Lumbar Degenerative Conditions

Symptoms

Degeneration of discs, or frankly arthritic changes of the lumbar spine may cause localised back pain, nerve pain in the leg, or spinal deformity.  Back pain often radiates to the hips and back of the thighs too, even when nerves are not involved. The experience of back pain ranges from one off episodes, to repeated episodes or constant pain.

Arthritis of the lumbar spine causes thickening of ligaments and bone spurs around the joints and discs of the spine. The discs dry out, lose height and in some cases become unstable. These changes can result in nerve pinching or spinal deformity. If a nerve is affected, then there will be shooting pain in the leg associated with weakness, numbness or tingling. Deformity may lead to a stooped or sideways tilted posture, and in some cases back pain and fatigue when trying to walk.

Treatment

Symptoms of degeneration of the spine usually develop over time. Early treatment of back pain is based on changing activity to avoid triggers for pain; anti-inflammatory medication (such as Nurofen, Indocid, Mobic or Celebrex); applying heat packs; and physiotherapy. Often pain will settle in a few weeks but may recur and be episodic, in which case it is important to try and be active anyway. Nerve pain can be managed in a similar way and cortisone spinal injections are an additional option, but relief from injections is often only temporary.

Surgical Treatment

Surgery is recommended for unrelenting nerve pain in one or both legs; on occasions surgery is used to correct spinal deformity. Procedures used to alleviate nerve pinching or deformity vary from simple to complex and the choice is based on X-rays, CT and MRI scans. Stay in hospital varies from one to several nights, and in cases of major surgery time in rehabilitation will be necessary.

Medical terminology:

  • Spondylosis = arthritis of the spine
  • Disc degeneration = a part of spondylosis
  • Facet joints = pairs of small joints at the back of the spine at each disc level
  • Spondylolisthesis = slippage of one vertebra on another
  • Foramen = exit point for a nerve from the spine
  • Stenosis (of a foramen or the spinal canal) = narrowing with pinching of nerves
  • Radiculopathy = damage to a nerve root in the spine
  • Kyphosis = forward bend of the spine
  • Scoliosis = side bend of the spine