From the Guidelines
Overcompensation for knee pain can indeed lead to degenerative arthritis of the lumbar spine due to altered biomechanics and abnormal stress on the spine. When someone experiences knee pain, they often unconsciously alter their walking pattern (gait) to reduce weight-bearing on the painful knee, which can place abnormal stress on the lumbar spine, particularly if maintained over months or years 1. This altered biomechanics can accelerate wear and tear on spinal joints, discs, and supporting structures. The spine must adapt to these unnatural movement patterns, which can disrupt the normal load distribution throughout the kinetic chain.
Some key factors to consider in preventing this cascade effect include:
- Addressing knee pain appropriately with proper treatment such as physical therapy focusing on both knee and core strengthening
- Appropriate pain management, such as the use of oral nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen, which have been shown to consistently demonstrate improved pain and function in patients with knee osteoarthritis 1
- Possibly using knee braces or orthotic devices to normalize gait
- Maintaining proper body mechanics and weight management, as sustained weight loss has been shown to benefit pain and, to a lesser extent, function in overweight and obese patients with knee osteoarthritis 1
It is essential to prioritize proper treatment and management of knee pain to prevent the potential long-term consequences on the lumbar spine. By addressing knee pain and maintaining proper biomechanics, individuals can reduce their risk of developing degenerative arthritis of the lumbar spine.
From the Research
Relationship Between Knee Pain and Lumbar Spine Degenerative Arthritis
- Overcompensation of knee pain can lead to altered biomechanics and gait patterns, which may put additional stress on the lumbar spine, potentially contributing to degenerative arthritis 2.
- Studies have found that patients with knee osteoarthritis (OA) and lower back pain (LBP) have poorer function and more disability than those with knee OA alone 2.
- The development and progression of knee OA in patients with degenerative spondylolisthesis may be induced by significantly greater mismatches of lumbo-pelvic sagittal alignment, which can also contribute to lumbar spine degenerative arthritis 2.
Biomechanical and Clinical Relationships
- High pelvic incidence is a risk factor for the development of spondylolisthesis and knee OA, which can also contribute to lumbar spine degenerative arthritis 2.
- Knee pain intensity is higher in patients with knee OA and LBP, indicating a potential relationship between the two conditions 2.
- Patients with concurrent LBP and knee OA have reported poor function and more disability, highlighting the need for careful assessment and treatment of both conditions 2.
Treatment and Management
- First-line treatment for knee OA consists of conservative management, including exercise, education, and self-management, which can also help to reduce the risk of lumbar spine degenerative arthritis 3, 4.
- Intra-articular hyaluronic acid injections and oral nonsteroidal anti-inflammatory drugs (NSAIDs) are common treatments for symptomatic knee OA, but their effects on lumbar spine degenerative arthritis are unclear 5.
- Physical therapists play a crucial role in the treatment and management of knee OA, and should be aware of the current recommended treatment strategies and outcome measures to provide effective rehabilitation 4.