describesdegenerative changes in Intervertebral discs, intervertebral bodies and facet joints of the spine
Can progress onto foraminal and canal stenosis, degenerative spondylitis or cauda equina syndrome
lumbar region mosteffected - high exposure to mechanical stress on how load goes through the spine
Normal process of aging: 80 - 90% of individuals between 45 - 60 yrs demonstrate osteophytes in lumbar spine so can be diagnosed with secondary illness
Not always painful - degenerative changes may present in younger pts without any trauma or history there should be a problem
the degenerative process in which OA mainly affects the lumbar spine is through affecting the vertebral bodies, the intervertebral foramen and the facet joints
Lumbar Joints:
Increased in load on joints, esp facet joints
Subchondral bone hypertrophy
Osteophyteformation
Disc/cartilage degeneration
Inflammatorymediators → Nociceptor activation (may not always be present if theres no current/ongoing inflammation within the joint)
Clinical Presentation of Spondylosis / OA - History and MOI:
Insidious onset LBP: pain is vague and often non specific
Could also be secondary to trauma
pts maybe 55 yrs +
Clinical Presentation of Spondylosis / OA - Subjective Features:
Can present withoutparaesthesia/anaesthesia/red flags, but beware of a progressing pathology - always ask special questions
Morningstiffness lasting less than 30 minutes
Aggs: prolonged sitting (due to intervertebral disc degeneration) and standing (facet joint OA)
Eases: walking
Clinical Presentation of Spondylosis / OA - Objective Features:
Decrease in ROM - due to stiffness
Poor quality of movement - due to osteophytes formation
Stiff end feel - feature of arthritic joints
Posture? - any changes due to decrease ROM?
Could have neurological changes if progressive
Clinical Presentation of Spondylosis / OA - Key impairments:
Unable to sit for a long time / aggravators in resting positions
Pain
ReducedROM - probably mostly when leaningforward or backwards
Clinical Presentation of Spondylosis / OA - Does this patient warrant a scan?
if we thought they had any red flags
if we thought they had any neurologicalsigns and symptoms and if they were progressive