Conservative therapy/physiotherapy

Physiotherapeutic therapy aims to maintain the mobility of the spine to a large extent and to minimize symptoms of osteoarthritis such as pain and tension. For the latter, massage techniques, trigger point treatment and fascia therapy are available. A stretching and exercise program should also be worked out with the patient, which he or she can carry out safely and independently at home.

The mobility of the spine can be passively improved by manual therapy by the therapist. Traction treatments can, for example, briefly relieve the affected joints in the sling table and ease pain. Postural correction is also particularly important, as is learning physiological, back-friendly behavior in everyday life.

The patient should know which posture is harmful to him or her and how to counteract it. A training for at home with exercises for relief after overloading, with mobilizing exercises and strengthening exercises for weak muscles should be worked out. The quality of the execution is important, because an incorrect execution can lead to further incorrect strains.

The patient should be informed about remedies to help himself/herself in acute pain conditions. Relieving positions such as step positioning should be mentioned here as an example. In addition to movement therapy and manual treatment by the therapist, there is a wide range of possibilities from physical therapy and electrotherapy.

Electrotherapy can have a pain-relieving effect. There are devices that the patient can use at home (e.g. TENS). Heat and cold applications can be helpful in cases of tension or inflammation. There is a wide range of courses and groups for patients with facet arthrosis. Back fitness courses, back school or even aqua gymnastics are often offered in every city and are often subsidized by health insurance companies.

Cortisone

In the case of severe therapy-resistant pain, cortisone can be injected directly into the facet joint. This usually takes place during CT imaging. This is referred to as pain therapy.

Often several sessions are scheduled over a period of 6-12 weeks. Cortisone is injected into the joint and can spread its anti-inflammatory effect there. The typical side effects of cortisone, such as weight gain, are not to be expected due to the local and relatively low dose.

The success of the therapy varies. In most cases, good short-term improvement of the symptoms can be achieved. However, it is not possible to make a prognosis as to how long this will last and it varies greatly from patient to patient. Cortisone is said to have a cartilage-damaging effect. Whether cortisone is the drug of choice for long-term therapy must be clarified by a doctor.