SIB #445- Pain and Lumbar Spine Osteoarthritis

The Study: Low back pain and lumbar spine osteoarthritis: how are they related?  

The Facts:

a. Lumbar spine osteoarthritis (OA) is one of the most common clinical presentations in most chiropractic practices.  

b. There are estimates that 40 to 85% of the population suffers from OA. 

c. Osteoarthritis of the spine is a narrowing of the disc space coupled with osteophytic formations.  

d. Eighty percent of Americans will suffer from low back pain at some point in their lives. 

e. OA is often clearly demonstrated on plane radiographs.   

f. But we have but a poor understanding of how to clinically correlate the findings on the x-ray with low back pain. 

g. The effectiveness of conservative care in preventing spine degeneration remains unknown.   

h. In the conclusion they state: “The radiographic features of spine degeneration are common and are associated with LBP and reduced physical function.”  “However, recent population-based studies have been unable to link FOA [Facet Joint Osteoarthritis} with LBP and the multidimensional nature of LBP may cloud these associations.”

Take Home:

We have a problem when we try to correlate the findings of osteoarthritis on x-ray with lower back pain.

Reviewer's Comments:

Everyone generally feels that a spine with a lot of osteoarthritis is a bad thing. However, there does not seem to be an objective method of correlating a certain amount of spinal osteoarthritis with the level of spinal pain. Additionally, we don’t to what degree, if any, conservative care may be helpful in preventing the condition. This paper was done by MDs and PTs. It would be helpful for the chiropractic profession to make a serious effort at producing studies to see if chiropractic care is actually helpful in managing and/or preventing spinal osteoarthritis.

Reviewer:  Roger Coleman DC 

Editor: Mark R. Payne DC

Reference: Goode AP, Carey TS, Jordan JM. Low back pain and lumbar spine osteoarthritis: how are they related? Curr Rheumatol Rep. 2013 Feb;15(2):305.

Link to Abstract: https://pubmed.ncbi.nlm.nih.gov/23307577/

Link to Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3606549/pdf/nihms434856.pdf