Spinal arthrosis of the lumbar spine
Of all the arthroselocalizations in the spine, spinal osteoarthritis in the lumbar spine is the most common because the lumbar spine carries the greatest weight. In addition, many movements that are not carried out in a way that is easy on the back place a heavy burden on the lumbar spine in particular. Typically, pain occurs in the lower back region.
They can radiate into the abdomen, buttocks and legs. Muscle weakness and loss of sensation can also be symptoms, as osteoarthritis can damage nerves. The mobility of the lumbar spine is tested during the physical examination.
An X-ray image is used to make a final diagnosis of the disease. Since the lumbar spine is a very stressed zone of the spine, the therapy focuses on strengthening the back muscles. Lifting heavy objects should be avoided.
Rotational movements of the upper body against the legs also worsen the situation. In addition, a suitable pain therapy should of course be carried out. Compared to the rest of the spine, surgery is more frequent in the lumbar spine.
Here, the reduction of pain is usually more important than maintaining complete mobility. Therefore, individual vertebral joints can be stiffened. This reduces the load on the arthritically altered vertebrae while still maintaining good everyday mobility.
How the treatment/therapy is carried out
The therapy of spinal osteoarthritis is usually purely symptomatic. A distinction is made between conservative (non-operative) and operative therapy. Both treatment methods aim to reduce pain.
The conservative therapy consists of a drug-based pain therapy and movement therapy. The pain medication is divided into three classes, which are used depending on the severity and duration of the pain.The classic painkillers such as Aspirin, Diclofenac, Ibuprofen, Paracetamol and Metamizol belong to the lowest class. They are usually taken as tablets/drops or applied as pain ointments.
The next level includes the low-potency (less effective) opioid painkillers dihydrocodeine, tilidine and tramadol, which are usually taken as tablets. The most effective are the highly potent opioid painkillers buprenorphine, Fentany. hydromorph, morphine and oxycodone.
They are also available as tablets, although pain patches or injections are often used. In addition, there is physiotherapy to strengthen the back muscles. Furthermore, the aim is to establish or maintain functional mobility that ensures suitability for everyday use.
Alternatively (and rarely) surgery is performed. The pain-conducting nerve fibers in the spine are sclerosed with heat or cold. In this way, no more pain signal reaches the brain and a pain-free interval of about 2 years can be achieved.
