What is spondylosis?

What is spondylosis?

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Spondylosis, also known as spinal osteoarthritis, is a degenerative condition that affects the spine. It involves changes in the structures of the spine over time, particularly the intervertebral  discs and facet joints. This condition is common in older adults. Aging is strongly associated with spondylosis, it must be emphasized that aging in itself does not cause spondylosis, nor should spondylosis be considered synonymous with the “normal” aging process.

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As people age, the intervertebral discs (which act as cushions between the spinal bones) lose water content and become thinner, reducing their ability to absorb shock. The facet joints, which connect the vertebrae and allow for movement, can also undergo wear and tear, leading to the development of bony outgrowths called bone spurs or osteophytes.

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Spondylosis can occur in any part of the spine, but it most commonly affects the cervical (neck) and lumbar (lower back) regions. The severity of spondylosis can vary from mild to severe, and not everyone with spondylosis experiences symptoms.

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Symptoms of spondylosis

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Symptoms may include:

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1. Pain: Typically, spondylosis causes localized pain in the affected area of the spine and may result from the stresses of excessive mobility or from stretch to hypomobile (tight) structures. In the cervical region, it can lead to neck pain, while in the lumbar region, it can cause lower back pain. In some patients, movement relieves the symptoms; in others, movement irritates the joints, and painful symptoms increase.
2. Stiffness: People with spondylosis may experience joint stiffness in the affected area following periods of rest, which can limit their range of motion.
3. Radiating pain: In some cases, spondylosis can result in the compression of nearby nerve roots or the spinal cord due to encroachment of osteophytes (bone spurs) on the spinal canal and intervertebral foramina, leading to radiating pain, tingling, or numbness in the arms or legs (depending on the location of the affected discs or joints) especially with spinal extension and side bending.
4. Muscle weakness: Compression of nerve roots may also lead to muscle weakness in the arms or legs.
5. Loss of bladder or bowel control (rare): In severe cases, compression of the spinal cord can cause loss of bladder or bowel control, which requires immediate medical attention.

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Diagnosis of spondylosis is usually made based on a combination of clinical examination, medical history, and imaging studies such as X-rays, MRI (Magnetic Resonance Imaging), or CT (Computed Tomography) scans. Treatment for spondylosis focuses on managing symptoms and may include:

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- Pain medications and anti-inflammatory drugs to alleviate pain and inflammation.

- Physical therapy to improve flexibility, strengthen supporting muscles, and maintain mobility.

- Heat or cold therapy to relieve muscle spasms and reduce pain.

- Lifestyle modifications, such as maintaining a healthy weight, regular exercise, and good posture to minimize stress on the spine.

- In some cases, corticosteroid injections may be used for temporary relief of severe pain and inflammation.

- Surgical intervention may be considered in severe cases where nerve compression is causing significant neurological problems.

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As with any medical condition, it is essential to seek advice from a healthcare professional for an accurate diagnosis and appropriate management of spondylosis.

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What causes spondylosis?

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Spondylosis is primarily caused by the natural wear and tear that occurs in the spine as part of the aging process. Several factors contribute to the development of spondylosis:

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1. Degeneration of intervertebral discs: The intervertebral discs act as shock absorbers between the vertebrae in the spine. Over time, these discs lose water content and become thinner, leading to reduced cushioning and flexibility. This degeneration can result in increased pressure on the facet joints and lead to the development of bone spurs.
2. Formation of bone spurs (osteophytes): As the intervertebral discs degenerate, the body may respond by forming new bone in the affected area, resulting in the development of bone spurs. These bony outgrowths can encroach on the space around nerves or the spinal cord, causing pain and nerve compression.
3. Changes in facet joints: The facet joints are the small, paired joints that connect the vertebrae and allow for movement in the spine. Over time, these joints can undergo wear and tear, leading to inflammation, pain, and stiffness. The degenerating joint is vulnerable to facet impingement, and sprains, as is any arthritic joint.
4. Repetitive stress and injuries: Activities that place repeated stress on the spine, such as heavy lifting, bending, or twisting, can accelerate the degeneration of spinal structures and increase the risk of developing spondylosis. Additionally, previous injuries to the spine, such as fractures or dislocations, can contribute to the development of the condition.
5. Genetic factors: There may be a genetic predisposition to spondylosis, as some individuals may have a higher likelihood of developing degenerative changes in their spine due to inherited traits.
6. Lifestyle factors: Certain lifestyle factors, such as sedentary habits, obesity, and smoking, can increase the risk of developing spondylosis or exacerbate existing symptoms.

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It's important to note that while spondylosis is a common part of the aging process, not everyone will experience symptoms or significant discomfort. Some individuals may have degenerative changes in their spine but remain asymptomatic.

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Although spondylosis is not preventable due to its association with aging, there are ways to manage its symptoms and slow its progression. Maintaining a healthy lifestyle, engaging in regular exercise, practicing good posture, avoiding excessive strain on the spine, and seeking appropriate medical care when needed can help improve the quality of life for individuals affected by spondylosis. If you experience persistent back or neck pain or other concerning symptoms, it is essential to seek evaluation and guidance from a healthcare professional.

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How can physical therapy help?

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Physical therapy can play a crucial role in managing spondylosis by helping to relieve pain, improve flexibility, strengthen supporting muscles, and enhance overall spinal function. A physical therapist can create a personalized treatment plan based on the individual's specific needs and the severity of their spondylosis. Here are some ways physical therapy can help with spondylosis:

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1. Pain relief: Physical therapists use various techniques and modalities, such as manual therapy, heat or cold therapy, ultrasound and electrical stimulation, to reduce pain and inflammation in the affected area.
2. Stretching exercises: Decreased flexibility in joints, muscles, and fascia may restrict the patient’s ability to resume normal spinal alignment. Manual techniques and safe self-stretching techniques are used to increase muscle, joint, and connective tissue mobility. 
3. Stability and Strengthening exercises: Stabilization exercises are used to emphasize movement and resistance to the extremities while maintaining control of the spinal position. Increasing the time and number of repetitions builds muscle endurance at each level of performance. When the patient learns effective spinal control with the stabilizing muscles in a variety of stabilization exercise routines, dynamic trunk and neck strengthening exercises, such as curl-ups and cervical motions are introduced to improve spinal muscle strength and performance. Care is taken to monitor symptoms and modify any activities that exacerbate the problems.
4. Posture/Kinesthetic Training:  One of the fundamental interventions for spinal rehabilitation is to develop patient awareness of safe spinal positions and spinal movement as well as the effects of different positions (e.g. lying, sitting, standing) have on the spine. Awareness of what posture makes the symptoms better or worse and identifying the neutral spine positioning or position of bias are important in helping patients manage their symptoms. Improving posture is essential for individuals with spondylosis. 
5. Joint mobilization: Physical therapists may use hands-on techniques to mobilize and improve the movement of affected spinal joints, reducing stiffness and promoting better range of motion.
6. Aerobic Conditioning: Aerobic conditioning exercises provide many benefits for the patients with spinal symptoms. The activity not only improves cardiopulmonary endurance but stimulates feelings of well-being and relief of symptoms. These exercises are initiated as soon as the patient tolerates repetitive activity without exacerbating symptoms.
7. Postural Stress Management and Relaxation Exercises: It is common that a patient’s symptoms are exacerbated with sustained postural stresses such as sitting at a computer, talking on a phone (head tilted), or repetitive forward bending. The physical therapists provide methods to correct the sustained or repetitive postural stresses. In addition, frequent changes of position and movement through the pain-free range of motions are encouraged. They will also teach how to consciously relax tension in muscles to relieve stress.
8. Environmental Adaptations: Ergonomic assessment and modification of home and working environments are necessary to correct stresses as well as prevent future recurrence of symptoms.
9. Education: Patient education is the key component to every goal and intervention. A physical therapist can educate the individual about spondylosis, its causes and symptoms as well as the role and importance of the rehabilitation program in managing their condition. They also teach patients about safe body mechanics, ways to manage symptoms, prevent exacerbation, and modify activities to protect the spine.
10. Aquatic therapy: Water-based exercises in a controlled environment can reduce the impact on the spine while still providing the benefits of exercise. Aquatic therapy can be particularly beneficial for individuals with severe spondylosis or those with limited weight-bearing abilities.
11. Traction: In some cases, spinal traction may be used to decompress the affected spinal segments, reducing pressure on nerves and providing pain relief. Traction has the mechanical benefit of temporarily separating the vertebrae, causing mechanical sliding of the facet joints in the spine, and increasing the size of the intervertebral foramina.
12. Functional Training: Once the patient has learned spinal control and stabilization and has developed adequate flexibility and strength for specific tasks, components of the task are incorporated into the exercise program and then into the patient’s daily lifestyle. Safe body mechanics are included in all aspects of care.
13. Home exercise program: A physical therapist can design a home exercise program tailored to the individual's needs, and teach how to safely and effectively incorporate it into their daily routine to reinforce the interventions and promote optimal recovery. 
14. Lifestyle modifications: Physical therapists can provide guidance on lifestyle changes, such as weight management, smoking cessation, and appropriate exercise routines, to support the management of spondylosis.
15. Prevention strategies: Education occurs on a continual basis. Physical therapists provide prevention strategies for each patients which includes: 

• When experiencing pain or recurrence of symptoms, check posture. Avoid any one posture for prolonged periods.
• If sustained posture is necessary, take frequent breaks and perform an appropriate range of motion exercises at least every half hour.
• Avoid hyperextending the neck or being in a forward-head posture or forward-bent position for prolonged periods.
• If in a tension-producing situation, perform conscious relaxation exercises.

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It's essential to start physical therapy early in the course of spondylosis to maximize its benefits and prevent further deterioration. Physical therapy can be a valuable non-invasive approach to managing spondylosis, and it can be used in conjunction with other treatments, such as medication and lifestyle modifications, to improve the overall well-being and function of individuals with spondylosis. As with any medical condition, it is essential to work with a qualified physical therapist who can tailor the treatment plan to the individual's specific needs and monitor progress effectively.

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Trust PeteHealth for treating spondylosis 

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