When arthritis affects the lower back, this is known as lumbar arthritis. The most common cause of lumbar arthritis is osteoarthritis (OA).
The spine is divided into five sections — the cervical, thoracic, lumbar, sacrum, and coccyx. Lumbar arthritis affects the lumbar portion of the spine, or lower back, which is situated just above the pelvis.
The lower back is the most common area for arthritis-related back pain.
Lumbar spine osteoarthritis is very common, affecting an estimated 30% of males and 28% of females aged 55–64 in the United States.
Various forms of arthritis can affect the lower back, including OA and spondyloarthritis.
This article provides an overview of lumbar arthritis, including its causes, symptoms, treatments, and diagnosis.
While experts consider OA a normal part of aging, the pain and stiffness of lumbar arthritis can limit a person’s ability to do routine tasks, especially those that require bending and stretching.
The main symptom of lumbar arthritis is lower back pain.
About 80% of back pain lasts less than a week. If it lasts much longer, doctors consider it chronic back pain, and arthritis may be the cause.
The lumbar spine carries most of the body’s weight, which means that both movement and inactivity can trigger symptoms.
Pain may be worse after standing or sitting upright for prolonged periods. Bending sideways or backward can also cause pain.
People may feel pain from lumbar arthritis in the center of their lower back. The pain may expand to the pelvic area or the sides of the buttocks. It can also extend into the thighs but rarely spreads to the knees.
Lumbar arthritis may also cause:
- muscle spasms
- joint creaking
- a decreased range of motion in the lower back
Symptoms are usually slow to develop and not noticeable at first. However, any rapid movement, twisting, and backward motion in the lower back may cause injury to the lumbar area and symptoms for people with this condition.
Lumbar arthritis results from specific types of arthritis. The most common reason for lumbar arthritis symptoms is OA, with other types sometimes involved.
The following are some forms of arthritis that can affect the lumbar spine:
OA is the most common form of arthritis. Lumbar OA occurs when the cartilage that protects the lowest joints in the spine, including the facet joints, breaks down, exposing small nerves within the bone.
Persistent damage from OA in the facet joints of the spine eventually causes those joints to wear away. As a result, the spine bones start to grind and push together with movement, and bone spurs can develop.
OA can affect anyone, but it is more common in females and people aged over 50. Risk factors for OA include genetics, a lack of activity, and overweight.
Spondyloarthritis primarily involves the spine and sacroiliac joints. The sacroiliac joints are located between the sacrum and bones of the pelvis, and sturdy ligaments support them. The sacrum is the main support of the spine.
According to a 2016 review, spondyloarthritis affects about 1.35% of people in North America. It often affects young adults, teenagers, or children.
The most common spondyloarthritis is ankylosing spondylitis.
Spondyloarthritis causes inflammation of tendons and ligaments where they enter bone, which is known as enthesitis.
Low back pain is a symptom of PsA. According to the Arthritis Foundation, about 20% of people with this condition have spine involvement. In some cases, bony overgrowth can cause the vertebrae to fuse, causing stiffness and pain with movement.
Enteropathic arthritis affects the sacroiliac joints, causing low back pain.
About 1 in 5 people with inflammatory bowel disease will develop enteropathic arthritis.
Osteoporosis causes bones to lose mass and become brittle and prone to injury with even the smallest traumas. Osteoporosis is primarily due to aging, a decrease in hormones, and chronic inflammatory diseases.
When osteoporosis affects the spine, the inner spongy and more solid outer parts of the vertebrae become weak and painful with time. Eventually, bone collapse can occur, which can then lead to secondary degenerative arthritis (osteoarthritis).
There are many possible causes of back pain.
To find out the cause of a person’s back pain, and to determine whether arthritis is present, a doctor will perform a physical examination and may recommend imaging scans, such as X-rays, MRI scans, CT scans, or bone density studies.
A doctor will also ask the person about:
- their symptoms
- the pattern and location of pain
- range of motion in the lower back
- any family history of arthritis or back pain
If standard medication does not work, doctors can prescribe stronger NSAIDs if necessary.
Some medications can reduce the progression of arthritis, including disease-modifying antirheumatic drugs (DMARDs).
Quick relief therapies for lumbar arthritis include hot and cold compresses to improve blood flow, reduce swelling, and relieve muscle spasms.
The following can help reduce the symptoms of lumbar arthritis:
- maintaining a moderate weight
- following a healthful diet, including foods that reduce inflammation
- avoiding smoking
- avoiding excess alcohol
Physical therapy can improve a person’s range of motion and flexibility while boosting muscle and bone strength, and core strengthening can stabilize the spine.
Regular physical activity can reduce pain and improve mobility, mood, and quality of life for people with arthritis. It also helps reduce the risk of other health problems, such as heart disease and diabetes.
Surgery, such as joint replacement or joint fusion surgery, could be the best option for some people with severe arthritis.
The same type of precautions taken for overall back health can also help prevent the development of or worsening of lumbar arthritis.
- reducing the risk of injury by lifting heavy items correctly
- practicing proper posture
- exercising regularly
- maintaining a moderate weight
- eating a healthful diet
- wearing proper shoes, as some shoes can throw off posture and cause long-term problems
- quitting smoking
People can typically manage arthritis and its symptoms at home or with help from a doctor.
About 54.3 million adults in the U.S., or 22.7% of the population, live with some form of arthritis, according to the Centers for Disease Control and Prevention (CDC). OA specifically affects over 32.5 million adults in the U.S.
If possible, people can benefit from working with a doctor to find the best treatment plan for their particular situation and symptoms.