Baastrup disease is a specific spinal condition that can be a source of back pain, often subtle in its presentation. This condition involves changes in the spine that can lead to discomfort and affect daily activities. Understanding this condition clarifies its impact on well-being.
What Exactly Is Baastrup Disease?
Baastrup disease, also known as kissing spine syndrome or interspinous osteoarthropathy, is a condition where adjacent spinous processes in the spine come into close contact. These bony projections extend backward from the vertebrae and can rub against each other. This contact most frequently occurs in the lumbar (lower back) region of the spine.
Friction between these bony structures leads to irritation and inflammation of the interspinous ligaments. These ligaments connect the spinous processes, providing spinal stability. Over time, this irritation can result in degenerative changes, including bone enlargement and the formation of bursae, which are fluid-filled sacs that can become inflamed.
Recognizing the Symptoms
Individuals with Baastrup disease experience localized back pain as the primary symptom. This pain is often described as an aching or sharp sensation directly over the affected spinal area. The discomfort worsens with movements that increase spinal extension, such as prolonged standing, walking, or bending backward.
Conversely, the pain is often relieved when the spine flexes forward, as this movement separates the spinous processes. Other symptoms include tenderness when pressure is applied directly over the involved spinous processes. Some individuals may also report lower back stiffness, particularly after periods of inactivity.
How Baastrup Disease Develops
Baastrup disease develops from degenerative changes within the spinal column, common with aging. Natural wear and tear on spinal components can alter their alignment and function. This includes a flattening of natural spinal curves or a reduction in the height of the intervertebral discs, which can bring the spinous processes closer together.
Altered spinal biomechanics and postural issues also contribute to the condition’s progression. For instance, a pronounced inward curve in the lower back, known as hyperlordosis, can increase the likelihood of the spinous processes making contact. Repetitive mechanical stress from everyday activities can worsen friction and degenerative changes between these bony structures.
Diagnosing and Treating Baastrup Disease
Diagnosing Baastrup disease involves a physical examination and imaging studies. During the physical assessment, a doctor looks for localized tenderness over the affected spinous processes and observes if pain worsens with spinal extension. This clinical evaluation helps pinpoint the area of concern.
X-rays are the primary imaging tool to confirm Baastrup disease. These images clearly show the close proximity or contact between adjacent spinous processes and may also reveal signs of degenerative changes such as bone sclerosis or enlargement. While MRI or CT scans provide more detailed views of soft tissues or help rule out other conditions, X-rays are often sufficient for initial confirmation of the “kissing spines” phenomenon.
Treatment for Baastrup disease begins with conservative management aimed at reducing pain and improving function. Rest and activity modification are recommended to avoid movements that exacerbate symptoms, such as prolonged standing or excessive spinal extension. Physical therapy plays an important role, focusing on exercises that strengthen core muscles, improve posture, and enhance spinal flexibility, which helps create more space between the spinous processes.
Pain medications, particularly non-steroidal anti-inflammatory drugs (NSAIDs), manage inflammation and discomfort. Local injections, such as corticosteroids administered directly into the interspinous space or a bursa, provide more targeted pain relief by reducing inflammation around the affected bones and ligaments. In cases where conservative treatments do not provide sufficient relief and symptoms remain severe, surgical options may be considered. Surgical procedures involve removing a portion of the spinous process to decompress the area, but these are reserved as a last resort due to their invasive nature.