Lumbar osteoarthritis or lumbar osteoarthritis: what is it exactly?
Osteoarthritis is the most common rheumatic disease: according to the French Society of Rheumatology, 65% of adults aged 65 and over are affected by this chronic pathology which is characterized by progressive joint degeneration.
L’lumbar arthritis (or “lumbar osteoarthritis” in medical language) concerns in particular the lumbar vertebrae, located at the bottom of the back, at the end of the spine. ” Osteoarthritis can affect the anterior part of the lumbar vertebrae, and in particular the intervertebral discs responsible for cushioning contact between the bones, and / or affect the posterior part of the lumbar vertebrae, small joints similar to “stool legs” which play a stabilizing role “explains Dr. Willy Vandelande, rheumatologist.
To know. According to the French Society of Rheumatology, osteoarthritis of the spine is the most common in the 65-75 age group with 70% to 75% of people affected.
Lumbar osteoarthritis (lumbar osteoarthritis): symptoms and risk factors
Clinically, lumbar osteoarthritis (whether it affects the posterior or anterior part of the lumbar vertebrae) is characterized by pain in the lower back (low back pain) possibly associated with pain in front of the thigh (cruralgia) and / or sciatica. “ Around the age of 60, sciatica and cruralgia are, in about 80% of cases, of osteoarthritis origin. “remarked Dr. Vandelande.
How is lumbar osteoarthritis diagnosed? The diagnosis of lumbar osteoarthritis is most often made by an x-ray examination which allows the deterioration of the joint to be visualized. ” X-rays can be supplemented by an MRI examination and / or by a scanner to rule out other pathologies (differential diagnosis) such as a tumor or spondylitis in younger patients; these additional examinations can also shed light on the consequences of lumbar osteoarthritis, such as nerve compressions “adds the doctor.
Risk factors: who is affected by lumbar osteoarthritis? Lumbar osteoarthritis mainly affects adults from 50-60 years old; women are a little more affected than men. ” In addition to genetic and family factors, this chronic pathology is more common in people who have been operated on for herniated disc, suffering from scoliosis, overweight and / or exercising a physical profession “explains Dr. Vandelande.
Lumbar osteoarthritis (lumbar osteoarthritis): what are the treatments?
They are intended to reduce the pain of osteoarthritis: first-line, the doctor will prescribe analgesic paracetamol, then (if this is not sufficient) may combine anti-inflammatory drugs. ” When the pain is really severe, you can prescribe tramadol or codeine, painkillers that are much more powerful but also have more serious side effects “adds the rheumatologist.
Physiotherapy sessions consist of stretching and muscle building exercises. The goal: to strengthen the muscles of the back and the abdominal belt to reduce the pressure on the lumbar vertebrae and slow down the progression of osteoarthritis disease. ” In case of overweight, it is also essential to adopt a healthy lifestyle – with a balanced diet and regular and appropriate physical activity “says Dr. Vandelande.
As a second intention, if physiotherapy proves insufficient, infiltrative treatments will be offered to the patient: if lumbar osteoarthritis affects the small posterior joints of the lumbar vertebrae, the infiltrations will be performed under fluoroscopic control. If lumbar osteoarthritis is accompanied by sciatica and / or cruralgia, the infiltrations will be done by the epidural route, directly into the medullary canal (where the bone marrow is located).
Attention : these injections (of cortisone derivatives) are intended to reduce pain – they do not cure the disease. ” Visco-complementation (that is to say: the injection of hyaluronic acid, which is proposed in particular in cases of osteoarthritis of the knee) is not effective againstlumbar arthritis “notes the rheumatologist.
And if that doesn’t work … ” After failure of other therapies, the patient will be offered a disc prosthesis (ie replacement of the damaged intervertebral disc (s) with metal prostheses) and / or joint rhizolysis (which consists of “coming” burn “the small posterior joints of the lumbar vertebrae, in order to remove the pain) “explains the specialist doctor.
As a last resort, the surgeon will perform a lumbar arthrodesis: this surgical operation consists in fusing the vertebrae using medical equipment – plates, screws or even metal rods.
Thanks to Dr. Willy Vandelande, rheumatologist at the St-Claude Clinic in St-Quentin (Hauts de France – ELSAN group).
Source : The big book of osteoarthritis – Jérôme Auger and Pr. Francis Berenbaum, ed. Eyrolles.