Low Back Pain and Lumbar Spine Osteoarthritis: How Are They Related?
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Lumbar spine osteoarthritis (OA) is very common, with estimates of prevalence ranging from 40–85 %. The process of degeneration of the spine has commonly been classified as OA (disc space narrowing together with vertebral osteophyte formation); however, anatomically, the facet joint is the only synovial joint in the spine that has a similar pathological degenerative process to appendicular joints. Low back pain (LBP) is also a common condition, with nearly 80 % of Americans experiencing at least one episode of LBP in their lifetime. The complex relationship between spine radiographs and LBP has many clinical and research challenges. Specific conservative treatments for spine degeneration have not been established; there has, however, been recent interest in use of exercise therapy, because of some moderate benefits in treating chronic LBP. An understanding of the relationship between spine degeneration and LBP may be improved with further population-based research in the areas of genetics, biomarkers, and pain pathways.
KeywordsLow back pain Osteoarthritis Spine osteoarthritis Disc space narrowing Intervertebral disc degeneration Vertebral osteophytes Facet joint osteoarthritis Epidemiology Treatment Risk factors Prevalence Gender Race
Dr Goode is supported by the NIH Loan Repayment Program, the National Institute of Arthritis Musculoskeletal and Skin Diseases (1-L30-AR057661-01), and by the Agency for Health Care Research and Quality (AHRQ) K-12 Comparative Effectiveness Career Development Award grant number HS19479-01. The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official views of the NIAMS or AHRQ.
The authors would like to thank Holly R. Thompson, BA, for her careful editing of the manuscript.
Dr Goode has received grant support from the Agency for Health Care Research and Quality. Dr Carey has served as a consultant for Blue Cross and the Blue Shield Association. Dr Jordan has received grant support from Johnson and Johnson, has received honoraria from LEK Consulting and Marston Consulting, holds stock options in Algynomics, and has had travel and/or accommodation expenses covered and/or reimbursed by the Osteoarthritis Research Society International and the Arthritis Foundation.
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