Clinical relationships between lower back pain and knee osteoarthritis
(Amarasinghe et al., 2023)

Knee osteoarthritis (OA), also known as degenerative joint disease of the knee, is typically the result of wear and tear and progressive loss of articular cartilage.

Osteoarthritis is typically a progressive disease that may eventually lead to disability. The intensity of the clinical symptoms may vary for each individual.

Osteoarthritis (OA) and lower back pain (LBP) are the most common health problems that lead to pain and disability worldwide. OA is a major form of arthritis causing pain and disability.

Some patients with knee OA may not respond well to the recommended knee exercises. This may be due to the possibility of additional concurrent conditions affecting knee OA, such as LBP.It is a common complaint in individuals with knee OA and concurrent LBP was reported in 57.4% of patients with KOA
 

Aetiology 

1. Alignment of lumbar-pelvic and lower extremities - The lumbar spine serves as the primary source of compensation, while hip flexion and pelvic anteversion increase for further compensation.
2. Greater pelvic anterior tilt: study showed greater pelvic anterior tilt (44.68°) angle was found in the patients with knee OA of both the LBP and non-LBP groups compared to healthy people.
   3. Pelvic retroversion causing hip external rotation and varus knee deformity - Pelvic retroversion is related to standing position. Varus knee alignment increases the medial tibiofemoral load and is associated with knee osteoarthritis. Thus, sagittal lumbo-pelvic malalignment, especially pelvic retroversion, could lead to the progression of OA
    

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Conclusion

Back pain is strongly associated with knee pain. Compared to the knee OA patients with mild LBP, patients with severe LBP had poorer pain score and high pelvic incidence which was found to be a risk factor for development of spondylolisthesis and OA. Increases pelvic retroversion, hip extension, knee flexion, and ankle dorsiflexion as compensation to this movement. These compensatory mechanisms induce load on the knee joint, resulting in the progression of knee OA.

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Again, we at Benphysio do provide this service in all our outlets in Oval Damansara, Bangsar, Puchong, KL Ampang, Cheras and Giza KD. We specialized in hands-on physiotherapy to treat the problem. Feel free to call us to make an appointment to get your problem diagnosed by our physiotherapists and fixed via hands on physiotherapy. We are available at Oval Damansara, Bangsar, Puchong, KL Ampang, Cheras and Giza KD.

References

• Amarasinghe, P., Wadugodapitiya, S., & Weerasekara, I. (2023). Biomechanical and clinical relationships between lower back pain and knee osteoarthritis: a systematic review. Systematic reviews, 12(1), 28. https://doi.org/10.1186/s13643-022-02164-3
• Suri P, Morgenroth DC, Kwoh CK, Bean JF, Kalichman L, Hunter DJ. Low back pain and other musculoskeletal pain comorbidities in individuals with symptomatic osteoarthritis of the knee: data from the osteoarthritis initiative. Arthritis Care Res. 2010;62:1715–1723. doi: 10.1002/acr.20324.
• Yasuda T, Togawa D, Hasegawa T, Yamato Y, Kobayashi S, Yoshida G, et al. Relationship between knee osteoarthritis and spinopelvic sagittal alignment in volunteers over 50 years of age. Asian Spine J. 2020;14:495–501. doi: 10.31616/asj.2018.0266.