From the Research
Baastrup's syndrome should be managed with a combination of conservative measures, including non-steroidal anti-inflammatory drugs (NSAIDs) and physical therapy, with surgical intervention considered for intractable pain, as supported by the most recent and highest quality study 1.
Diagnosis and Treatment
Baastrup's syndrome is a condition characterized by low back pain caused by the close approximation and contact of adjacent spinous processes, typically in the lumbar spine. It occurs when the normal space between these bony projections decreases, leading to inflammation and pain.
- The diagnosis of Baastrup's syndrome rests on clinical examination and detailed imaging studies, including standard and dynamic flexion-extension radiographs of the lumbar spine, MRI, and CT scans 1.
- Treatment typically involves conservative measures, including:
- Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (400-800mg three times daily) or naproxen (500mg twice daily) for pain relief and inflammation reduction.
- Physical therapy focusing on core strengthening and proper posture.
- Weight management to reduce pressure on the spine.
- For severe cases, corticosteroid injections between the affected spinous processes may provide temporary relief, as demonstrated in a case report 2.
- Surgery is rarely needed but may be considered for intractable pain, with partial removal of the impinging spinous processes resulting in excellent clinical relief, as reported in a retrospective case series 3.
Epidemiology and Prevention
- Baastrup's disease is a common cause of low back pain, with a mean age of 59.6 years and a male-to-female ratio of 1.3:1, according to a systematic review 1.
- The condition is more common in older adults and those with degenerative disc disease, as the loss of disc height brings the spinous processes closer together.
- Maintaining good posture, regular exercise, and avoiding activities that exacerbate symptoms can help manage this condition long-term.
- Early diagnosis and proper treatment can prevent long-term disability and improve quality of life, as highlighted in a case report 4.