* older patients
* obese individuals
* heavy laborers
* those with previous injuries to the spine

Where does arthritis occur in the spine?
Arthritis of the lumbar spine is a problem that occurs in the joints that connect each spinal segment, or vertebrae. The vertebrae are connected in three places. In front of the spinal cord, the vertebrae are separated by a cushion-like spinal disc. Behind the spinal cord, the vertebrae are connected by two small joints called facet joints. These facet joints, together with the spinal disc, allow movements of the spine including forward bending, arching your back, or sideways twisting.

When the facet joints become arthritic, these spinal movements become painful and stiff. Lumbar spine arthritis often is seen together with other spinal conditions including:

* Disc Degeneration
As the facet joints wear out in arthritic conditions of the spine, the disc can also wear out over time. Facet arthritis often proceeds along with disc disease of the lumbar spine.
* Spinal Stenosis
Spinal stenosis is also often seen in patients with lumbar spine arthritis. As arthritis progresses, nerves become pinched, leading to symptoms of spinal stenosis. These symptoms may include leg pain, numbness, tingling, and difficulty walking.

What are the symptoms of lumbar spine arthritis?
Arthritis of the lumbar spine most often causes stiffness and pain of the low back. Patients often notice their back is especially stiff in the early morning after getting out of bed, and may loosen over the course of the day. Symptoms also often become worse with prolonged or strenuous activity.

When lumbar facet joint arthritis worsens, the joints form bone spurs, the tissue swells from inflammation, and the nerves around these joints can become pinched. This is a condition called spinal stenosis, which is often seen in patients with lumbar arthritis. These patients often experience the common symptoms of spinal stenosis.
Lumbar Spine Arthritis Treatment
Treatment of lumbar spine arthritis depends on the symptoms experienced by the patient. Treatments always begin with simple measures and become more involved if patients don’t find relief with these simple steps.

Some of the treatments available for lumbar spine arthritis include:

* Physical Therapy
Physical therapy is used to strengthen the muscles of the lumbar spine. By better supporting the spine with stronger muscles, less of the burden is placed on the facet joints. Even in patients who are fit and active, muscles around the spine can be further strengthened to alleviate symptoms.
* Weight Loss
Losing weight is a difficult task in patients who have worn-out joints. However, losing even a small amount of weight is often a sufficient step to relieving pain. By removing even 10 pounds or more, the facet joints will support less of a load, and pain may be sufficiently relieved.
* Anti-Inflammatory Medications
Anti-inflammatory medications can decrease the amount of inflammation around the arthritic joints. By lowering the inflammatory response, pain is often alleviated. Always use anti-inflammatory medications under your doctor’s supervision.
* Ice & Heat Applications
Ice and heat applications can be very effective at relieving pain in the back. Patients usually find that heat is most effective before activity to “loosen” the spine, and ice is best used after any strenuous activities.
* Chiropractic Treatment
Chiropractors treat spine alignment, often with a process called manipulation. These treatments do not alter the spinal alignment, but they can provide excellent relief of pain. Often the relief is temporary, but chiropractic treatments are a reasonable treatment to consider during a flare-up of lumbar arthritis.
* Alternative Treatments
Alternative treatments include acupuncture, massage, magnet therapy, natural remedies, and others. There is no doubt that many patients find significant relief from these types of treatments. While the scientific studies are lacking to support these treatments, most have few side-effects and are reasonable treatments to attempt.
* Epidural Injections
Epidural injections are a way to administer a steroid shot around the area of the arthritis. Cortisone is a powerful anti-inflammatory medication. Using a needle allows the medication to be delivered right to the area of the arthritis. In patients with arthritis of a single facet joint, an even more precise injection, called a selective facet joint injection, can be performed.
* Spinal Fusion Surgery
Spine fusion is a surgical procedure used to eliminate movement between adjoining vertebrae. When all other treatments fail to provide relief of symptoms, a spine fusion may be a reasonable option for the treatment of severe facet arthritis.

Why do some patients tend to have low back strains and sprains more often?
Good question! We do know some factors that tend to influence the development of this type of problem, but often these symptoms strike in unexpected situations. Most commonly, patients who develop a lumbar strain or sprain are doing an activity that places their back at risk. This may be a sudden forceful movement, lifting a heavy object, or twisting the back in an unusual manner. Knowing how to properly lift can help to prevent many back injuries.

Some well known factors that contribute to low back pain include:

* Poor conditioning

* Obesity

* Smoking

* Improper use/lifting technique

If you have persistent problems with your lumbar spine, consider these issues. If you smoke, are overweight, or do not perform regular back strengthening exercises, then you have steps that you can take to help control your symptoms. or lumbar sprain?
Muscle strains and lumbar sprains are the most common causes of low back pain. A low back muscle strain occurs when the muscle fibers are abnormally stretched or torn. A lumbar sprain occurs when the ligaments, the tough bands of tissue that hold bones together, are torn from their attachments. Differentiating a strain from a sprain can be difficult, as both injuries will show similar symptoms. Many doctors refer to both injuries as a category called “musculoligamentous injuries” of the lumbar spine. In general, it doesn’t matter what you call the problem because the treatment and prognosis for both back strains and sprains is the same.

Nearly everyone will experience low back pain at some point in their life–it is the second most common cause of missed days of work in the United States! (Only a common cold causes more missed work). Almost all of these low back injuries are due to injuries of the muscle or ligament. If you don’t know the cause of your back pain, you should have it evaluated by a doctor. Some warning signs of a serious injury to the spine include:

* Loss of control of bladder or bowels

* Progressive lower extremity weakness

* Severe, constant pain

As said earlier, most back pain is caused by a muscle strain or ligament sprain. However, there are serious conditions that require more immediate treatment. If you are unsure of the cause of your symptoms, you should be evaluated by a physician.

Why are sprains and strains of the low back so common?
The spine is supported by large muscles called the paraspinal muscles. These muscles both support the spinal column as well as the weight of the upper body. The five lumbar vertebrae are connected by tough ligaments that help to maintain the position of the spinal column.

These muscles, ligaments, and bones all work together to provide control and strength for nearly all activities. The lumbar spine and its muscles are needed for most all movements and activities. For this reason, the lumbar spine is prone to injury, and when an injury has been sustained, we are prevented from performing many activities.

What are the symptoms of a low back injury?
Most lumbar muscle strains and sprains cause symptoms isolated to the low back, usually they do not cause problems in the legs like some other spine conditions. The most common symptoms of a lumbar strain or sprain are:

o Pain around the low back and upper buttocks

o Low back muscle spasm

o Pain associated with activities, and generally relieved with rest

What causes these symptoms of low back pain and spasm?
When the lumbar spine is strained or sprained, inflammation of the soft-tissues results. This inflammation causes pain and can cause muscle spasm. People are often surprised at how painful and debilitating a lumbar strain or sprain can be–these are not small injuries. They often force patients to remain in bed for a day or two, and can cause intermittent symptoms for weeks. That said, over 90% of patients are completely recovered from an episode of lumbar muscle strain or sprain within one month.

Why do some patients tend to have low back strains and sprains more often?
Good question! We do know some factors that tend to influence the development of this type of problem, but often these symptoms strike in unexpected situations. Most commonly, patients who develop a lumbar strain or sprain are doing an activity that places their back at risk. This may be a sudden forceful movement, lifting a heavy object, or twisting the back in an unusual manner. Knowing how to properly lift can help to prevent many back injuries.

Some well known factors that contribute to low back pain include:

* Poor conditioning

* Obesity

* Smoking

* Improper use/lifting technique

If you have persistent problems with your lumbar spine, consider these issues. If you smoke, are overweight, or do not perform regular back strengthening exercises, then you have steps that you can take to help control your symptoms.