Here’s another blog from a Mississauga Chiropractor…
Lumbar Degenerative Joint Disease (DJD) is a progressive loss of articular fibrocartilage & reactive changes at the joint margin & subchondral bone. It may also me referred to as lumbar spondylosis (bony over-growths-osteophytes) or osteoarthrosis. DJD is the most common form of joint disease & leading cause of disability in the elderly. It is most common in weight bearing joints and is often found at L4-L5 in the lumbar spine.
a) Prevalence at ~90% in patients over the age of 65
b) Prevalence increases dramatically after the age of 50
c) Gender: far more common in females (10:1)
a) Slowly developing dull achy joint pain or pain following joint use
b) Morning stiffness, with pain relieved by rest
c) May reveal a postural abnormality (hyperlordosis or scoliosis)
d) Range of motion may be decreased
There is an extremely poor correlation between the degree of radiographic evidence of degeneration & the clinical presentation of the patient’s pain. Many patients will have moderate degenerative changes visible on x-ray but experience no pain.
a) Pain Management:
- Patient should rest in positions that minimize symptoms
- Heat – Most patient respond extremely well to heat (hot packs in the office or hot baths/showers or hot-tub at home)
b) Spinal Manipulative Therapy (SMT) or mobilizations as tolerated to improve joint mobility & relieve pain
c) Massage Therapy to address tight hip flexors & erector spinae that may cause hyperlordosis; Soft Tissue Therapy &/or Swedish massage.
d) Passively stretch the tight hip flexors and erector spinae
e) Lumbar traction to unload the joints
f) Electrotherapy: TENS, IFC
a) Prognosis is fair to good for some symptomatic relief
b) The primary focus is to manage the symptoms and improve the biomechanics because there isn’t a cure