is no other known precipitating factor for the joint damage. Secondary term is used when there was a prior injury or damage to the joint, like trauma for example that contributed to the development of arthritis.
How does a patient present?
Patients with this arthritis in the spine manifest with;
• Lower back pain
• Muscle spasm
• Back pain shooting down (radiculopathy)
• Numbness & tingling (pins & needles) in the legs
• Bladder & bowel complaints
• Leg weakness etc.
Of course many of the above symptoms are secondary effect of the arthritis in lower spine resulting in conditions like spinal stenosis, radiculopaty (pinching of spinal nerve roots) etc. If plain arthritis is there without involvement of the spinal roots or lower end of spinal cord then pain & stiffness maybe the only manifestations.
A neurologist is commonly involved in the management of patients with arthritis in lower spine.
For the diagnosis & management aspects click on
Arthritis in the Spine
Arthritis in Lower Spine to Neurology Articles
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