Osteoarthritis and low back pain are common bedfellows. This is because osteoarthritis in the lumbar spine can involve the growth of bone spurs (osteophytes) that pinch nerves as they exit the spinal column. The growth of these bone spurs gradually narrows the space around the spinal nerves. When this narrowing (spinal stenosis) becomes significant, even small changes in posture or a little inflammation can cause nerve compression. The result can be pain in the lower back, as well as symptoms of sciatica.
The sciatic nerve root is at L3 in the lumbar spine, which is a common site of spinal stenosis. The whole lumbar spine is quite mobile, having to deal with a lot of movement and strain throughout life. In the long term, this movement can lead to wear and tear and osteoarthritis.
In some cases, the growth of bone spurs (along with ligament calcification and thickening) are thought to be an attempt by the body to stabilise an unstable joint. This can be helpful in some instances, but it can also end up compressing surrounding tissues, including the sciatic nerve.
Symptoms of osteoarthritis and sciatica
The symptoms of osteoarthritis in the lumbar spine are often on just one side of the body (unilateral), unlike with, say, rheumatoid arthritis (which affects all joints). Osteoarthritis usually arises later in life as a result of cumulative joint damage from simple wear and tear, and injuries. The damage is not always equal across the body, including in the spine, so one side of the lumbar spine may be stenotic (narrowed), while the other side could be relatively unaffected.
Symptoms of osteoarthritis and sciatica can include pain, and altered sensation in the lower back, buttocks, legs or feet. See this earlier blog post for an in-depth look at acute and chronic symptoms of sciatica.
Diagnosing osteoarthritis and low back pain
It is fairly easy to recognise low back pain, but it is not always clear what is causing the symptoms. In some cases, pain in one area of the body can be caused by tissue damage and nerve compression in another area. This is known as referred pain. For example, although the sciatic nerve root is at L3 in the lumbar spine, not all back pain caused by sciatica is connected to nerve compression in the lower back. Problems including strain, spasm, or tension in the piriformis muscle in the thigh are also a common cause of sciatica.
If there isn’t a problem in the piriformis muscle or the spinal muscles, a physician may order further tests. These tests can help determine if spinal stenosis is the cause of low back pain or other sciatica symptoms. Such tests may include diagnostic imaging in the form of x-rays or magnetic resonance imaging (MRI). These techniques help the physician to visualise the bones, discs, ligaments and other tissues in the spine. They can then see if any of these structures are likely to be pinching or irritating the spinal nerves.
Low back pain relief
Effective relief from sciatica and low back pain may be as simple, for some people, as using a Deep Tissue Shiatsu Back Massager to relax the muscles in the back or thigh. In other cases, particularly where osteoarthritis is the root cause of low back pain, a person may require surgery to remove bone spurs in the spine and free the spinal nerves.
Other ways to relieve sciatica and osteoarthritis low back and leg pain include:
- Improving posture (postural reminder apps are available!)
- Buying a new mattress
- Wearing different shoes
- Avoiding activities that worsen back pain, such as some yoga postures
- Enaging back-strengthening exercises
- Treating underlying inflammation
- Decompressing the spine through non-surgical means.
Conservative treatment of sciatica is usually successful, and most cases of low back pain do not require surgery. The use of lumbar supports, physical therapy, and lifestyle changes to minimize inflammation can provide effective relief without the risks of surgery or medications.