Baastrup’s Disease is a spinal condition that can cause pain in the lower back. While it is a common cause of low back pain, it is often misdiagnosed. This article will explain this condition.
Understanding Baastrup’s Disease
Baastrup’s Disease is also known as “kissing spine syndrome” due to the contact between adjacent spinal bones. This condition primarily affects the lumbar spine, the lower back. Specifically, it involves the spinous processes, bony projections from each vertebra.
It involves the degeneration and enlargement of these spinous processes. This leads to them contacting each other. Friction and repeated contact cause inflammation in the interspinous ligament and can form an adventitious bursa, a fluid-filled sac, contributing to pain.
Several factors contribute to its development. Aging is a common factor, as degenerative changes in the spine occur over time. Repetitive stress or microtrauma to the spine, poor posture, and obesity can also increase the likelihood of developing Baastrup’s Disease. Additionally, certain spinal deformities, such as excessive lordosis (an exaggerated inward curve of the lower back), can predispose individuals to this condition.
Recognizing the Symptoms
The primary symptom is localized low back pain. This pain often worsens with spinal extension, like bending backward, or with prolonged standing. Conversely, the pain may lessen when bending forward.
Pain can vary, described as sharp or a deep ache. While typically confined to the midline of the back, it can sometimes radiate to the buttocks or thighs. However, it generally does not extend below the knee, distinguishing it from conditions like sciatica.
Physical examination often reveals localized tenderness over the affected spinous processes. Other symptoms include stiffness in the lower back and a limited range of motion in the lumbar spine. Symptom severity varies and may be intermittent.
Diagnosis and Management
Diagnosing Baastrup’s Disease involves a thorough clinical examination and imaging studies. During the physical assessment, a healthcare provider will palpate the spine for tenderness and evaluate how movements, particularly extension, affect pain levels. This hands-on approach helps pinpoint the specific area of discomfort and assess the range of motion.
Imaging studies are also used to confirm the diagnosis and rule out other conditions. X-rays can reveal the close proximity or contact of the spinous processes, along with signs of reactive bone changes like sclerosis or osteophytes. Magnetic Resonance Imaging (MRI) is valuable for assessing inflammation, such as interspinous bursitis, and any associated soft tissue changes. Computed Tomography (CT) scans provide detailed views of the bony structures, helping to identify fractures or degenerative changes. A diagnostic injection of local anesthetic into the affected interspinous space can further confirm the diagnosis if it temporarily alleviates the pain.
Management of Baastrup’s Disease often begins with conservative approaches. These include rest, modifying activities that aggravate symptoms, and using pain relievers such as non-steroidal anti-inflammatory drugs (NSAIDs). Physical therapy is also a common recommendation, focusing on strengthening core muscles, improving posture, and stretching to enhance spinal mobility. Localized corticosteroid injections into the inflamed area can provide temporary pain relief by reducing inflammation.
When conservative measures are insufficient, minimally invasive procedures may be considered. Radiofrequency ablation can be used to target and desensitize the nerves transmitting pain signals from the affected area. In rare cases of persistent, severe pain, surgical options may be explored, such as the partial removal of the impinging spinous process (interspinous process decompression) or, less commonly, spinal fusion. Lifestyle adjustments, including weight management and ergonomic considerations, can also play a role in long-term symptom management.