What is Spondylosis?
Spondylosis is a condition caused by the wearing of the discs and bones in the spine. It may appear in the cervical, thoracic or lumber regions of the spine, and is also known as spinal osteoarthritis. It may also be associated with the development of bone spurs in the spine and compression of the spinal nerve roots.
Baptist Health is known for advanced, superior care for patients with orthopedic conditions and the diagnosis, treatment and management of spondylosis. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.
Signs and Symptoms of Spondylosis
Many people with spondylosis have no noticeable symptoms. The most common symptom of spondylosis is pain or stiffness in the neck or back that is often worse when first getting up or after periods of strenuous activity. Depending on the area affected, other symptoms may include:
- Pain that radiates into the shoulders, arms, hips or legs (depending on the part of the spine affected)
- Weakness of the arms and/or legs
- Difficulty walking or lack of coordination
- Grinding or popping sounds when twisting your spine or turning your neck
- Tingling, numbness or weakness in the extremities
- Loss of bladder or bowel control
- Difficulty swallowing
Diagnosis of Spondylosis
If spondylosis is suspected, a physical examination including questions about symptoms will be completed. Advanced diagnostic procedures and technology are utilized to effectively diagnose, determine treatment, and sometimes monitor the condition. Common diagnostic procedures can include:
Blood test: Blood tests check the levels of certain substances that can may point to rheumatoid arthritis or other conditions that could be cause spondylosis.
CT scan: X-rays and computers are used to create more detailed images of the affected area than a traditional X-ray.
Electromyography (EMG): During this test, small, thin needles are placed in the muscles of the arms and legs to record the electrical activity and indicate function. This test is used to assess whether the spinal nerve is being impacted by the spondylosis.
Magnetic Resonance Imaging (MRI): A large magnet, radio waves and a computer are used to produce pictures of the affected area.
Myelogram: This is a special type of CT scan. In this procedure, a contrast dye is injected into the spinal canal to make the spinal cord and nerve roots show up more clearly.
X-rays: This is a common imaging test of bones or joints that can be used to detect bone spurs and spinal compression.
Spondylosis can be caused by a variety of different factors, some benign and others more serious.
Common spondylosis causes:
- Being overweight or obese—The excess weight and pressure on the spine can cause spondylosis.
- Neck or back injuries—Damage to your spine or overuse of your spine can cause spondylosis.
- Long-term overuse from heavy lifting, bending, or twisting—Repeatedly performing any of these tasks may lead to spondylosis.
- Smoking—The chemicals in cigarettes and cigars can cause spondylosis by irritating the nerves in your spine.
Risk factors that can contribute to spondylosis include:
Age: Spondylosis is most commonly caused by aging. In fact, more than 85 percent of people over age 60 have some degree of spondylosis, though in many cases it is mild and causes no symptoms.
Family history: A family history of spondylosis or other degenerative conditions such as osteoporosis that affect the spine increase your risk for spondylosis.
While many risk factors cannot be controlled, you can help prevent spondylosis in these ways:
Maintain a healthy weight: Being overweight increases pressure on your spine, which speeds up the normal wear on your joints.
Maintain a healthy diet: Getting the proper amounts of essential vitamins and minerals helps reduce the loss of bone, muscle and connective tissues and promotes new growth.
Stay active: A regular fitness routine that includes exercises to strengthen your back and other core muscles, and regular stretching to improve flexibility helps reduce stress on your spine, avoid injury, and prevent spondylosis.
Maintain good posture and use proper lifting techniques: Any activity that puts added stress on your spine can wear down your discs and cause injuries.
Avoid smoking: Smoking interferes with oxygen and nutrient delivery to muscles and joints, and speeds up the aging process.
Prognosis of Spondylosis
The prognosis for people with spondylosis depends upon the severity of symptoms and the part of the spine affected. Many patients are able to improve or manage their condition with medications, physical therapy and other non-surgical treatments. Patients with severe pain or neurologic symptoms may require surgery.
Spondylosis Treatment and Recovery
Spondylosis treatment depends on the type and severity of symptoms. The main treatments for spondylosis are:
Over-the-counter pain relievers and anti-inflammatories such as aspirin, acetaminophen, ibuprofen and naproxen sodium are commonly used to treat mild pain or stiffness associated with spondylosis. For more severe pain, your doctor may prescribe cox-2 inhibitors or administer steroid and anesthetic injections. Some types of anti-seizure medications and anti-depressants are also used to treat chronic nerve pain from spondylosis, and in rare cases your doctor may prescribe narcotics to be used temporarily for severe pain.
Heat, cold and local therapies
Applying heat increases the supply of oxygen to the affected area and relaxes muscles, while applying cold reduces inflammation and decrease pain. Massage and other local therapies can also help relieve symptoms.
Bracing: May include a soft corset back brace or a soft cervical collar
A soft brace that wraps around the neck or back can be used temporarily to limit motion and allow your spine to rest/recover.
Exercise and behavior modification
An exercise regimen designed to improve flexibility and extension of the back muscles, widen the space between the vertebrae, develop muscles that support the spine and improve aerobic fitness helps reduce symptoms associated with spondylosis. Additional behavior modification may include practicing proper techniques when lifting heavy objects, maintaining good posture, using body pillows and sleeping in positions that reduce strain on your back, moving around frequently, stretching, eating healthy, reducing stress and quitting smoking.
Depending on the cause of your back pain and the effectiveness of other treatments, your doctor may recommend the following procedures:
- Foraminotomy: If spondylosis is causing nerve compression, your doctor may recommend a foraminotomy to widen the opening where nerve roots leave your spinal canal to relieve pressure on the nerves and reduce pain.
- Laminectomy/diskectomy: If your spondylosis has resulted in a slipped or herniated intervertebral disc, your doctor may surgically remove the disc to relieve compression on the nerves in the spine. In some cases, the disc may be replaced with a synthetic disc.
- Spinal fusion: After a diskectomy, the spine often needs to be stabilized. This is usually done by replacing the intervertebral disc with bone from a cadaver or your own hip or pelvis or using a synthetic substitute. In some cases, bone morphogenic proteins may be placed in the affected area to stimulate bone growth and eliminate the need for grafts. The adjoining vertebrae are then fused together with plastic or metal rods and screws.
- Laser surgery: In this procedure, a laser is used to remove areas of the disc or vertebrae that may be impacting the nerve and causing pain.
Complications of spondylosis may include:
Depression or anxiety: Those who have chronic back pain are at increased risk for depression or anxiety.
Permanent nerve damage: If the spinal cord or nerve roots are heavily impacted, it may cause permanent damage and that results in loss of motor skills and other functionality.
Spinal stenosis: The wearing of the discs that serve as padding between the vertebrae and overgrowth of bone as compensation can cause the canal that contains the spinal cord to narrow and press on the roots of one or more spinal nerves.
Spondylolisthesis: Continued degeneration of the spinal discs may cause the vertebrae to slip over one another and become displaced, causing severe pain, loss of motor coordination and other symptoms.
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