Pain in the lower (lumbar) region of the back is incredibly common. It directly affects between 60 and 90 percent of adults at some point in their lives. Barring an injury that occurs suddenly, the single most common cause of low back pain is lumbar arthritis. Here are a few facts about lumbar arthritis that everyone needs to know.

Lumbar arthritis is a form of osteoarthritis. This means that it is a degenerative condition that normally develops over a long period of time. Being over weight and working in certain occupations that require a great deal of heavy lifting can aggravate this condition.

As with all forms of arthritis, symptoms of lumbar arthritis are swelling and pain in the affected joints. The pain is often worse first thing in the morning and improves as one’s level of activity increases. For most patients, the pain is limited to the lower back and pelvic region.

In some cases, degenerative changes taking place in the lumbar spine as discs become compressed and lose height and elasticity lead to a portion of the disc bulging into the spinal canal. This can cause a narrowing of the spinal canal known as spinal stenosis. In some cases, pressure is placed on the spinal cord itself or on nerve rootlets that exit the spinal column. Depending on what level the nerves are pinched at, pain can radiate into the legs and patients may experience numbness and tingling sensations in the legs.

Treatment for lumbar arthritis is much like the treatment for all types of arthritis. Doctors often prescribe NSAID medications (non steroidal anti-inflammatory drugs) to reduce the swelling in the affected joints. This is often enough to relieve a great deal of the pain as long as no nerves are compromised or damaged. More stubborn cases may require steroid injections into the spaces between the bones of the spine to reduce swelling. These injections are done with a fluoroscope being used to show the doctor exactly where the needle is in the spinal column in order to prevent causing further damage with the needle.

Because the lumbar spine supports the entire weight of the upper body on a column comprised of only five bones, any damage to this area tends to cause muscle spasms as the body attempts to firm itself up and protect the spinal cord. These spasms are often painful in their own right, so most doctors also prescribe muscle relaxant medications such as flexeril or Skelaxen.

Most cases of lumbar arthritis respond well to the conservative treatment options mentioned above. However, there are some stubborn cases that do not. Also, cases where spinal stenosis is compromising nerve rootlets as they exit the spinal canal need to have this pressure relieved. For these reasons, there are surgical procedures that can be used to treat the worst cases of this type of arthritis.

A laminectomy is a type of operation where an orthopedic or neurosurgeon removes a small section of bone to release the pressure on the spinal cord or its associated nerve rootlets. Another operation that is commonly performed is a lumbar fusion where the surgeon removes the bulging disc and attaches the two bones using a rod and screws. This operation releases the bound nerves, but often results in chronic pain that is totally disabling.

In the last few years, doctors have introduced a new operation where they remove the damaged disc and replace it with one synthetically created. Unfortunately, this operation is still new enough that it is impossible to accurately assess its success rate and determine if the benefit outweighs the risks. Surgery is only considered in extreme cases that do not respond to more conservative treatments or where nerves are compromised and could be permanently damaged.