What are the primary causes of spondylosis. How do risk factors contribute to its development. What symptoms should individuals be aware of when dealing with mild to moderate spondylosis. How does spondylosis affect different parts of the spine.

The Fundamentals of Spondylosis: A Comprehensive Overview

Spondylosis is a degenerative condition affecting the spine, characterized by the wear and tear of discs and joints, as well as the growth of bone spurs on vertebrae. This progressive disorder can impact spinal mobility and potentially affect nerve function. While spondylosis can occur in various regions of the spine, cervical spondylosis, which affects the neck, is the most prevalent form, particularly among older adults.

According to statistics from the American Academy of Orthopaedic Surgeons, over 85% of individuals above the age of 60 experience cervical spondylosis. This high prevalence underscores the importance of understanding the condition, its causes, and its potential impact on quality of life.

Types of Spondylosis

• Cervical spondylosis: Affects the neck region
• Thoracic spondylosis: Impacts the middle section of the spine
• Lumbar spondylosis: Occurs in the lower back
• Multilevel spondylosis: Involves multiple areas of the spine

Is spondylosis always a cause for serious concern. While the effects of spondylosis can vary among individuals, it typically does not lead to severe complications. Many people experience intermittent pain and stiffness, but these symptoms often come and go without causing significant disruption to daily life.

The Anatomy of the Spine and Its Role in Spondylosis

To fully grasp the impact of spondylosis, it’s crucial to understand the structure and function of the spine. The spine plays a vital role in providing structural support to the body, bearing most of its weight, and protecting the main nerve branches that extend from the brain.

Key Components of the Spine

• Vertebrae: 24 bones that make up the cervical, thoracic, and lumbar regions of the spine
• Facet joints: Allow for flexible movement between vertebrae
• Intervertebral discs: Provide cushioning and facilitate smooth movement

How do intervertebral discs change with age. As individuals grow older, these discs tend to become drier, thinner, and harder, reducing their ability to cushion impact. This natural aging process contributes to the development of spondylosis and increases the risk of vertebral compression fractures, especially in those with osteoporosis.

The Pathophysiology of Spondylosis: Understanding the Degenerative Process

Spondylosis is primarily a result of the natural aging process and the cumulative effects of daily wear and tear on the spine. As the body ages, several changes occur within the spinal structure:

1. Disc degeneration: Intervertebral discs lose moisture and elasticity, becoming thinner and less effective at cushioning.
2. Cartilage erosion: The protective cartilage on facet joints wears down, leading to increased friction between bones.
3. Bone spur formation: As bones rub together, the body may form bony growths called osteophytes or bone spurs.
4. Reduced flexibility: The combination of disc degeneration and bone spur formation results in a stiffer spine with less smooth movement.

Does the degenerative process affect everyone equally. The impact of these changes can vary significantly among individuals, depending on various risk factors and lifestyle choices.

Risk Factors Contributing to Spondylosis Development

While age is the primary risk factor for spondylosis, several other elements can influence its onset and progression:

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

Can lifestyle modifications help mitigate the risk of spondylosis. While some risk factors are beyond an individual’s control, adopting a healthy lifestyle that includes regular exercise, maintaining a healthy weight, and avoiding smoking can potentially slow the progression of spondylosis and alleviate symptoms.

Recognizing the Symptoms of Mild to Moderate Spondylosis

The manifestation of spondylosis symptoms can vary greatly among individuals. Many people with age-related spondylosis may not experience any noticeable symptoms. For others, symptoms may appear intermittently or be triggered by sudden movements.

Common Symptoms of Mild to Moderate Spondylosis

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

Are there any severe symptoms that require immediate medical attention. In some cases, individuals may experience more severe symptoms such as loss of bladder or bowel control. These symptoms, along with significant weakness or numbness in the limbs, warrant prompt medical evaluation as they may indicate more serious complications.

Complications and Related Conditions in Spondylosis

As spondylosis progresses, it can lead to various complications or related conditions that may exacerbate symptoms or cause additional health concerns:

Spinal Stenosis

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

• Pain in the neck or back, potentially radiating down the legs
• Foot problems
• Numbness or weakness in affected areas

Cervical Radiculopathy

Cervical radiculopathy occurs when changes in a disc or bone cause pinching of nerves in the spine. This can lead to:

• Shooting pain
• Numbness
• Hypersensitivity in affected areas

Cervical Spondylotic Myelopathy

This serious condition involves compression of the spinal cord. Symptoms may include:

• Pain and numbness in the limbs
• Loss of coordination in the hands
• Imbalance and difficulty walking
• Bladder problems in advanced stages

Scoliosis

Research suggests a potential link between degeneration of the facet joints and adult-onset scoliosis, which involves an abnormal curvature of the spine.

How can early recognition of these complications impact treatment outcomes. Identifying these complications in their early stages can lead to more effective management strategies, potentially slowing progression and improving quality of life for individuals with spondylosis.

Diagnostic Approaches for Mild to Moderate Spondylosis

Accurate diagnosis of spondylosis is crucial for developing an effective treatment plan. 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 muscle weakness or numbness
• Reflexes and sensory responses
• Gait and balance

Imaging Studies

Various imaging techniques can provide detailed information about the spine’s structure:

• X-rays: Help visualize bone spurs and narrowing disc spaces
• MRI (Magnetic Resonance Imaging): Offers detailed images of soft tissues, including discs and nerves
• CT (Computed Tomography) scans: Provide cross-sectional images of the spine

Electromyography (EMG)

This test measures electrical activity in muscles and nerves, helping to identify nerve compression or damage.

What role do patient-reported symptoms play in diagnosis. While objective tests are crucial, a patient’s description of their symptoms provides valuable context for healthcare providers, aiding in accurate diagnosis and tailored treatment planning.

Treatment Strategies for Mild to Moderate Spondylosis

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

Conservative Treatments

• Physical therapy: Exercises to improve flexibility, strength, and posture
• Pain management: Over-the-counter or prescription pain relievers and anti-inflammatory medications
• Heat and cold therapy: To alleviate pain and reduce inflammation
• Lifestyle modifications: Weight management, ergonomic adjustments, and smoking cessation

Alternative Therapies

Some individuals find relief through complementary approaches such as:

• Acupuncture
• Chiropractic care
• Massage therapy
• Yoga or tai chi

Advanced Interventions

For more severe cases or when conservative treatments prove ineffective, healthcare providers may recommend:

• Epidural steroid injections
• Nerve blocks
• Surgical interventions (in rare cases)

Can a multidisciplinary approach improve outcomes for spondylosis patients. Integrating various treatment modalities and involving healthcare professionals from different specialties often leads to more comprehensive and effective management of spondylosis, addressing both physical symptoms and overall well-being.

Living with Spondylosis: Strategies for Long-term Management

While spondylosis is a chronic condition, many individuals can maintain a good quality of life with proper management. Long-term strategies for living with spondylosis include:

Regular Exercise

Engaging in appropriate physical activity can help:

• Maintain flexibility and range of motion
• Strengthen supporting muscles
• Improve overall cardiovascular health

Ergonomic Considerations

Making adjustments to your work and living environments can reduce strain on the spine:

• Using ergonomic chairs and workstations
• Practicing proper lifting techniques
• Taking frequent breaks to change positions

Stress Management

Chronic pain can be both a cause and result of stress. Implementing stress-reduction techniques such as meditation, deep breathing exercises, or counseling can be beneficial.

Nutritional Support

A balanced diet rich in anti-inflammatory foods and essential nutrients can support overall spine health and potentially alleviate symptoms.

How does patient education impact the long-term management of spondylosis. Empowering patients with knowledge about their condition, its progression, and self-management techniques can lead to better adherence to treatment plans and improved outcomes over time.

Emerging Research and Future Directions in Spondylosis Management

The field of spondylosis research continues to evolve, with ongoing studies exploring new treatment modalities and management strategies. Some areas of current interest include:

Regenerative Medicine

Researchers are investigating the potential of stem cell therapy and platelet-rich plasma (PRP) injections to promote tissue repair and regeneration in the spine.

Advanced Imaging Techniques

Improvements in imaging technology may allow for earlier detection of spinal changes, potentially enabling more proactive interventions.

Targeted Drug Delivery Systems

Development of novel drug delivery methods could enhance the effectiveness of pain management while minimizing systemic side effects.

Minimally Invasive Surgical Techniques

Ongoing refinement of surgical approaches aims to reduce recovery time and improve outcomes for patients requiring surgical intervention.

How might advances in personalized medicine impact the treatment of spondylosis. As our understanding of genetic factors and individual variations in disease progression grows, tailored treatment approaches based on a patient’s unique profile may become more common, potentially leading to more effective and targeted interventions.

In conclusion, mild to moderate spondylosis, while a common consequence of aging, need not significantly impair quality of life. Through a combination of proper diagnosis, tailored treatment strategies, and proactive self-management, many individuals can effectively manage their symptoms and maintain an active lifestyle. As research continues to advance our understanding of this condition, we can anticipate even more effective approaches to spondylosis management in the future.

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.