How to Decrease the Risk of Lumbar/Lower Back Arthritis

The lower back is a source of tremendous strain because of its function for load-bearing, particularly at L4-L5 and L5-S1. Over time, this can cause degeneration of the facet joints and disc leading to a narrowing of the hole where the nerves to the legs exit the spine. This is called spinal stenosis.

It is vital therefore, that every other structure surrounding the lower back move freely, so that stress is distributed evenly, and not just at the very lower segments. This will help delay the onset of lower back arthritis significantly.

Most people however have areas that have locked up, primarily due to the activities they engage in. Prolonged sitting, standing posture, and work habits are just a few of those activities.

Here are the primary areas where people tend to develop restrictions in movement which result in excessive strain on the lower back:

(PICTURES FORTHCOMING IN THE NEXT WEEK)

The Upper Lumbar Spine
The upper lumbar spine consists of segments T12-L4. This can be seen easily when asking someone to bend forward, as no curve will develop over these segments. This means that forward bending is taking place entirely at L4-S1. Most of the time, this requires a skilled manipulation of the area to free it up. However, here is a stretch that may help some to increase the movement of the upper lumbar spine:

Inadequate Hip Flexion
Hip flexion refers to pulling the thigh up to the chest. When bending forward, the chest is bending toward the thigh (hip flexion in reverse). When the hip stops bending, all the stress is then placed on the lower back. Here is a typical stretch to help with hip flexion.

Inadequate Hip Extension
Hip extension refers to pulling the thigh back behind you. Normal isolated hip extension should result in a 20 degree angle at the hip. For many, the hip barely gets to a 0 degree angle, because either the hip joint or the muscles in front of the hip (illiopsoas, rectus femoris) are tight. This means that during walking for example, the lower back has help pull leg behind you. Here is an excellent stretch to help with hip extension.

Poor Muscle Stabilization of the Lower Back
See the article Making Your Back Muscles and Abdominals Work for You for more information on how to address this area.

Steve Daisey MPT, CSCS

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The information presented on DaiseyPT.com is provided for educational purposes only and is not intended to be a substitute for professional medical or physical therapy advice. You should not use the information on this web site for diagnosing or treating a medical or health condition. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.

The exercises presented in these articles pose risks if performed incorrectly or if performed by persons who may be inappropriate for them. They are provided for informational purposes only and to provide education and insight into a particular interest. Daisey Physical Therapy & Sports Medicine Inc. does not recommend performing them without a complete history and examination as well as professional instruction. Daisey Physical Therapy & Sports Medicine assumes no liability for any injury that may occur by attempting the exercises presented here.