What is spondylosis and how does it affect the spine. How can spondylosis be diagnosed and treated. What are the common symptoms of spondylosis and when should you seek medical attention. How does spondylosis differ from other spinal conditions.

What is Spondylosis? Unraveling the Complexity of Spinal Degeneration

Spondylosis is a broad term encompassing various degenerative conditions of the spine. It refers to the natural wear and tear that occurs in the spinal column over time. This condition can affect different parts of the spine, including the cervical (neck), thoracic (upper back), and lumbar (lower back) regions.

The term “spondylosis” is derived from Greek, where “spondylos” means vertebra and “osis” denotes a condition or disease. It’s important to note that spondylosis is not a specific diagnosis but rather a descriptive term used to indicate spinal degeneration.

Types of Spondylosis

• Cervical spondylosis: Affects the neck region
• Thoracic spondylosis: Involves the upper and mid-back
• Lumbar spondylosis: Impacts the lower back

Is spondylosis the same as arthritis? While spondylosis is often used interchangeably with spinal osteoarthritis, it encompasses a broader range of degenerative changes in the spine. These changes can include disc degeneration, facet joint osteoarthritis, and the formation of bone spurs.

The Anatomy of Spondylosis: Understanding Spinal Structures and Their Role

To fully comprehend spondylosis, it’s crucial to understand the basic anatomy of the spine. The spine consists of vertebrae (bones) stacked on top of each other, with intervertebral discs acting as cushions between them. Facet joints connect the vertebrae and allow for movement, while ligaments provide stability.

Key Spinal Components Affected by Spondylosis

1. Intervertebral discs: Act as shock absorbers between vertebrae
2. Facet joints: Allow for spinal movement and flexibility
3. Vertebrae: The bones that make up the spinal column
4. Ligaments: Provide stability and support to the spine

How does spondylosis affect these spinal structures? As spondylosis progresses, the intervertebral discs may lose height and hydration, leading to decreased cushioning. Facet joints can develop osteoarthritis, causing pain and stiffness. Vertebrae may form bone spurs in response to increased stress, and ligaments can thicken or weaken, affecting spinal stability.

Causes and Risk Factors: What Contributes to the Development of Spondylosis?

Spondylosis is primarily associated with the natural aging process. However, several factors can contribute to its development or acceleration. Understanding these risk factors can help individuals take preventive measures and manage their spinal health more effectively.

Common Risk Factors for Spondylosis

• Age: The primary risk factor, as spinal degeneration naturally occurs over time
• Genetics: Family history can influence susceptibility to spinal degeneration
• Occupation: Jobs involving repetitive motions or heavy lifting can increase risk
• Injuries: Previous spinal injuries may accelerate degenerative processes
• Obesity: Excess weight puts additional stress on the spine
• Smoking: Can affect blood supply to spinal structures and impair healing
• Sedentary lifestyle: Lack of physical activity may weaken supporting muscles

Can spondylosis be prevented? While it’s not always possible to prevent spondylosis entirely, adopting a healthy lifestyle, maintaining proper posture, and engaging in regular exercise can help slow its progression and minimize symptoms.

Symptoms of Spondylosis: Recognizing the Signs of Spinal Degeneration

The symptoms of spondylosis can vary widely among individuals. Some people may experience no symptoms at all, while others may suffer from chronic pain and reduced mobility. It’s essential to recognize the potential signs of spondylosis to seek appropriate medical attention when necessary.

Common Symptoms of Spondylosis

• Neck or back pain, which may be localized or radiating
• Stiffness, especially after periods of inactivity
• Reduced range of motion in the affected area
• Muscle weakness or numbness in extremities
• Headaches (particularly with cervical spondylosis)
• Grinding or popping sensations during movement
• Fatigue due to chronic pain or discomfort

Do all cases of spondylosis cause symptoms? No, many individuals with spondylosis may be asymptomatic. Symptoms often develop gradually and may worsen over time if left untreated.

Diagnosis and Imaging: How Spondylosis is Identified and Evaluated

Diagnosing spondylosis typically involves a combination of clinical evaluation, physical examination, and imaging studies. Healthcare providers use these tools to assess the extent of spinal degeneration and determine the most appropriate treatment plan.

Diagnostic Approaches for Spondylosis

1. Medical history: Discussing symptoms, lifestyle, and family history
2. Physical examination: Assessing range of motion, reflexes, and muscle strength
3. X-rays: Revealing bone changes, disc height loss, and spurs
4. MRI (Magnetic Resonance Imaging): Providing detailed images of soft tissues and nerves
5. CT (Computed Tomography) scan: Offering cross-sectional views of spinal structures
6. Electromyography (EMG): Evaluating nerve function and muscle response

What is the gold standard for diagnosing spondylosis? While X-rays can reveal many aspects of spinal degeneration, MRI is often considered the most comprehensive imaging tool for diagnosing spondylosis, as it provides detailed information about both bone and soft tissue structures.

Treatment Options: Managing Spondylosis and Improving Quality of Life

Treatment for spondylosis aims to alleviate symptoms, improve function, and prevent further degeneration. The approach to treatment often depends on the severity of symptoms and the extent of spinal degeneration. Many cases can be managed effectively with conservative measures, while more severe cases may require more invasive interventions.

Conservative Treatment Options

• Physical therapy: Strengthening exercises and stretches
• Pain management: Over-the-counter or prescription medications
• Lifestyle modifications: Weight management and ergonomic adjustments
• Chiropractic care: Spinal manipulation and alignment techniques
• Acupuncture: Alternative therapy for pain relief
• Hot and cold therapy: To reduce inflammation and relieve pain

Advanced Treatment Options

• Epidural steroid injections: To reduce inflammation around nerves
• Radiofrequency ablation: Using heat to disrupt pain signals
• Spinal cord stimulation: Electrical impulses to mask pain signals
• Surgery: Reserved for severe cases or when conservative measures fail

Is surgery always necessary for spondylosis? No, surgery is typically considered a last resort when conservative treatments have failed to provide adequate relief. Many individuals with spondylosis can manage their symptoms effectively through non-surgical approaches.

Living with Spondylosis: Strategies for Long-term Management and Prevention

While spondylosis is a chronic condition, there are many strategies individuals can employ to manage symptoms, maintain spinal health, and improve overall quality of life. Adopting a proactive approach to spinal care can help slow the progression of degeneration and minimize its impact on daily activities.

Lifestyle Modifications for Managing Spondylosis

1. Regular exercise: Focus on low-impact activities and core strengthening
2. Proper posture: Maintain good alignment during sitting, standing, and sleeping
3. Ergonomic adjustments: Optimize workspaces to reduce spinal strain
4. Healthy diet: Consume anti-inflammatory foods and maintain a healthy weight
5. Stress management: Practice relaxation techniques to reduce muscle tension
6. Sleep hygiene: Ensure proper support and alignment during sleep
7. Smoking cessation: Improve overall health and spinal tissue integrity

Can lifestyle changes reverse spondylosis? While lifestyle modifications cannot reverse existing spinal degeneration, they can significantly slow its progression, reduce symptoms, and improve overall spinal health.

Spondylosis vs. Other Spinal Conditions: Understanding the Differences

Spondylosis is often confused with other spinal conditions due to similarities in symptoms or terminology. It’s important to distinguish between these conditions to ensure proper diagnosis and treatment. Here, we’ll explore how spondylosis differs from other common spinal disorders.

Spondylosis vs. Spondylitis

Spondylosis refers to degenerative changes in the spine, while spondylitis is an inflammatory condition affecting the spine and surrounding tissues. Spondylitis typically causes more systemic symptoms and may be associated with autoimmune disorders.

Spondylosis vs. Spondylolisthesis

Spondylolisthesis occurs when one vertebra slips forward over the one below it. While it can be a result of spondylosis in some cases, spondylolisthesis is a distinct condition that may require different treatment approaches.

Spondylosis vs. Spinal Stenosis

Spinal stenosis is a narrowing of the spinal canal, which can be a consequence of advanced spondylosis. However, not all cases of spondylosis lead to stenosis, and stenosis can occur due to other factors as well.

How can you differentiate between these conditions? Accurate diagnosis typically requires a combination of clinical evaluation, imaging studies, and sometimes specialized tests. A healthcare professional can help determine the specific condition and develop an appropriate treatment plan.

In conclusion, spondylosis is a common condition that affects many individuals as they age. By understanding its causes, symptoms, and management strategies, people can take proactive steps to maintain spinal health and improve their quality of life. While spondylosis cannot be completely prevented or reversed, early intervention and lifestyle modifications can significantly impact its progression and symptoms. If you suspect you may have spondylosis or are experiencing persistent spinal pain, consult with a healthcare professional for proper evaluation and personalized treatment recommendations.

Spondylosis: What It Actually Means

Spondylosis is a broad term that simply refers to some type of degeneration in the spine.

Spondylosis is an umbrella term used to describe pain from degenerative conditions of the spine. Watch: Spondylosis Video

Most often, the term spondylosis is used to describe osteoarthritis of the spine, but it is also commonly used to describe any manner of spinal degeneration.

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Spondylosis Is a Descriptive Term

As with many other terms to describe spinal problems, spondylosis is more of a descriptive term than it is a clinical diagnosis. Literally it can be translated to mean that one has both pain and spine degeneration, regardless of what is causing the pain or where the degeneration is occurring.

Watch: Video: What Is a Degenerative Disc and the Degenerative Cascade?

For example:

• The patient may have pain from facet joint osteoarthritis, causing pain during times of high activity or after extended inactivity
• There could be spinal stenosis, an abnormal narrowing of the spinal canal, which is creating leg pain when the patient walks
• The pain could be caused by degenerative disc disease, in which a degenerated disc that becomes dehydrated and loses some of its function. The degenerated disc can cause low back pain or neck pain, and possibly leg pain or arm pain.

These examples are only a few of the many possible contributors to a patient’s pain.

See When Back Pain May Be a Medical Emergency

In This Article:

• Spondylosis: What It Actually Means

• Answers to Common Spondylosis Questions

• Spondylosis Video

After arriving at a confirmed clinical diagnosis for the cause of a patient’s pain (rather than just the finding that there is spondylosis, which may or may not be causing the pain), physicians then usually use more specific terms for the diagnosis (such as osteoarthritis, lumbar degenerative disc disease or cervical degenerative disc disease, or lumbar spinal stenosis or cervical spinal stenosis) because those terms more effectively describe what is causing the pain.

Dr. David DeWitt is an orthopedic surgeon practicing at the NeuroSpine Center of Wisconsin, where he specializes in spine surgery. He has more than 15 years of experience evaluating and treating spine diseases and trauma.

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Editor’s Top Picks

• Spondylolysis and Spondylolisthesis

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• Living with Degenerative Disc Disease

• Spondylosis Video

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What Is Degenerative Spondylosis? | Discogenic, Lumbar, and Endplate

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WHEN YOUR CONDITION IS DEGENERATIVE DISC DISEASE (SPONDYLOSIS)

Degenerative Disc Disease (DDD), also known as Spondylosis, is a condition that usually occurs due to aging. As the term implies, it is the progressive deterioration of the discs between the vertebral bodies.

Spondylosis (a different term than spondylolisthesis) is typically a degenerative condition of the joints of the spine and is also known as spinal osteoarthritis. The discs, joints, and ligaments of the spine are generally involved.

The discs lose their cushioning effect between the spinal bones, the ligaments become weaker or thicken, and the bones can develop bony growths or spurs. Aging and repetitive stresses to the spine are the primary causes of this degeneration, but they also can be present in younger adults who have had prior trauma.

Not everyone will have symptoms (usually pain) as a result of spondylosis. If severe, spondylosis may cause pressure on nerve roots with subsequent pain or tingle in the arms or legs.

Spondylosis is a degenerative condition of spinal joints and is also known as spinal osteoarthritis. Discs, joints, and ligaments are usually involved. Discs lose their cushioning effect, ligaments become weaker or thicken, and vertebrae can develop bony growths or spurs.

Spondylolisthesis occurs when there is an abnormal alignment of the spine when seen from the side or lateral view. The vertebra above slides forward relative to the one below it. This misalignment may result from several causes, including trauma or degeneration.

There may be abnormal spinal motion associated with this condition. Spondylolisthesis may result in back or neck pain, but extremities can be involved in the spinal cord, or nerve roots are compressed or irritated. Commonly, patients will complain of muscle spasms, thigh and/or buttock pain, and/or tight hamstrings.

There are patients who have spondylolisthesis and do not have symptoms. Spondylolisthesis can be congenital (present at birth) or develop in adolescence or adulthood. The disorder may result from the physical stresses to the spine from physical activity, trauma, and general wear and tear.

In some individuals, the vertebra loses flexibility. Others experience bone spurs or disc bulging that can compress a nerve root, which can cause chronic pain, numbness, and weakness in certain body parts. This condition, however, can occur anywhere along the spinal column, with most cases occurring at the cervical region (degenerative disc disease of the neck) and at the lumbar area (lower back).

Spondylosis occurs with aging, as the shock-absorbing cushions termed intervertebral discs, lose fluid resulting in decreased flexibility of the spine, bulging, thinning, and lesser cushioning ability of the discs. Aside from the normal wear and tear as the individual ages, degenerative disc disease can also occur due to injury as a result of external trauma or repetitive stress on the vertebra.

Other common factors that can contribute to the advancement of disc degeneration include obesity, smoking, and genetic factors.

Symptoms

Not everyone will have symptoms (usually pain) as a result of spondylosis. If severe, spondylosis may cause pressure on nerve roots with subsequent pain or tingle in the arms or legs. The most common clinical manifestation of degenerative disc disease is lower back pain that may or may not radiate to the upper part of the thighs. Some individuals who experience pain from Spondylosis describe morning pain as lower back stiffness or rigidity.

Diagnosing

Your doctor will first perform a physical exam to observe your posture, range of motion, and physical condition, noting any movement that causes you pain. A neurological exam may also be performed to test your reflexes and muscle strength.

During the neurological exam, your doctor will test your sensation, reflexes, and muscle strength. Very commonly with spondylolisthesis, the neurological exam findings are relatively normal.

As your doctor develops the diagnosis, imaging tests may be performed. The best initial test for diagnosis of spondylolisthesis is an X-ray taken in the standing position, with the spine flexed and then extended. For further confirmation of spondylolisthesis, a CT scan may be ordered.

If the slipped vertebra is suspected to be pressing on nerves, the doctor may order a myelogram or an MRI scan.

Treatments

Treatment varies with the severity of the spondylolisthesis. Most patients require only physical therapy combined with activity modification. If pain is arising from nerve root irritation, an epidural steroid injection may be considered.

For cases with severe pain not responding to therapy, if the slip is severe or there are neurologic changes, the slipping vertebra might be surgically fused to the vertebra below it. It is important to discuss treatment options with your doctor in deciding which treatment, if any, may be best for you.

Non-surgical treatments for spondylosis include epidural injections, chiropractic care, pain management medications, and physical therapy. If the pain continues or there is evidence of a severely compressed nerve, surgery may be considered. Surgery for spondylosis involves two main components: eliminating what is causing pain and then fusing the spine to control movement.

Surgery may also include decompression, which means removing the tissue that is pressing on nerves. Spondylosis and disc degeneration causing functionally disabling pain that fails to improve with conservative treatment may be treated with fusion or disc replacement surgery.

Every case is different. It is therefore very important to discuss treatment options with a spine specialist familiar with all types of spinal surgery in deciding which treatment, if any, may be best for you.

Frequently Asked Questions

Will exercise help?

Like unused rubber that gets brittle as it ages, bones and joints get fragile with immobility. Regular exercise is the key to preventing further damage and complication. However, exercise should be done with caution and to an extent that is comfortable and pain-free.

Exercise #1

• Sit comfortably with both feet on the floor
• Keep your neck straight
• Bring the back of your head up
• Feel the stretch of your neck
• Repeat a few times

Exercise #2

• Sit comfortably with both feet on the floor
• Relax both of your shoulders and arms
• Move your left ear towards your left shoulder as far as you can tolerate without lifting your shoulder
• Return to starting position
• Perform the same exercise on the right side
• Repeat for few times as tolerated

Exercise #3

• Sit comfortably with both feet on the floor
• Relax both of your shoulders and arms
• Keep your neck straight and look straight ahead
• Gently turn your head to the right as far as comfortable (maintain your gaze straight and parallel to the floor)
• Return to starting position
• Perform the same exercise on the right side
• Repeat for few times as tolerated

Exercise #4

• Sit comfortably with both feet on the floor
• Relax both of your shoulders and arms
• Gently move your head down with your chin towards the chest as far as comfortable
• Keep your back and neck aligned
• Return to starting position
• Repeat step 3 for few times as tolerated

Can Epsom Salts help to reduce my pain?

The Magnesium content present in Epsom salt works wonders in healing. It aids in balancing the pH levels in the body. When pH levels are balanced, the stiffness can be minimized. It also helps in lessening the pain of DDD in your neck and shoulders.

To prepare for an Epsom salt treatment, take a couple of tablespoonful of Epsom salt and add water to make a paste. Apply it to your neck and shoulders. Keep it on for approximately 15 minutes, and then wash it off. However, if you have diabetes, cardiac or kidney problems, consult your doctor first prior to using this home management.

Why did I get this?

In most cases, it is just the normal aging process. It can certainly be affected by genetics and if your mother and father have problems with their back it is not unusual that you too will have problems with your back.

Is Degenerative Disc Disease a disease?

No, it really isn’t a disease in the typical sense, meaning that there is not a pill you can take to stop it, and it is not life-threatening. It is more of a wear and tear process.

Will have to live it the rest of my life?

No, most patients usually will respond to an active exercise program, strengthening their core or trunk muscles, learning proper body posture and body mechanics, losing weight if they are overweight, and the use of anti-inflammatories in the vast majority of cases.

How common is Degenerative Disc Disease?

We know that 90% of individuals will experience 1 episode of low back pain and about a third of this 90% will have chronic intermittent back pain. If one exercises and takes care of their spine, the pain-free intervals can actually be quite long and recovery from these episodes will be relatively shortened.  That’s why it is very important to practice good body posture and body mechanics and to do your exercises.

I have young children. Will they get Degenerative Disc Disease?

Unfortunately, we know that genetics does play a role in the conditions that our family gets. While there has been research to determine what genes may be associated with Degenerative Disease, it is not clear-cut at the present time. The most important thing is for all patients to be physically fit, of normal weight, and to practice good body posture and body mechanics.

Leaders in Advanced Spine Procedures

To find out whether you would benefit from artificial disc surgery, make an appointment to visit Texas Back Institute in the Dallas, TX, area for an evaluation. We always reserve surgery as a last resort, so we’ll seek to relieve pain first through conservative treatments such as physical therapy and pain management. If severe pain persists and it is determined that you would benefit from surgery, we can help you determine whether artificial disc replacement is right for you.

Book an Appointment Now

Deforming spondylosis – treatment, symptoms, causes, diagnosis

The term deforming spondylosis has Latin roots (spondyl means the spine, and osis – disorders) and the term reflects the presence of problems in the spine. Currently, this term refers to degenerative changes in the joints of the spine (osteoarthritis or osteoarthritis) and, like osteochondrosis, spondylosis is an involutionary process in the spine. As the body ages, the structures of the spine wear out, especially the joints, ligaments, and intervertebral discs.

However, the aging of the organism is a purely individual process. Just as some people start going gray earlier, the development of spondylosis also appears earlier in some people. In fact, some people may not experience pain at all. It all depends on how part of the spine has undergone degeneration, and how these changes affect the spinal cord or spinal roots.

Deforming spondylosis can develop in all parts of the spine (cervical thoracic and lumbar) and, depending on the localization of degenerative changes in spondylosis, there will be corresponding symptoms. Spondylosis ( spondylosis deformans ) is often referred to as osteoarthritis or osteoarthritis of the spine.

Deforming spondylosis is a degenerative process that goes in parallel with osteochondrosis and degenerative changes occur in the following structures of the spine.

Intervertebral discs . As people age, certain biochemical changes occur that affect tissues throughout the body. There are also changes in the structure of the intervertebral discs (in the annulus fibrosus, in the nucleus pulposus). The annulus fibrosus consists of 60 or more concentric bands of collagen fibers. The nucleus pulposus is a jelly-like substance inside the intervertebral disc, surrounded by the annulus fibrosus. The core consists of water, collagen fibers and proteoglycans. Degenerative involutional changes can weaken these structures, causing the annulus to wear out or tear. The water content in the core decreases with age, which affects the depreciation properties of the intervertebral disc. The result of structural changes in disc degeneration may be a decrease in the height of the intervertebral disc and an increased risk of disc herniation.

Facet joints (or zygapophyseal joints) . Each vertebral body has four facet joints that work like hinges. This allows the spine to flex, extend, and rotate. Like other joints, facet joints are covered with cartilage. Cartilage is a special type of connective tissue that is provided with lubrication and a good sliding surface. With degenerative changes in the facet joints, cartilage tissue disappears and osteophytes form. These changes can lead to joint hypertrophy (osteoarthritis, osteoarthritis).

Bones and ligaments . Osteophytes can form near the end of the vertebral plates, which can lead to impaired blood supply to the vertebra. In addition, the end plates may thicken due to sclerotic phenomena; thickening or thickening of the bones under the end plates. Ligaments are bands of fibrous tissue that connect the vertebrae and they protect the spine from excessive movement such as hyperextension. Degenerative changes cause the ligaments to lose their strength. Changes to, for example, the yellow ligament can lead to hardening and thickening of the ligament, which in turn can lead to an effect on the dura mater.

Symptoms in spondylosis of various parts

Spondylosis of the cervical region. The complex anatomical structure of the cervical spine and the wide range of motion make this spine very prone to degenerative disorders. Pain in the neck with spondylosis in this department is common. The pain may radiate to the shoulder or down the arm. When osteophytes cause compression of the nerve roots that innervate the limbs, in addition to pain, weakness in the upper limbs may also appear. In rare cases, bone spurs (osteophytes) that form in the front of the cervical spine can lead to difficulty swallowing (dysphagia).

When spondylosis is localized in the thoracic spine, pain due to degenerative changes (spondylosis) often appears with forward flexion and hyperextension. Flexion causes faceted pain.

Lumbar spondylosis is common in people over 40 years of age. The most common complaints are back pain and morning stiffness. Changes, as a rule, take place in several motor segments. The lumbar spine bears most of the weight of the body. Therefore, when degenerative changes compromise structural integrity, symptoms, including pain, may accompany any physical activity. Movement stimulates pain fibers in the annulus and joints. Sitting for long periods of time can lead to pain and other symptoms due to pressure on the lumbar vertebrae. Repetitive movements such as lifting weights and bending over can increase pain.

Symptoms of spondylosis can range from mild to severe and become chronic or even crippling. These may include:

• Cervical region
  
  • Pain that comes and goes
  • Pain that radiates to the shoulders, arms, hands, fingers
  • Morning stiffness in the neck or shoulder or limited range of motion upon waking
  • Neck or shoulder soreness or numbness
  • Weakness or tingling in the neck, shoulders, arms, hands, fingers
  • Headache in the occipital region
  • Unbalance
  • Difficulty swallowing
• Thoracic spine
  
  • Upper and middle back pain
  • Pain occurs when bending and straightening the trunk
  • Morning stiffness in the back after waking up
• Lumbar Spine
  
  • Pain that comes and goes
  • Morning stiffness in lower back after getting out of bed
  • Pain that improves with rest or after exercise
  • Pain in the lower back or numbness
  • Ischialgia (moderate to severe pain in the legs)
  • Weakness, numbness or tingling in the lower back, legs or feet
  • Walking disorder
  • Impaired bowel or bladder function (these symptoms are rare, but possible with compression of the cauda equina).

Causes of spondylosis deformans

Body aging is the main cause of spondylosis. The body is subjected to daily stress for many years, and over time, changes occur in various structures of the spine. Before symptoms such as pain and stiffness appear, degeneration of the spinal structures occurs. Spondylosis is a cascade process: one anatomical change leads to another, resulting in changes in the structure of the spine. These changes together cause spondylosis and the corresponding symptoms.

As a rule, degenerative changes begin in the intervertebral discs first. For this reason, patients with spondylosis often also have osteochondrosis. The consequences of these degenerative changes in the spine are closely related.

Changes begin in the discs, but eventually the aging process also affects other parts of the motor segments of the spine. Over time, the collagen that makes up the annulus begins to change. In addition, the water content in the disk is reduced. These changes reduce the cushioning functions of the disk and the ability to absorb load vectors. With degeneration, the disc becomes thinner and denser, which already leads to changes in the joints, which take part of the load of the disc on themselves, providing stabilization of the spine. When the disc becomes thinner, the cartilage of the joints begins to wear out faster, the mobility of the spine increases, and conditions arise for irritation of the nerve roots located nearby. This hypermobility, in turn, causes a compensatory reaction of the body in the form of excessive growth of bone tissue in the area of ​​the joints (osteophytes). Osteophytes with sufficient magnification can have a compressive effect on the roots of the spinal cord and cause a corresponding clinical picture. Osteophytes can also cause spinal stenosis. As a rule, the cause of stenosis of the spinal canal is not osteochondrosis, but spondylosis.

In the development of spondylosis, to a certain extent, genetic determinism plays a role. Also, bad habits, such as smoking, have a certain influence.

Diagnosis

It is not always easy to determine that spondylosis is the cause of back pain because spondylosis can develop gradually as a result of body aging, and pain can also be due to another degenerative condition such as osteochondrosis. First of all, a neurologist is interested in answers to the following questions:

• Beginning of pain manifestations
• Activities that preceded the onset of pain
• What measures were taken to relieve pain
• Presence of irradiation of pain
• Pain aggravating or pain relieving factors

The neurologist will also perform a physical examination and examine the patient’s neurological status (posture, range of motion in the spine, presence of muscle spasm). In addition, the neurologist should also examine the joints (hip joints, sacroiliac joints), as the joints can also be a source of back pain. During a neurological examination, a neurologist will check tendon reflexes, muscle strength, and the presence of sensory disturbances.

Verification of the diagnosis also requires instrumental methods, such as radiography, MRI or CT, which allow visualization of changes in the spine. Radiography well reflects changes in bone tissues and allows you to visualize the presence of bone growths (osteophytes). But for a more accurate diagnosis, methods such as CT or MRI are preferable, which also visualize soft tissues (ligaments, discs, nerves). In some cases, it is possible to use scintigraphy, especially if it is necessary to differentiate oncological processes or infectious (inflammatory) foci.

In the presence of damage to the nerve fibers, the doctor may prescribe ENMG, which allows you to determine the degree of conduction disturbance along the nerve fiber and determine both the degree of damage and the level of damage. Based on the totality of clinical data and the results of instrumental methods, the examination by a neurologist can make a clinical diagnosis of spondylosis and determine the necessary treatment tactics.

Treatment

In most cases, the course of spondylosis is quite slow and requires almost no treatment. With the active course of spondylosis, treatment is required, which can be both conservative and, in some cases, surgical. Most often, spondylosis requires conservative treatment. Various therapies are used to treat spondylosis.

Acupuncture . This treatment method can reduce back and neck pain. Needles that are inserted at specific points can also be stimulated both mechanically and electrically. In addition, acupuncture increases the production of its own painkillers (endorphins).

Bed rest. In severe cases, severe pain may require bed rest for no more than 1-3 days. Prolonged bed rest increases the risk of developing complications such as deep vein thrombosis and back muscle wasting.

Traction therapy . In most cases, spinal traction is rarely needed or used to relieve symptoms associated with spondylosis.

Manual therapy . Manipulations of a chiropractor using various techniques can increase the mobility of motor segments and remove muscle blocks.

Medical treatment . Drugs for the treatment of spondylosis are mainly used to relieve pain. These are drugs such as NSAIDs. In addition, muscle relaxants can be used if there are signs of muscle spasm. Tranquilizers can also be used to relax muscle spasm, which can also improve sleep. Opioids are used in the treatment of pain only occasionally, with severe pain manifestations. Any drug treatment should be carried out only as prescribed by the attending physician, since almost all drugs have a number of side effects and have certain contraindications.

Epidural steroid injections are sometimes used for pain syndromes and can relieve pain, especially when there is swelling and inflammation in the spinal roots. Typically, the steroid is administered in combination with a local anesthetic. The effect of such injections is usually limited to 2-3 days, but this allows you to remove the pathological process and connect other methods of treatment.

Facet joint injections are also used in the treatment of spondylosis and improve the mobility of the facet joints, reduce pain associated with arthrosis of the facet joints.

LFC . This treatment method is one of the most effective treatments for spondylosis. Dosed physical activity allows you to restore the normal muscle corset, reduce pain, increase the stability of the spine, improve the condition of the ligamentous apparatus and stop the progression of degenerative processes in the spine. As a rule, exercise therapy is prescribed after the relief of acute pain.

Physiotherapy . Modern methods of physiotherapy (for example, HILT therapy, SWT therapy, electrical stimulation, cryotherapy) can not only reduce pain manifestations, but also influence the development of degenerative processes in the spine to a certain extent.

Corsetting . The use of corsets in spondylosis is possible for a short period of time, since prolonged use of the corset can lead to atrophy of the back muscles.

Lifestyle change. Losing weight and maintaining a healthy lifestyle with a balanced diet, regular exercise, and smoking cessation can help treat spondylosis at any age.

Surgery

Only a small percentage of spondylosis cases require surgery. Surgical methods of treatment are mainly necessary in the presence of persistent, resistant to conservative treatment of neurological symptoms (weakness in the limbs, dysfunction of the bladder, intestines, or other manifestations of compression effects on the spinal cord and roots). Surgical treatment consists in decompression of the nerve structures (for example, removal of osteophytes that have a compressive effect on the nerve structures). Depending on the extent of the operation, spinal fusion may be performed to stabilize the vertebrae. Currently, minimally invasive methods of surgical treatment are widely used, which allows you to quickly restore the function of the spine and normalize the quality of life.

Spondylosis – treatment, symptoms, causes, diagnosis

Spondylosis literally means hardening or fixation of the vertebrae as a result of pathological changes in the spine. Spondylosis is caused by degenerative changes in the spine, such as the formation of osteophytes (bone spikes) and degenerative-dystrophic changes in the intervertebral discs. Changes in the spine with spondylosis are referred to as osteoarthritis. For example, the phrase “spondylosis of the lumbar spine” means the presence of degenerative changes such as osteoarthritis in the intervertebral joints and the presence of degenerative changes in the intervertebral discs in the lumbar spine.

Spondylosis can affect all parts of the spine (cervical thoracic lumbar), but the most common is cervical and lumbar spondylosis. Thoracic spondylosis often causes no symptoms. With lumbosacral spondylosis, changes occur not only in the lumbar spine, but also in the sacral region. There are several medical terms that are similar in name to spondylosis and are therefore often confused. These are terms such as:

• spondylitis: inflammation of one or more vertebrae of infectious (including specific origin) or non-infectious origin (in inflammatory diseases such as ankylosing spondylitis). Spondylitis is a completely different disease, because in spondylosis degenerative processes take place, while spondylitis is an inflammatory disease
• spondylolysis: incomplete development and formation of the articular part of the vertebra (pars interarticularis). This defect predisposes to spondylolisthesis due to the development of motor segment instability
• spondylolisthesis: displacement forward or backward of the vertebral body in relation to the underlying vertebra. For example, L4 to L5 anterior spondylolisthesis means that the fourth lumbar vertebrae has moved forward relative to the fifth vertebra. As a result, the geometry of the spine changes.
• spondylosis deformans : occurs due to the growth of osteophytes or bony bridges around a degrading intervertebral disc (this term is almost synonymous with spondylosis).
• stenosis: narrowing of the spinal canal. This is a narrowing of the spinal canal that limits the space needed for the spinal cord and nerves. Pressure on the spinal cord and nerves due to the narrowing of the spinal canal can cause symptoms such as pain, numbness, and tingling.

Causes and risk factors

Spondylosis is an age-related change in the spine. As we age, the bones and ligaments in the spine wear down, resulting in bony growths. In addition, intervertebral discs degenerate, weaken, which can lead to the formation of protrusions or herniated discs. The cause of early spondylosis may be heavy physical exertion of a professional nature. Spondylosis is quite common. The first symptoms may appear between the ages of 20 and 50. More than 80% of people over the age of 40 have radiographic evidence of spondylosis. The rate of development of spondylosis depends on both genetic factors and the presence of injuries or excessive loads on the spine.

Symptoms

Many people who have spondylosis on x-ray have no symptoms. Statistically, lumbar spondylosis , present in 27%-37% of people without any symptoms.

In some people, spondylosis causes back and neck pain due to nerve compression. Nerve compression is caused by herniated discs or osteophytes in the facet joints, which narrow the space where the nerves pass and cause spinal or foraminal stenosis. Even with small disc herniations, when they do not cause root compression, local inflammation and irritation of nerve fibers are possible. In addition, herniated discs can put pressure on the ligaments of the spine and cause pain. With compression, conditions arise for stimulating the growth of blood vessels and nerves, and this leads to a chronic pain syndrome. With pain syndrome, individual parts of the spine try to compensate for pain, and as a result, areas of soreness, muscle spasm, and trigger points appear.

Symptoms of spondylosis include localized pain in the area of ​​the spondylosis, usually in the lower back or neck. If a herniated disc causes nerve compression, the pain may radiate to the limb. For example, large disc herniations in the lumbar spine can compress a nerve and cause pain that starts in the lower back and then travels down one leg and foot. This condition is commonly referred to as sciatica. Back pain due to a herniated disc typically worsens with prolonged standing, sitting, and leaning forward, and often improves with changes in position and walking. Back pain due to arthrosis of the facet joints is usually worsened by walking and standing, and relieved by straightening the torso. Nerve compression can cause numbness and tingling. With severe compression of the nerves, muscle weakness in the limb may appear. If a herniated disc puts pressure on the spinal cord, it can cause damage to the spinal cord (myelopathy). Myelopathy symptoms include numbness, tingling, and muscle weakness. For example, a large herniated disc in the cervical spine can lead to cervical myelopathy, resulting in symptoms such as numbness, tingling, and weakness in the arms and possibly legs. As a rule, patients with spondylosis have already been in contact with doctors, since CT or MRI radiography well visualize changes in the spine characteristic of this disease. The reason for the obligatory visit to the doctor are the following reasons:

• No effect of prescribed treatment
• Presence of evidence of acute nerve dysfunction (eg, weakness in one or more limbs)
• Bladder or bowel dysfunction accompanied by acute pain in the lower back or neck indicates severe nerve dysfunction and requires hospitalization
• Numbness in the groin or ischial area may indicate serious dysfunction of the nerve structures and also requires immediate hospitalization.

Diagnosis

Spondylosis is diagnosed using radiological methods such as plain radiography, MRI or CT. Radiography allows visualization of osteophytes, thickening of the joints and a decrease in the distance between the vertebrae. A CT scan of the spine is able to visualize the spine in more detail and can diagnose narrowing of the spinal canal (stenosis) if present. An MRI study is the most informative and allows you to visualize soft tissues (disks, ligaments, nerves) and diagnose the presence of compression of nerve structures, which often allows you to find out the true cause of pain in spondylosis.
If nerve damage is suspected, ENMG may be prescribed to determine the degree of nerve fiber damage and conduction disturbance. Sometimes, to clarify the diagnosis, a radioisotope scan may be prescribed, based on varying degrees of absorption of radioactive material by tissues with different metabolisms (for example, with inflammation or tumors, more radioisotope will accumulate abnormally in the bone tissue).

Treatment

There is currently no treatment that can reverse spondylosis because it is a degenerative process. Treatment of spondylosis is to treat symptoms such as pain in the lower back or neck and is similar to that in the treatment of degenerative disc disease.

Medical treatment. There are no medications that reliably stop the degenerative process in the spine. In pain syndrome, as a rule, drugs of the NSAID group and muscle relaxants are widely used. Non-steroidal anti-inflammatory drugs can be very effective in relieving back and neck pain associated with spondylosis (ibuprofen, movalis, naproxen). Muscle relaxants such as cyclobenzaprine (Flexeril) and tizanidine (Zanaflex) have been shown to significantly reduce muscle spasm associated with spondylosis. For severe pain, analgesics such as tramatodol or drugs of the narcotic group can be used.
Antidepressants may be used for chronic pain. Medicines called tricyclic antidepressants, including amitriptyline (Elavil) and doxepin (Sinevkan), have been used for many years in low doses to treat chronic back pain. Recently, an antidepressant such as duloxetine (Cymbalta) has been used, and its effectiveness in chronic back pain has been reliably proven. A good effect is the use of ointments containing capsaicin.

Physiotherapy helps reduce pain, improve microcirculation in the tissues of the spine.

LFK . A carefully selected program of exercises both with weights (on simulators) and in the form of gymnastics (qigong or yoga) can also reduce both pain manifestations and improve the functionality of the spine.

Manual Therapy Gentle manual therapy techniques achieve mobilization of the motor segments and reduce pain. However, some patients should not be subjected to manual manipulation, especially when spondylosis is combined with a disease such as ankylosing spondylitis.

Acupuncture reduces pain and improves conduction along nerve fibers.

Minimally invasive procedures, such as injecting steroids into the epidural space or into joints or injecting into trigger points, can also reduce pain.