Mississauga Chiropractor Presents: Lumbar Degenerative Joint Disease

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Here’s another blog from a Mississauga Chiropractor…

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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.

 

Demographics:

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)

 

History:

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.

 

Management:

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

g)      Acupuncture

 

Prognosis:

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

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