Abstract
Background: Lumbar spondylosis (LS) is one of the most common degenerative spinal disorders in older adults, with a prevalence of 60–80% among asymptomatic individuals and 90–95% among patients with recurrent low back pain. The lumbar spine bears substantial mechanical loads during daily activities, with loading increasing significantly during sitting, standing, and particularly during forward flexion. Consequently, lumbar spondylosis is closely associated with occupational posture and repetitive mechanical stress. Obesity further increases biomechanical loading on the lumbar spine and accelerates the degenerative process. Degeneration typically begins within the intervertebral nucleus pulposus, subsequently involving the facet joints, vertebral bodies, annulus fibrosus, and spinal ligaments. Progressive structural deterioration leads to compression of pain-sensitive spinal structures and lumbar nerve roots. Over time, spinal instability and advanced intervertebral disc herniation may develop as natural consequences of lumbar degeneration. In the early stages, lumbar spondylosis is often asymptomatic. As degeneration progresses, patients commonly experience recurrent low back pain triggered by prolonged sitting or standing, eventually progressing to persistent low back pain with radiation to the buttock and lower extremities due to lumbar nerve root compression. Imaging modalities, including plain radiography, computed tomography (CT), and magnetic resonance imaging (MRI), play a crucial role in confirming the diagnosis and identifying the underlying degenerative changes. Conservative treatment remains the first-line approach and includes activity modification, physical therapy, and nonsteroidal anti-inflammatory drugs (NSAIDs) such as celecoxib, diclofenac, and dexketoprofen. Dexketoprofen 50 mg/day has demonstrated efficacy in relieving low back pain associated with lumbar spondylosis. Surgical intervention is reserved for patients who fail conservative management or develop neurological deficits secondary to nerve root compression.
