Lumbar Spondylotic and Arthritic Pain

Abstract

Lumbar spondylosis is a slowly progressive, degenerative condition of the spine that can lead to a wide range of painful symptoms. Aging and trauma are the main risk factors for developing spondylosis, and no associations have been established with other conditions such as lifestyle, height, obesity, physical activity, smoking, and alcohol use. Degenerative changes of the vertebrae and disc lead to periarticular inflammation and cartilaginous erosion causing subsequent lumbar facet joint pathology and pain. Articular thickening and associated ligamentous hypertrophy can cause spinal stenosis or radiculopathy. Radiography is the initial diagnostic imaging of choice, and MRI can be useful for defining abnormalities of the vertebra, discs, posterior elements, nerve roots, and spinal cord. Physical therapy, oral anti-inflammatories, and corticosteroid injections are the mainstays of conservative treatment. Surgery should only be performed in the setting of chronic intractable pain or progressive neurologic deficits.