What are the main causes of spondylosis. How do risk factors contribute to its development. What symptoms should you watch out for in mild to moderate cases.

Understanding Spondylosis: Types and Prevalence

Spondylosis is a degenerative condition affecting the spine, characterized by the deterioration of spinal discs and joints, as well as the growth of bone spurs on vertebrae. This arthritis-like disorder can impact spinal mobility and potentially affect nerve function. The most common form is cervical spondylosis, which targets the neck region.

According to the American Academy of Orthopaedic Surgeons, cervical spondylosis affects over 85% of individuals aged 60 and above. However, spondylosis can occur in various parts of the spine:

• Cervical spondylosis (neck)
• Thoracic spondylosis (mid-back)
• Lumbar spondylosis (lower back)
• Multilevel spondylosis (multiple spinal regions)

While the effects of spondylosis vary among individuals, they rarely cause severe problems. Many people experience intermittent pain and stiffness as primary symptoms.

The Anatomy of the Spine and Its Role in Spondylosis

To comprehend spondylosis fully, it’s crucial to understand spinal anatomy. The spine serves as the body’s primary support structure, bearing most of its weight and protecting vital nerve branches from the brain. Contrary to popular belief, the spine is not straight but curved, comprising three main sections: cervical, thoracic, and lumbar. These sections contain 24 bones called vertebrae.

Between the vertebrae lie facet joints, allowing for spinal flexibility. Additionally, intervertebral discs separate the vertebrae, consisting of:

• Cartilage endplates
• A tough exterior (annulus fibrosus)
• An inner core (nucleus pulposus)

These discs facilitate smooth movement and provide cushioning against impact. As we age, these discs become drier, thinner, and harder, reducing their cushioning ability. This deterioration explains why older individuals are more susceptible to vertebral compression fractures compared to younger people.

The Degenerative Process: How Spondylosis Develops

Spondylosis primarily results from the natural wear and tear that occurs over time. As we age, several changes take place in the spine:

1. Intervertebral discs lose moisture and elasticity, becoming thinner and less effective at cushioning.
2. Facet joints experience cartilage erosion, leading to bone-on-bone friction.
3. Bone spurs (osteophytes) may form as a result of this increased friction.
4. The spine becomes stiffer and less flexible due to the loss of rubbery tissues and the development of bone spurs.

These changes can affect individuals differently, depending on various risk factors. While age-related wear and tear is the primary cause, other factors can accelerate or exacerbate the condition.

Risk Factors Contributing to Spondylosis Development

Several factors can increase an individual’s likelihood of developing spondylosis or experiencing more severe symptoms:

• Genetic predisposition
• Obesity or being overweight
• Sedentary lifestyle and lack of exercise
• Previous spinal injuries or surgeries
• Smoking
• Occupations involving repetitive or weight-bearing spinal movements
• Mental health conditions such as anxiety or depression
• Presence of psoriatic arthritis

Understanding these risk factors can help individuals take proactive steps to mitigate their risk of developing spondylosis or manage existing symptoms more effectively.

Recognizing Symptoms of Mild to Moderate Spondylosis

While many individuals with age-related spondylosis may not experience symptoms, others may encounter various signs indicating the condition’s presence. Common symptoms of mild to moderate spondylosis include:

• Stiffness in the affected area of the spine
• Mild pain that worsens with certain movements or prolonged inactivity
• A grinding or popping sensation during spinal movement
• Weakness in the hands or legs
• Poor coordination
• Muscle spasms and pain
• Headaches
• Balance issues and difficulty walking

It’s important to note that symptoms can be intermittent, with periods of relief followed by symptom recurrence. In some cases, sudden movements may trigger symptom onset.

Are there any warning signs that require immediate medical attention?

While most symptoms of mild to moderate spondylosis are manageable, certain signs warrant prompt medical evaluation:

• Sudden, severe pain in the neck or back
• Numbness or weakness spreading to the arms or legs
• Loss of bladder or bowel control
• Difficulty with fine motor skills or coordination
• Unexplained weight loss or fever accompanying spinal pain

These symptoms may indicate more serious complications and should be assessed by a healthcare professional as soon as possible.

Potential Complications and Related Conditions

While mild to moderate spondylosis often remains manageable, it can sometimes lead to or be associated with other spinal conditions. Understanding these potential complications is crucial for comprehensive management:

Spinal Stenosis

Spinal stenosis involves the narrowing of the spinal canal, which houses the spinal cord nerves. Symptoms may include:

• Neck or back pain that may radiate down the legs
• Foot problems
• Numbness or weakness in affected areas

Cervical Radiculopathy

This condition occurs when spinal nerves become pinched due to disc or bone changes. Common symptoms include:

• Shooting pain along the affected nerve pathway
• Numbness in specific areas
• Hypersensitivity in the affected region

Cervical Spondylotic Myelopathy

This more severe complication involves compression of the spinal cord itself. Symptoms may progress over time and can include:

• Pain and numbness in the limbs
• Loss of hand coordination
• Balance problems and difficulty walking
• In advanced stages, bladder control issues

Adult-Onset Scoliosis

Research suggests a potential link between facet joint degeneration and the development of scoliosis in adults. This condition involves an abnormal curvature of the spine and may exacerbate existing spondylosis symptoms.

Diagnostic Approaches for Spondylosis

Accurate diagnosis of spondylosis is crucial for effective management. Healthcare providers typically employ a combination of methods to assess the condition:

Physical Examination

A thorough physical exam allows doctors to evaluate:

• Range of motion in the affected area
• Presence of tenderness or muscle spasms
• Neurological function, including reflexes and muscle strength

Imaging Studies

Various imaging techniques can provide detailed information about spinal structures:

• X-rays: Reveal bone spurs, disc height reduction, and overall spinal alignment
• MRI (Magnetic Resonance Imaging): Offers detailed images of soft tissues, including discs and nerves
• CT (Computed Tomography) scans: Provide cross-sectional images of bony structures

Electromyography (EMG)

This test measures electrical activity in muscles and can help identify nerve compression or damage associated with spondylosis.

Treatment Options for Mild to Moderate Spondylosis

Management of mild to moderate spondylosis typically focuses on symptom relief and preventing progression. Treatment approaches may include:

Conservative Measures

• Physical therapy to improve flexibility and strengthen supporting muscles
• Pain management techniques, including heat/cold therapy and gentle stretching
• Lifestyle modifications, such as ergonomic adjustments and weight management

Medications

Various medications may be prescribed to manage pain and inflammation:

• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Muscle relaxants for acute muscle spasms
• In some cases, corticosteroid injections for targeted pain relief

Alternative Therapies

Some individuals find relief through complementary approaches:

• Acupuncture
• Chiropractic care
• Massage therapy

It’s important to consult with a healthcare provider before starting any new treatment regimen, as individual needs may vary based on the severity and specific symptoms of spondylosis.

Preventive Strategies and Long-Term Management

While spondylosis is often a natural part of aging, certain strategies can help minimize its impact and slow progression:

Regular Exercise

Maintaining an active lifestyle is crucial for spinal health. Beneficial activities include:

• Low-impact aerobic exercises like swimming or cycling
• Core-strengthening exercises to support the spine
• Gentle stretching routines to improve flexibility

Proper Posture and Ergonomics

Adopting good posture habits and ergonomic practices can significantly reduce stress on the spine:

• Use ergonomic chairs and workstations
• Practice proper lifting techniques
• Take regular breaks to stretch and move during prolonged sitting

Healthy Lifestyle Choices

Overall health plays a crucial role in managing spondylosis:

• Maintain a healthy weight to reduce spinal stress
• Quit smoking, as it can accelerate disc degeneration
• Stay hydrated to support disc health
• Consume a balanced diet rich in anti-inflammatory foods

Regular Check-ups

Periodic evaluations by a healthcare provider can help monitor the condition’s progression and adjust management strategies as needed.

By implementing these preventive measures and working closely with healthcare professionals, individuals with mild to moderate spondylosis can often maintain a good quality of life and minimize the condition’s impact on daily activities.

Recent Advances in Spondylosis Research and Treatment

The field of spondylosis management is continually evolving, with ongoing research aimed at improving diagnostic accuracy and treatment efficacy. Some recent developments include:

Advanced Imaging Techniques

Newer imaging modalities, such as dynamic MRI and 3D CT scans, offer more detailed views of spinal structures, allowing for earlier detection and more precise treatment planning.

Regenerative Medicine

Emerging therapies like stem cell treatments and platelet-rich plasma (PRP) injections show promise in promoting tissue repair and reducing inflammation associated with spondylosis.

Minimally Invasive Surgical Techniques

For cases where conservative management is insufficient, advancements in minimally invasive spine surgery offer potential benefits such as:

• Smaller incisions and reduced tissue damage
• Faster recovery times
• Lower risk of complications compared to traditional open surgery

Wearable Technology

The development of smart wearable devices allows for real-time monitoring of posture and movement patterns, potentially aiding in the prevention and management of spondylosis symptoms.

As research continues, individuals with spondylosis may benefit from an expanding array of treatment options tailored to their specific needs and condition severity.

Living with Spondylosis: Coping Strategies and Support

Adapting to life with spondylosis can be challenging, but various coping strategies can help individuals maintain a positive outlook and quality of life:

Education and Self-Management

Understanding the condition empowers patients to take an active role in their care. Key aspects include:

• Learning about spondylosis and its management
• Recognizing personal triggers and symptom patterns
• Developing a personalized self-care routine

Stress Management

Chronic pain conditions like spondylosis can be emotionally taxing. Stress reduction techniques may include:

• Mindfulness meditation
• Deep breathing exercises
• Yoga or tai chi practices adapted for spinal conditions

Support Networks

Connecting with others who understand the challenges of living with spondylosis can provide valuable emotional support and practical advice. Options include:

• Local support groups
• Online forums and communities
• Professional counseling or therapy

Adaptive Tools and Techniques

Various assistive devices and modifications can help maintain independence and reduce strain on the spine:

• Ergonomic tools for daily tasks
• Supportive pillows and mattresses
• Home modifications to improve accessibility

By incorporating these strategies and maintaining open communication with healthcare providers, individuals with spondylosis can often achieve a balance between managing their condition and enjoying a fulfilling life.

Causes, risk factors, and symptoms

Spondylosis is a type of arthritis that happens when discs and joints degenerate, when bone spurs grow on the vertebrae, or both. These changes can impair the spine’s movement and affect the nerves and other functions.

Cervical spondylosis is the most common type of progressive disorder that affects the neck during aging.

According to the American Academy of Orthopaedic Surgeons, more than 85 percent of people older than 60 have cervical spondylosis.

Other types of spondylosis develop in different parts of the spine:

• Thoracic spondylosis affects the middle of the spine.
• Lumbar spondylosis affects the lower back.
• Multilevel spondylosis affects more than one part of the spine.

The effects of spondylosis vary among individuals, but they do not usually cause serious problems.

When a person has symptoms, these are often pain and stiffness that tend to come and go.

Spinal osteoarthritis is another term for spondylosis. Osteoarthritis describes arthritis that results from wear and tear. It can affect any joint in the body.

Share on PinterestSpondylosis happens when the discs and joints of the spine degenerate with age.

The spine helps give the body structure and supports most of its weight. It also carries and protects almost all of the main nerve branches that run from the brain.

The spine curved, not straight, and the cervical, thoracic, and lumbar parts of the spine contain 24 bones known as vertebrae.

Between these vertebrae are joints that allow the spine to move flexibly. These are called the facet joints.

Also, soft, rubbery tissue called intervertebral discs separate the vertebrae. These consist of cartilage endplates and a tough exterior, the annulus fibrosus, surrounding an inner core, the nucleus pulposus.

Intervertebral discs help achieve smooth movement, and they cushion against any impact on the bones.

As a person ages, the discs become drier, thinner, and harder, and they lose some of their cushioning ability. This is why an older person is more likely to have a compression fracture of the vertebra than a younger person.

A vertebral compression fracture results from bone collapsing in the spine. It commonly occurs with osteoporosis.

The facet joints between the vertebrae also function less well with age because of wear and tear on their cartilage surfaces.

As the cartilage erodes, the bones start to rub together, causing friction. This can result in the formation of bony growths, called bone spurs.

The loss of rubbery tissues and the development of spurs make the spine stiffer. Back movement also becomes less smooth, and friction increases.

Daily wear and tear over time is the general cause of spondylosis.

These changes affect people differently, depending on each individual’s risk factors.

Risk factors include:

• having a genetic tendency
• having obesity or being overweight
• having a sedentary lifestyle with a lack of exercise
• having injured the spine or undergone spinal surgery
• smoking
• having a job that requires repetitive or weight-bearing movements that involve the spine
• having a mental health condition, such as anxiety or depression
• having psoriatic arthritis

Share on PinterestSymptoms can include weakness and tingling in the limbs.

Most people with age-related spondylosis do not experience any symptoms. Some people have symptoms for a while, but then they go away. Sometimes, a sudden movement can trigger symptoms.

Common symptoms are stiffness and mild pain that gets worse following certain movements or long periods without moving, while sitting for a long time, for example.

More severe symptoms include:

• a grinding or popping feeling when moving the spine
• weakness in the hands or legs
• poor coordination
• muscle spasms and pain
• headaches
• loss of balance and difficulty walking
• loss of bladder or bowel control

Some initial changes or symptoms help doctors determine what type of spondylosis a person has. In other people, these same issues can develop as complications, according to research published in the BMJ in 2007.

Below, find examples of these kinds of changes:

Spinal stenosis: This is a narrowing of the canal that carries the spinal cord nerves. Symptoms include pain in the neck or back that may extend down the leg, problems with the feet, and numbness or weakness.

Cervical radiculopathy: Changes in a disc or the bone can cause nerves in the spine to become pinched, leading to shooting pain, numbness, and hypersensitivity.

Cervical spondylotic myelopathy: This involves the spinal cord becoming compressed, or squeezed. Symptoms include pain and numbness in the limbs, a loss of coordination in the hands, imbalance and difficulty walking, and in the later stages, bladder problems.

Scoliosis: Research suggests that there may be a link between degeneration of the facet joints and scoliosis in adults.

These changes can make other symptoms worse. The location of symptoms such as pain will depend on the part of the spine that spondylosis affects.

Most cases of spondylosis produce only mild, occasional stiffness and pain, and they do not need treatment.

Home remedies

If a person experiences pain, they can try the following:

• Over-the-counter pain relief medication: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may help.
• Keeping physically active: Low-impact exercise, such as swimming or walking, can help with maintaining flexibility and strengthening the muscles that support the spine.
• Improving posture: Slouching, for example, can make the pain worse.
• Physical therapy: A physical therapist may suggest specific exercises or massage.
• Back support: A person may need to choose a chair or mattress that supports their back better.
• Rest during periods of inflammation: When symptoms are troublesome, try resting for a while.

Alternative treatments

Share on PinterestReceiving a massage from a trained provider may help relieve discomfort.

Some people use the following to manage symptoms:

• acupuncture
• chiropractic treatment
• massage
• ultrasound treatment
• electrical stimulation

Research indicates that some of these may provide relief for nerve pain or damage that stems from the neck.

Medications

If pain is severe or persistent, a doctor may suggest:

• prescription pain relief medication
• muscle-relaxants, to reduce spasms
• drugs that ease nerve pain
• topical creams
• steroid medications, either in pills or as injections, when pain is severe
• an injection that combines steroid and anesthetic medication

A steroid injection aims to relieve pain by reducing inflammation. Using X-ray guidance, the doctor will inject the steroid into the roots of the affected nerves.

However, steroids can also have adverse effects, so a doctor will usually try to limit their use.

It is essential to follow the doctor’s advice when using medications.

A doctor will only suggest surgery if symptoms are severe and persistent and if no other treatment has helped.

A person might need surgery if pinched nerves result in serious numbness, weakness, or loss of bowel or bladder control, and if the damage is likely to get worse without surgery.

The type of surgery will depend on the problem and its location. A doctor can identify the affected areas with imaging technology, such as X-rays.

Surgery might involve removing a disc or piece of bone that is pressing against the nerves, then fusing nearby vertebrae. Or, a surgeon may replace a damaged disc with an artificial one.

In the past, spinal surgery was a major procedure. Now, endoscopic — or keyhole — surgery may be an option. This is far less invasive than open surgery.

According to the American Association of Neurological Surgeons, minimally invasive spinal surgery involves fewer risks, because:

• The incision is smaller.
• There is less blood loss during surgery.
• There is less chance of muscle damage.
• Recovery is faster.
• A doctor can use a local anesthetic.

Also, there is a reduced risk of pain and infection after surgery and less need for medication.

Minimally invasive spinal surgery is often an outpatient procedure, which means that many people return home the same day.

However, most people with spondylosis do not need surgery. A doctor will discuss the risks of spinal surgery, compared with the potential benefits.

Spondylosis is a common problem that affects the spine, and most people are likely to develop some degree of spondylosis as they get older. Many will not experience symptoms, or symptoms will be mild.

However, if pain is severe and numbness and weakness affect a person’s quality of life, a doctor may recommend surgery.

Lumbar and Cervical Spondylosis: Symptoms & Treatments

Spondylosis is a nearly universal condition in those who reach advanced age, but it can also affect younger people. While some people experience no symptoms, others may feel stiffness and/or pain in the neck, shoulders or between the shoulder blades.

• What is spondylosis?
• What are the symptoms?




• Are some people more susceptible?
• How is it diagnosed?
• What type of doctor treats it?
• How is it treated?
• What is the surgery for it?

What is spondylosis?

Spondylosis is another word for osteoarthritis of the spine, a condition that usually develops with age, and is the result of normal “wear and tear” on both the soft structures and bones that make up the spine.

Although any part of the spine may be affected, spondylosis is more frequently seen in the spine’s highest and lowest sections – the cervical (neck) and lumbar (low back) areas, respectively. The condition is less commonly found in the thoracic spine (middle portion), possibly because the rib cage serves to stabilize this area and make it less subject to the effects of wear and tear over time.

Illustration of cross-section of spine, dorsal (back to front) and lateral (side) views, showing its vertebral sections.

What are the symptoms of spondylosis?

People with spondylosis experience may or may not experience pain or, indeed, any symptoms at all. Those who have no symptoms may become aware of the condition only when they are being assessed for another medical issue that calls for imaging of the spine with an X-ray, MRI, or CT scan. When symptoms are present, they vary depending on the area where the condition develops and the structures that are affected, but they can include pain or limited range of motion.

Individuals with spondylosis who are otherwise without pain may experience crepitus, a feeling or sound of crunching in the spine, along with a limited range of motion. This usually is not concerning for nerve or spinal cord damage.

What are the symptoms of cervical spondylosis?

Neck pain and/or stiffness are common symptoms. In cases where spondylotic changes to the spine put pressure on adjacent nerves, patients may experience pain, numbness or tingling that extends down the arm, with or without symptoms in the neck itself. This type of nerve pain, which results from compression or inflammation of the nerve the cervical spine is known as cervical radiculopathy. Severe cases may also cause compression the spinal cord which may manifest as weakness or impaired motor function in the arms or hands, or other symptoms in a condition called cervical myelopathy.

What are the symptoms of lumbar spondylosis?

Low back pain, leg pain and/or other signs of nerve compression are the most common symptoms. Pain or tingling symptoms that extend outward to the hip or down the leg can result from compression or inflammation of nerves, a condition referred to as lumbar radiculopathy. For example, a person may have pain in their knee and think it is injured, but later learn that this pain is caused by spondylosis that is compressing a nerve which extends down to the knee. Irritation of the sciatic nerve in particular, is quite common, and is commonly known as sciatica.

Is spondylosis serious?

Because spondylosis can affect people in many different ways, there is no single answer to this question. Many cases of spondylosis are effectively treated with physical therapy and pain relief measures. However, orthopedists advise seeking more immediate care if the following symptoms, which are associated with pressure on the nerves, are present:

• weakness, including foot drop (difficulty lifting the toes and forefoot off the floor)
• bladder or bowel dysfunction, especially incontinence
• changes in balance that cannot be attributed to other factors
• numbness either in a stripe-like pattern or involving the fingers
• severe pain, especially electrical or shock like pain
• pain in the arms and/or legs that has not responded after attempting other nonsurgical measures like physical therapy, oral pain medications and/or injections

Are some people more likely to develop spondylosis than others?

Spondylosis is likely to affect most people to some degree as they age, as it is the natural result of years of the spine being subject to the forces of gravity. There may be a genetic component (an inherited tendency) to develop the condition, but research has not clearly established this link.

An association between traumatic injury to the spine and the development of spondylosis later in life has been established.

How is spondylosis different from spondylolisthesis?

Although the names sound similar, spondylolisthesis is a condition in which one of the vertebrae (the bones that make up the spine) has moved out of place – usually in a forward direction. While this is a distinct diagnosis, spondylolisthesis may occur as a result of spondylosis, which can cause other structures of the spine move out of their normal position.

Other conditions that may result from spondylosis include:

• spinal stenosis – a narrowing of the spinal canal
• degenerative scoliosis – a sideways curvature of the spine due to osteoarthritis
• degenerative disc disease – wear and tear of the disc space

How is spondylosis diagnosed?

A diagnosis of spondylosis is based primarily on information seen on images of the spine: Changes to the bones are most clearly seen on X-ray, while changes to the soft structures – including the disks that act as cushions between the vertebrae – are more clearly seen on MRI or CT scans.

Abnormalities that may be detected include bone spurs, which are small growths of extra bone, or bulging or herniated discs. Both of these findings can cause narrowing in the spinal canal and put pressure on adjacent nerves. It’s important to note that wear and tear on the spine may show up on imaging tests, without the individual experiencing any pain or discomfort.

To better understand the impact spondylosis may be having on a patient, the orthopedist may order X-rays to look at the skeleton in motion, for example when the spine and neck bend backward or forward.

What type of doctor treats spondylosis?

People should first consult their primary care physician for back and neck pain. For persistent pain or symptoms associated with pressure on the nerves, such as weakness, are best assessed by a physician who specializes in musculoskeletal medicine, such as a physiatrist (a doctor who practices physical and rehabilitative medicine), a pain management doctor or a spine surgeon.

Once a diagnosis has been made, the type of physician who may best treat a patient’s symptoms depends on individual case. For many people, a physiatrist and physical therapist can treat people nonsurgically. In cases where spondylosis-related anatomic changes require removal or release of tissue, a spine surgeon will become involved. In some cases, a physiatrist or spine surgeon may also refer the patient to see a neurologist for additional care. (Find a doctor at HSS who treats spondylosis.)

How is spondylosis treated?

Treatment for spondylosis depends on the specific set of symptoms and findings that a patient is found to have and the area of the spine that is affected. Initial measures almost always include physical therapy to strengthen the muscles that support the spine and, in some cases, epidural injections to reduce inflammation and pain. Short courses of oral pain medication, like anti-inflammatories, may also be prescribed.

Although non-operative treatment won’t change the structural effects of spondylosis – the wear and tear on tissues and the pressure on the nerves – it can provide relief while the nerve adapts to these changes in the spine anatomy. In many cases, this allows the symptoms to decrease without surgery.

What is the surgery for spondylosis?

If a person continues to have pain and debility from spondylosis after conservative measures are tried, surgical treatment may be recommended. The specific procedure needed depends on the abnormalities present in the spine, but it will generally involve addressing the area of the spine that is pressing on a nerve.

Some examples of minimally invasive surgical treatment for spondylosis include:

• removal of a bone spur in cervical spondylosis
• placement of spacers to recreate space lost by disc wear, allowing nerves to be free of compression
• removal of soft tissues that can become thickened in spondylosis that press on nerves

In some cases, a patient with spondylosis will require more extensive surgery to remove more a portion of the spine that is causing pain, and a fusion of the vertebrae, a surgery that stabilizes the bone.  Anterior cervical discectomy with fusion (ACDF surgery) is one such procedure in the neck. For low back pain or other problems associated with lumbar spondylosis, a lumbar laminectomy, with or without fusion, or various other types of lumbar fusion surgery may be appropriate.

What is the recovery time for spondylosis surgery?

Recovery time varies depending on the nature of the surgery, with minimally invasive procedures permitting a more rapid return to daily activities. Many patients will complete a course of physical therapy beginning at six weeks after their operation. Keeping the supporting muscles flexible and strong and maintaining a healthy weight are the best way to prevent further problems in the spine.

Patients are also advised to assess and adjust ergonomic conditions that may have exacerbated their pain, for example raising a computer monitor to eye level to eliminate the tendency to hunch forward while doing office work.

Are there any dietary supplements that can help treat or prevent spondylosis?

There is no evidence at this time that any particular diet or supplement will help with spondylosis. It’s always a good idea to follow a healthy diet and to use supplements with caution, as these products are not regulated by the US Food and Drug Administration (FDA).

Updated: 4/17/2023

Authors

Sariah Khormaee, MD, PhD

Assistant Attending Orthopedic Surgeon, Hospital for Special Surgery
Assistant Professor of Orthopedic Surgery, Weill Cornell Medical College

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Spondylosis Success Stories

symptoms, causes, diagnosis, prevention and treatment

Spondylosis is a chronic disease that, without timely treatment, can lead to limited mobility and dysfunction of internal organs. At an early stage, it is usually asymptomatic, so a person does not go to the doctor for a long time. The sooner the treatment of pathology is started, the easier it will be to slow down its development and avoid complications.

Contents

• What is spondylosis
• Causes of the disease
• Symptoms of the disease
• Classification of spondylosis
• Grades of spondylosis
• Diagnosis of spondylosis
• Treatment of spondylosis

900 22 What is spondylosis

Spondylosis is a degenerative chronic disease of the spine resulting from aging, overuse and injury spinal column. In this case, the vertebrae are fixed and compacted, which is due to degenerative-dystrophic disorders in them and in the intervertebral discs.

With deforming spondylosis of the lumbar or other part of the spine, the bone tissue grows and osteophytes are formed. Over time, this can lead to fusion of the vertebrae with a significant limitation of spinal mobility and disability of the patient.

Early symptoms of spondylosis may appear at a young age – from twenty to thirty years. As a rule, in this period, the clinical manifestations of the disease are not too pronounced and do not interfere with normal life. The statistics are such that by the age of fifty, both sexes equally turn to doctors about the progression of spondylosis.

Causes of the development of the disease

Spinal spondylosis develops for various reasons. Most often provoking factors are:

• traumatic injuries of the spine;
• diseases accompanied by spinal deformity;
• osteochondrosis;
• sedentary lifestyle;
• prolonged hypothermia of the body, in which the blood supply to the spinal column is disturbed;
• heavy loads on the spine by profession;
• bone changes due to aging;
• metabolic disorder.

Regardless of what factor provoked spondylosis, you need to see a doctor. He will conduct a detailed diagnosis and prescribe treatment.

If you ignore the problem, then the pathology will progress, which over time will lead to the development of complications that limit the mobility of a person.

Symptoms of the disease

The clinical picture of spondylosis depends on its type. At the initial stage of the development of pathology, its signs are almost invisible and can mimic the symptoms of other diseases. Gradually manifestations become significant and begin to influence a person’s life.

The main symptom of spondylosis is pain in the spine. Depending on the nature of the pathology and the degree of pinching of the nerve roots, they can be expressed in different ways. Other signs of the disease are:

• inability to fully move due to back pain;
• reduced cushioning when walking;
• crunch in the back, neck;
• severe headaches;
• severe dizziness;
• decreased visual acuity;
• paresthesia of limbs;
• tinnitus;
• violation of posture, curvature of the spinal column;
• deterioration in performance.

In the absence of correct and timely treatment, the spinal column becomes completely ossified, which leads to the loss of the ability to move normally. A person cannot fully work and gets a disability.

Classification of spondylosis

There are several types of the disease. Classification is carried out according to the localization of violations.

Thoracic spondylosis

Pathology usually occurs due to injuries of the spine, insufficient calcium content in the body, congenital anomalies and age-related changes in the spinal column. It often provokes the development of cardiopathy, accompanied by severe pain in the region of the heart, respiratory disorders, muscle spasms and numbness of the extremities.

In the early stages, such spondylosis resolves without an obvious clinical picture. Usually the patient does not go to the doctor for a long time, as nothing bothers him. As the disease progresses, pain appears, and the range of motion in the thoracic segment of the spine also decreases.

Spondylosis of the sacral spine

This pathology is the most common among similar degenerative-dystrophic diseases. She is characterized by pain in the lumbar region (lumbar ischalgia), numbness in various parts of the legs.

A characteristic sign of spondylosis of the lumbosacral region is a decrease in pain in the “embryo” position, as well as when bending forward. The patient is also troubled by the following symptoms:

• feeling of stiffness in the lower extremities and lower back in the morning;
• Lameness that gradually becomes permanent.

The sacrum is involved in the process already in advanced cases. In the later stages, the patient complains of constant “dull” pain in the lumbar region.

Cervical spondylosis

Pathology is quite common. In this case, degeneration of the cervical vertebrae and the formation of osteophytes occur. As a result, radiculopathy develops with its further consequences.

A sign of cervical spondylosis is spastic paresis in the extremities due to compression of the vertebrae. If violations are preceded by trauma, then the spinal cord is often affected. Due to paresis of the limbs, tissue atrophy occurs, which leads to their thinning and disability of the patient.

Lumbar spondylosis

In most cases, the pathology is due to the aging of the body, but sometimes it occurs in young people due to gross violations of posture. It may be asymptomatic and discovered incidentally on X-ray, MRI, or CT. Some patients experience pain, limited movement.

Degrees of spondylosis

The disease proceeds in a chronic form. In this case, the vertebrae are gradually deformed, changing their boundaries, narrowing the spinal canal. Bone tissue grows, osteophytes are formed. In a small number of patients, the vertebrae fuse, which adversely affects the nerves, organs, muscle tissue and blood vessels.

Pathology goes through three stages of development:

• First stage. There are no symptoms of the disease. On the vertebrae there are small processes.
• Second stage. Osteophytes proliferate. With strong physical exertion and hypothermia, aching pains occur. There is stiffness of movement.
• Third stage. The vertebrae are fused, which leads to limited mobility of the spine. Severe pain occurs, muscle tone increases.

Diagnosis of spondylosis

Before prescribing treatment to a patient, the doctor recommends additional examinations. This is necessary to determine whether we are really talking about spondylosis, as well as to identify the severity of the disease. There are the following diagnostic methods:

1. X-ray of the spine. Allows you to detect osteophytes and thickening of the joints.
2. ct. It is carried out to establish the narrowing of the spinal canal, as well as to determine the height of the intervertebral fissures.
3. MRI. It is considered the most informative method of examination of the spine. Allows you to establish the causes of the pathology, as well as determine whether the nerves were pinched, the vertebrae were compressed, etc.

Comprehensive diagnostics helps to make a correct diagnosis, determine the stage of development of the pathology, as well as identify complications.

Treatment of spondylosis

Unfortunately, there are no ways to help completely cope with the pathology. Therefore, therapy is aimed at mitigating the signs of the disease and preventing complications.

The doctor chooses the treatment, depending on the severity, the characteristics of the course of the pathology, and only after examinations.

Medicines are used to treat the main symptoms of the disease.

The specialist may prescribe the following drugs:

• non-narcotic analgesics for pain control;
• NSAIDs that eliminate inflammation and swelling of tissues, reduce pain and improve mobility of the articular-motor apparatus;
• chondroprotectors for the prevention of cartilage destruction;
• muscle relaxants that eliminate muscle spasm and reduce pain caused by pinched nerve roots;
• narcotic analgesics – in extreme cases, when non-narcotic drugs do not stop severe pain in the spine.

If the inflammatory process is very pronounced, then NSAIDs are used, as well as physiotherapy (ultrasound, electrophoresis with an analgesic, dynamic currents). The doctor may prescribe analgesics for intramuscular injection, as well as paravertebral blocks.

These treatments relieve the signs of spondylosis, but do not stop its development. The main ways to slow down the progression of the disease are physiotherapy exercises (exercise therapy) and massage.

Exercises are performed only after the pain syndrome has been eliminated. Regular exercise stimulates the blood supply to the muscles and the spinal column, and also helps to reduce the load on the spine by forming a muscular corset. Exercise therapy contributes to the development of motor stereotypes that help prevent overload of the affected part of the spine.

Massage helps to increase blood flow to certain areas, as well as reduce muscle tension and improve mobility. With spondylosis, intensive massage is not carried out, as well as spinal traction and manual therapy.

In the treatment of pathology, physiotherapy is used to relieve pain, relieve swelling of soft tissues, and normalize local blood supply.

For the treatment of spondylosis of the lumbar spine, or another part of it, the doctor may prescribe acupuncture. It helps to reduce pain and improve the passage of impulses along the nerve fibers.

If conservative treatments fail, surgery is usually performed. Other indications for surgery:

• severe spinal stenosis;
• severe nerve root compression;
• large intervertebral hernia;
• significant malfunction of internal organs due to spondylosis;
• violations of control over the function of the pelvic organs;
• paresis of the limbs.

In these cases, based on the cause of spondylosis, the following surgical interventions can be performed: laminectomy, arthroplasty, microdiscectomy, autotransplantation.

Spondylosis is a chronic disease that cannot be completely eliminated. But you can slow down its progression and prevent negative consequences. To do this, you need to follow the recommendations of the doctor and undergo repeated examinations on time.

Do not self-medicate if you are experiencing back pain, mobility problems, numbness or other symptoms. Contact the rehabilitation clinic in Khamovniki to undergo the necessary examinations and receive medical recommendations.

symptoms, degrees, correction and treatment of kyphosis – Clinic of NCC No. 2 (CCH RAS) in Moscow

Kyphosis is a disordered position of the spine with a bend to the back. The two main natural curves are in the thoracic and sacral regions. In contrast to these bends, there are two others – in the neck and lower back. This provides the cushioning necessary for the full movement of a person. Prolonged loads, injuries, forced postures, diseases – all this can cause deformation of the spine with a change in the natural shape of the bends. Increasing the curve towards the back is called kyphosis. The most common is thoracic kyphosis.

Causes of development

In children and adolescents, kyphosis of the spine can develop due to poor posture, congenital anomalies, Scheuermann-Mau disease. In adults, the causes of curvature are:

• Spinal infections affecting the joints (eg tuberculosis).
• Ankylosing spondylitis.
• Osteoporosis.
• Degenerative arthritis.
• Marfan syndrome.
• Birth defects.
• Poliomyelitis, paralytic changes.
• Tumors.
• Back injuries.
• Transferred operations.

The cause of functional kyphosis is incorrect posture (may be due to improper organization of the workplace, psychological problems, muscle weakness). This type is treated quickly and simply by eliminating the cause and conducting exercise therapy classes.

Symptoms

The underlying factor is the degree of curvature.

• Kyphosis 1 degree is manifested by fatigue and mild muscle pain, mainly at the end of the day. You can also observe a violation of posture, stoop.
• Kyphosis of the 2nd degree, when kyphosis is aggravated and supplemented by compensatory lordosis, pain and stoop increase, head and shoulders go down.
• Kyphosis of the 3rd degree is accompanied by limited mobility of the spine, there are disturbances in the work of internal organs as a result of squeezing them with a deformed chest.

Types of kyphosis

All cases of kyphosis are divided into the following types:

• Congenital, when the developmental anomaly of the vertebrae was initially laid.
• Physiological – correct curvature of the spine.
• Mobile – curvature in the area of ​​the thoracic region caused by muscle weakness.
• Tuberculous.
• Scheuermann’s kyphosis is a deforming osteopathy that occurs in adolescents.
• Rachitic – occurs in babies due to the weakness of all elements of the system.
• Compression – a consequence of a compression fracture that reduces the height of the vertebrae.
• Total – arcuate curvature along the entire spine.
• Cervical kyphosis is a rather rare but still occurring condition.
• Reinforced – the occurrence of an angle of inclination of the spine of more than 30 degrees.
• Smoothed – the effect of a flat back, when there is no natural curve of the spine.

What is the danger of the disease

Any curvature of the spine, if left untreated, will lead to disruption of the internal organs and, as a result, all body systems. It’s also an aesthetic issue. Over time, without treatment, the curvature becomes irreversible and can only worsen over the years. As a result, the patient risks getting problems in the work of the gastrointestinal tract, heart, genitourinary system, musculoskeletal system, etc. Common complications of kyphosis are osteochondrosis, intervertebral hernia.

Diagnosis

It all starts with a questioning of the patient, the formation of an anamnesis, the identification of factors that gave impetus to the development of the disease. Also, the specialist examines the patient, previously determining the degree of violation. Such an examination is supplemented by an x-ray examination to determine the degree of curvature and the detection of other concomitant factors. Also, for these purposes, MRI of the spine and ultrasound of the intervertebral discs, as well as angiography, are prescribed, if there are indications for this.

Treatment

Used conservative and surgical treatment. The operation is used quite rarely, only in particularly difficult cases and when therapy does not give the desired result. Conservative treatments for kyphosis include:

• Medications – anti-inflammatory, pain-relieving medications when needed.
• Performing special exercises aimed at strengthening the muscular corset, relaxation, correcting the shape and setting the spine in the desired position.
• Physiological kyphosis does not require treatment.
• Pathological kyphosis is effectively eliminated by exercise therapy.