Spondylosis refers to a range of problems with the spine caused by wear and tear on the intervertebral discs. Physical therapy, pain medications, or surgery can relieve the symptoms of wear and tear. Most people 65 and older have some form of spondylosis.
What is spondylosis?
Spondylosis is a general term for problems with the discs of the spine that usually develop with advancing age. As the discs dehydrate and shrink, bone spurs and other signs of osteoarthritis develop. Spondylosis is very common and worsens with increasing age. A genetic component is also thought to be partly to blame, as some families show more cases of spondylosis than others. However, more than 90 percent of people over 65 develop some degree of spondylosis, which shows up on X-rays. However, many people do not notice serious symptoms of spondylosis. If they do occur, conservative treatment is usually successful.
Causes
Throughout life, the physics of a person’s spine changes due to various stresses that can lead to spondylosis. The intervertebral discs serve as a kind of buffer between the vertebrae. In most people, the discs begin to shrink and dehydrate after the age of 40. This leads to increased bone contact and discomfort. Weakening discs can also become damaged, often causing nerve irritation. Weakening discs can likewise lead to a misguided response from the body, resulting in increased bone spurs. These bone spurs impede the normal movement of the spine. Ligaments between the vertebrae can also become stiffer with age and restrict movement, which is also its common sign of spondylosis.
Symptoms, complaints and signs
Spondylosis can manifest itself through a whole range of symptoms and complaints. Among other things, the disease makes itself felt through severe pain in the neck, spine, buttocks and legs. The complaints occur in individual areas or in the entire back region and sometimes radiate into the buttocks. This can be accompanied by tension, which is usually experienced by sufferers as extremely distressing. The pain is described by those affected as throbbing to stabbing. In addition, an unpleasant tingling sensation occurs. The symptoms occur during movement and subside during periods of rest. In the course of the disease, the pain gradually decreases. However, in the long term, there may be restrictions in the mobility of the spine. Those affected are then no longer able to tilt the upper body forward or to the side. Movement sequences such as bending or lifting are associated with severe pain. If the disease is severe, it can lead to permanent movement restrictions. In principle, however, spondylosis can be treated well, and chronic complaints are rare. The disease is usually overcome within a few weeks to months.
Diagnosis and course
For a diagnosis of spondylosis, the physician will usually begin with a physical examination. Here, the focus is on the mobility of the spine and whether certain movements cause pain or tension. The strength and reflexes of the muscles are also tested here. This is usually followed by one or more imaging procedures. For example, simple x-rays of the neck can show whether displacements or bone spurs have developed that cause poor posture, pressure or pain. A computed tomography scan offers the ability to image the spine from many different angles and show even minor scabs. Magnetic resonance imaging (MRI) can also show changes in the soft tissue of ligaments or help identify areas where nerves are being pressed. A myelogram involves injecting a fluid into the spine before an X-ray, which can be seen more clearly on the images. But an electromyogram can also more accurately show the effects of possible spondylosis. The latter examination measures the activity of the nerves.
Complications
Spondylosis can promote hernias in the spine, among other conditions. A typical complication of the disease is also the so-called osteochondrosis.This disease is also due to disc wear and tear and occurs more frequently in the context of spondylosis. In addition, chronic neck and back pain may occur. Complaints in the area of the lumbar spine and intervertebral discs cannot be ruled out either. In cases of prolonged disease, painful muscle tension and paralysis may occur. Depending on which treatment method is chosen, adverse events may occur. With drug therapy, a decrease in mental and physical performance is possible. In addition, side effects, interactions and allergic reactions may occur. An injection with prednisone carries similar risks, but can also lead to infections at the injection site and other complaints. In the case of undiagnosed heart disease, cardiovascular problems and, in the worst case, even cardiac death may occur. A surgical procedure also carries risks. Occasionally, for example, nerve injuries occur, resulting in sensory disturbances and temporary paralysis. After surgery, scars may develop or there may be unpleasant wound healing problems.
When should you see a doctor?
Since spondylosis does not heal on its own, the person affected by this condition should usually always see a doctor. The earlier the doctor is consulted and treatment is initiated, the better the further course is usually. Therefore, the patient should contact a physician at the first symptoms and signs of spondylosis. A doctor should be consulted if the affected person suffers from severe pain in the neck or back. Severe limitations in movement may also indicate spondylosis and should likewise be examined by a physician if they occur over a long period of time. Many sufferers also experience tingling in various parts of the body or severe numbness. Furthermore, tension or severe pain in the muscles can also indicate spondylosis and must also be examined by a doctor. The first diagnosis can be made by an orthopedist or by a general practitioner. Further treatment usually requires treatment by a specialist.
Treatment and therapy
Treatment of spondylosis depends on the signs and symptoms. The goals of treatment are to limit discomfort and pain, ensure normal activity, and prevent further damage to the spine. If common pain medications no longer help, the doctor may prescribe muscle relaxants. These help if there are regular spasms in the back. In some cases, medications that are otherwise used to treat epilepsy have also proven helpful. They act on the damaged nerves. Stronger narcotics may be needed to manage more severe pain. Injection with prednisone into the affected areas has also shown promise as a treatment. Treatment for spondylosis can be done with a physical therapist. This person teaches exercises that help the affected person strengthen weakened areas of the back and relieve pressure on others. This often leads to a reduction in symptoms. If all conventional treatments fail, the only option is surgery. This ensures that there is enough space for the intervertebral discs and nerves again.
Prevention
Spondylosis is a result of wear and tear. High loads on the back from repetitive physical activities over a long period of time can lead to premature spondylosis. Increased body weight is also a risk factor and leads to back problems more quickly. The same applies to permanent incorrect posture and lack of exercise of the back muscles. Accordingly, attention should be paid to diet and health sports.
Aftercare
Aftercare treatment strategies primarily target pain symptoms in patients with spondylosis. Pain management can be accomplished through the use of medications or local anesthetic procedures. Alternative procedures in follow-up care include acupuncture and psychological pain management and behavioral therapy. In addition, patients can contribute to their own pain relief by learning relaxation techniques. Examples include progressive muscle relaxation, autogenic training and yoga.During follow-up care, the physician advises the patient and educates him or her about the prognosis, about coping strategies for everyday activities, and encourages the patient in a goal-oriented manner. The primary task is to find a balance between sparing the patient during phases of pain and activating and avoiding longer phases of sparing. Thus, sports therapy measures are not advisable in acute periods of patients with spondylosis. On the other hand, light gymnastic exercises can help reduce pain and counteract immobility. Complex movement patterns are thus maintained and restored. In addition, physiotherapy and occupational therapy can be used in acute phases. Thus, conservative treatments may well succeed in relieving pain in affected areas of the patient’s movements.
What you can do yourself
With spondylosis, rest and sparing apply. The affected joints hurt a lot and often swell as well. This can lead to movement restrictions, which may also pose a health risk. For this reason, patients should spend the first days and weeks after diagnosis in bed. However, to avoid sores and other discomfort, gentle exercise should be taken. A daily walk or 15 minutes of physiotherapy will help alleviate discomfort. It may take a few days for the prescribed painkillers and anti-inflammatories to take full effect. The detailed measures required for spondylosis depend on the individual course of the disease. In the case of mild symptoms, rest and relaxation are sufficient. Since spondylosis is a degenerative disease, there are no long-term treatment options. Patients often require therapeutic support, for which, for example, the psychologist or a specialist therapist is responsible. If conservative treatment is no longer effective, surgery is necessary. Following this, bed rest is important. The wound must be carefully cared for to prevent inflammation and infection. Depending on the symptom picture, the doctor will prescribe further medication.
