Lombalgie et arthrose, existe-t-il un lien systématique ?

In the light of recent research in anatomy and biomechanics showing the absence of nociceptive innervation of cartilage and studying the lumbar spine during extension, it appears important to challenge some points of established belief too often quoted to justify therapeutic failure. As long as the subchondral bone and synovial membrane are not involved, osteoarthritis does not inevitably lead to pain. A radiologic aspect of osteoarthritis can no longer be systematically incriminated as being the source of our patients' pain. The loss of joint mobility caused by osteoarthritis gives physiotherapists a key role in suggesting therapeutic solutions, as long as there is no inflammatory phenomenon in addition to the clinical symptoms. Various etiologies other than osteoarthritis can cause low back pain. Therefore, a possible central origin should be considered in chronic low back pain. Thus, diagnostic work-up needs to be refined so as to target etiology and adapt treatment strategy, taking imagery into account only when radiological and clinical data match.