Abstract
This retrospective
study explored the association between osteoarthrosis and lower back pain (LBP)
and evaluated spine-targeted nursing interventions in 40 patients with
osteoarthrosis. Patients were divided into LBP group (n=20, with persistent LBP
≥3 months) and non-LBP group (n=20, without LBP), with each group further split
into intervention (n=11) and control (n=9) subgroups. Intervention subgroups
received spine-targeted nursing (core strengthening exercises, ergonomic
posture training, pain modulation techniques), while controls received routine
care. Primary outcomes included correlation between lumbar osteoarthrosis
severity (Kellgren-Lawrence grade) and LBP intensity (Numeric Rating Scale,
NRS) and change in Oswestry Disability Index (ODI) at 6 months. Results showed
significant positive correlation between Kellgren-Lawrence grade and initial
NRS score (r=0.73, p<0.01). Intervention subgroups in both groups
demonstrated greater improvement in ODI (LBP group: 28.6±6.3 vs 14.2±5.1;
non-LBP group: 12.3±4.8 vs 5.7±3.2, p<0.01 for both). Spine-targeted nursing
interventions effectively reduce LBP and improve functional outcomes in
osteoarthrosis patients, with particular benefit in those with severe lumbar
osteoarthrosis.
Keywords: Osteoarthrosis; Oswestry disability index; Kellgren-lawrence
grade
Introduction
Lower back pain (LBP)
is a common comorbidity in patients with osteoarthrosis, with 50-60% of
individuals with lumbar spine osteoarthrosis reporting chronic LBP that impairs
daily functioning1. The relationship involves degenerative changes in
lumbar facets and intervertebral discs, which alter spinal biomechanics and
trigger pain through nerve compression and inflammation2. This study investigates the osteoarthrosis-LBP
association and evaluates targeted nursing interventions, addressing the lack
of spine-specific care protocols for this population3.
Methods
Study design and
participants
Retrospective analysis of 40 patients with
radiographically confirmed osteoarthrosis (lumbar spine: 25 cases, combined
lumbar + hip/knee: 15 cases). Inclusion criteria: age 45-80 years;
Kellgren-Lawrence grade I-IV for lumbar osteoarthrosis; LBP defined as NRS
score ≥4 on most days for ≥3 months. Exclusion criteria: inflammatory
spondylarthritis, spinal fractures, malignancy and radiculopathy with motor
deficit.
Grouping & interventions
Control subgroups: Routine care (pain
assessment, general mobility advice).
Intervention subgroups:
Added infection-preventive interventions:
• Core strengthening exercises: Progressive lumbar stabilization training (3x/week) focusing on transversus abdominis and multifidus muscles.
• Ergonomic posture training: Teaching neutral spine alignment during sitting, standing and lifting, with workplace/household modification recommendations.
• Pain modulation techniques: Heat therapy (15 mins, 2x/day) combined with guided breathing exercises for pain perception management.
• Activity pacing: Scheduling rest breaks during prolonged activities to avoid LBP exacerbation.
Outcome measures
• Primary: Correlation between lumbar Kellgren-Lawrence grade and initial NRS score; change in ODI (0-100, higher=worse disability) at 6 months.
• Secondary: LBP duration (hours/day), lumbar range of motion (ROM) and patient-reported global improvement (PGI) scale.
Statistical analysis
SPSS 26.0 used for
Pearson correlation, independent t-tests and χ² tests. p<0.05 was
significant.
Results
Osteoarthrosis-LBP relationship and baseline data
Significant positive
correlation between lumbar Kellgren-Lawrence grade and initial NRS score
(r=0.73, p<0.01). LBP group had higher initial ODI and lower lumbar ROM (Table
1).
Table 1: Baseline
Characteristics
|
Characteristics |
LBP Group (n=20) |
Non-LBP Group (n=20) |
p-value |
|
Age (years, x̄±s) |
63.5±8.7 |
61.8±7.9 |
0.52 |
|
Male gender, n (%) |
11(55.0) |
10(50.0) |
0.76 |
|
Osteoarthrosis location (lumbar only/combined) |
13/7 |
12/8 |
0.82 |
|
Lumbar Kellgren-Lawrence grade (x̄±s) |
3.0±0.8 |
1.6±0.7 |
<0.001 |
|
Initial NRS score (x̄±s) |
6.8±1.4 |
2.1±1.0 |
<0.001 |
|
Initial ODI (x̄±s) |
42.8±8.5 |
18.0±6.3 |
<0.001 |
|
Lumbar ROM (degrees, x̄±s) |
35.2±7.3 |
58.6±9.1 |
<0.001 |
Table 2: Change in ODI at 6
Months
|
Group |
n |
Baseline |
6 Months |
Reduction (mean±SD) |
p-value |
|
LBP Intervention |
11 |
43.2±8.1 |
14.6±5.3 |
28.6±6.3 |
<0.001 |
|
LBP Control |
9 |
42.3±8.9 |
28.1±7.2 |
14.2±5.1 |
- |
|
Non-LBP Intervention |
11 |
17.8±6.5 |
5.5±3.1 |
12.3±4.8 |
<0.001 |
|
Non-LBP Control |
9 |
18.2±6.1 |
12.5±4.3 |
5.7±3.2 |
- |
Secondary outcomes
Intervention subgroups
demonstrated significant improvements in all secondary measures (Table 3).
Table 3: Secondary Outcomes at 6
Months
|
Outcome |
LBP Group |
Non-LBP Group |
p-value (intervention effect) |
|
LBP duration (hours/day) |
Intervention:2.1±1.3 |
Intervention:0.3±0.5 |
<0.001 |
|
|
Control:5.8±1.7 |
Control:1.2±0.8 |
- |
|
Lumbar ROM (degrees) |
Intervention:52.6±8.4 |
Intervention:65.3±7.9 |
<0.001 |
|
|
Control:40.3±7.8 |
Control:52.1±8.5 |
- |
|
PGI scale (1-7, higher=better) |
Intervention:5.8±1.1 |
Intervention:6.2±0.9 |
0.002 |
|
|
Control:3.2±1.0 |
Control:4.1±1.2 |
- |
Discussion
This study confirms
a strong correlation between lumbar osteoarthrosis severity and LBP intensity,
consistent with mechanisms involving facet joint hypertrophy and disc
degeneration4. The 3.2-fold higher NRS score in the LBP group
aligns with evidence that advanced lumbar osteoarthrosis increases pain
sensitivity through central sensitization5.
Spine-targeted
interventions reduced LBP primarily through core strengthening, which
stabilizes the lumbar spine and reduces facet joint loading6. Ergonomic training
addressed postural triggers, while pain modulation techniques (heat therapy,
breathing exercises) targeted both nociceptive and psychophysical pain
mechanisms7. The significant improvement in lumbar ROM in
intervention subgroups confirms functional benefits beyond pain reduction.
Notably, the non-LBP
intervention subgroup maintained low pain levels, highlighting preventive value
in early lumbar osteoarthrosis8. Limitations
include lack of imaging follow-up to quantify structural changes and small
sample size. Future studies should incorporate MRI assessments of disc and
facet joint status.
Conclusion
Lumbar osteoarthrosis severity
correlates significantly with LBP intensity and disability. Spine-targeted
nursing interventions effectively reduce LBP, improve mobility and enhance
functional status. These strategies are critical for managing LBP in
osteoarthrosis patients across disease stages.
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