“Osteo” means bone “Arthro” means joint and “itis” means inflammation and dysfunction. Hence Osteoarthritis means joint  inflammation and dysfunction. Arthritis can occur at any joint in your body, most commonly it can occur in your hip and knee joints however it is also common in your lower back facet joints that make up your lumbar spine vertebral column. Osteoarthritis usually presents as generalised lower back pain, buttock and pelvic pain and stiffness particularly pronounced in the first half hour of movement following a period of rest. The first hour of the morning tends to be tight and sore with the ache easing throughout the day.


What is lumbar spine osteoarthritis?

During your everyday activities and movements your joints are exposed to constant low-level damage. The majority of the time your body will repair the damage itself and you remain below the threshold where you experience any pain or symptoms. But with osteoarthritis the protective cartilage around the ends of your bones start to break down. Often the body’s response is to form bony growths around the area (osteophytes) to try and restore stability. Osteoarthritis is much like grey hair and wrinkles; they are trophies for making it over the age of 25! These additional bits of bone can make the joints stiff and painful. In more advanced cases the formation of bone growths can narrow the area where your nerves exit leading to lumbar spine stenosis.


What are the additional risk factors for lumbar spine osteoarthritis?

We know a number of factors that can increase your risk of developing lumbar spine osteoarthritis. The main risk factors are:

  • Obesity - the more weight you carry the more pressure going through your lower back joints.
  • Age - more wear and tear of the bones = more adaptation by the body to make more bone
  • Previous Trauma at the lower back e.g. a broken vertebra from a car accident.
  • Repetitive joints stress on their lower back e.g. an athlete that has participated in high impact sports with previous facet joint injuries (Link) will be more susceptible to develop Osteoarthritis
  • Females, after the age of 45 women are more likely than men to develop lumbar spine osteoarthritis
  • Family History


How Does Physiotherapy Help?

Physiotherapy is the gold standard first line treatment for arthritis at the lumbar spine. Although there is no absolute cure for Osteoarthritis we can manage the symptoms and get you back to doing what you love! With osteoarthritis there are periods of flare ups and periods where it feels settled. Our job here at Fixio Physio Dee Why is to work out what is driving the flare ups of arthritis and collectively come up with solutions for you.

Generally this is done in two steps, the first being to reduce your osteoarthritis flare up that is causing you pain and stiffness in your lower-back. Once the pain is settled, we need to get your lumbar spine and core as strong as possible, this will allow you to increase your exercise level without having flare ups in the future.

To reduce your pain our spinal physiotherapists may use a variety of treatment modalities that could be effective for you depending on your history and what’s helped you in the past. For instance generally patients with spine osteoarthritis find heat, gentle massage and mobilisation and in some cases dry needling helpful to reduce symptoms. Other times we may need to discuss pain medication options with your G.P. in order to get you exercising better.

After the flare up has begun to settle, we can focus on a long-term strategies to improve strength and endurance of your lower back. Patients with lumbar spine osteoarthritis respond really well to low impact strengthening exercises, this could include swimming, hydrotherapy or our very own Clinical Conditioning and Pilates classes right here at Fixio. This of course depends on your personal preference and exactly what your goals are. We will also give you specific physiotherapy exercises to address any particular muscle imbalances or strength deficits we have identified during your assessment.


By Damien Glover