Characterisation of the correlation between standing lordosis and degenerative joint disease in the lower lumbar spine in women and men: a radiographic study

Abstract

BackgroundDegenerative joint disease (DJD) in the lumbar spine is a common condition that is associated with chronic low back pain. Excessive loading of lumbar joints is a risk factor for DJD. Changes in lumbar lordosis significantly redistribute the forces of weight-bearing on the facet joints and the intervertebral discs. However, the relationship between lumbar lordosis and DJD has not been characterized in men and women.MethodsWe characterised the correlation between standing lumbar lordosis and DJD in standing radiographic images from 301 adult female and male chiropractic patients. DJD was rated using the Kellgren-Lawrence scale, and lordosis was measured using the Cobb angle. Linear and curvilinear correlations were investigated while controlling for age and sex.ResultsWe found a highly significant curvilinear correlation between lordosis and DJD of the lower lumbar spine in both sexes, but especially in women, irrespective of the effects of age. We found the effect size of lordosis on lower lumbar DJD to be between 17.4 and 18.1% in women and 12.9% in older men. In addition, lordosis of 65 (95% CI 55.3–77.7) and 68 (98% CI 58.7–73.3) degrees were associated with minimal DJD in the lower lumbar spine of women and men respectively, and were therefore considered ‘optimal’. This optimal lordotic angle was 73 (95% CI 58.8–87.2) degrees in older men.ConclusionsBoth hypo- and hyper-lordosis correlate with DJD in the lumbar spine, particularly in women and in older men. These findings may well be of relevance to spinal pain management and spinal rehabilitation.

Neuromuscular exercise reduces low back pain intensity and improves physical functioning in nursing duties among female healthcare workers; secondary analysis of a randomised controlled trial

“…Female nurses with a recent back injury show more impairments in lumbar control compared to healthy nurses [14]. Both hypo- and hyper-lordosis correlate with degenerative joint disease, particularly in women [24]. Lumbar movement control, especially control of the lumbar neutral spine posture, has been suggested to play a key role in maintaining a healthy spine [25].…”

The Impact of Whole-Body Electromyostimulation on Body Posture and Trunk Muscle Strength in Untrained Persons

“…The reduction of a pronounced lumbar lordosis is considered an important therapeutic approach because interrelationships with increased degeneration are known, in particular in the facet joints (articulationes processuum articularium) (Murray et al, 2017). It is also known that the position of the pelvis in the sagittal plane plays a key role in the reduction of lumbar lordosis ( flèche lombaire ) (Buchtelová et al, 2013).…”

“…It is assumed that permanent poor posture in daily routines leads to muscular and articular overload, which in turn results in physical problems (Bruno et al, 2012; Araujo et al, 2017; Jentzsch et al, 2017). Particularly posture issues such as hyperlordosis and a hunched back are considered to be the reasons for back problems (Jentzsch et al, 2017; Murray et al, 2017). Current studies show an interrelationship between individual posture parameters and the occurrence of lower back pain (Kim et al, 2006; Dolphens et al, 2012; Aggarwal et al, 2013).…”

Repeat Radiography in Monitoring Structural Changes in the Treatment of Spinal Disorders in Chiropractic and Manual Medicine Practice: Evidence and Safety

“…54-56 Thus, the long-term consequences of spinal deformity or subluxation is spinal osteoarthritis and degenerative disc disease. 57-65 Further, it is a logical premise that if posture deteriorates over time, then the earliest recognition should warrant consideration for its correction. This would change the otherwise untoward trajectory of postural deterioration coupled with the degenerative spine tissue cascade, which would evolve over several years.…”