Spondylosis, osteoarthritis, and degenerative joint disease are terms that may be used interchangeably. Spondylosis can become disabling, and affect any level of the spine; cervical (neck), thoracic (mid back), lumbar (low back), sacral (lower back) spine. Joints, ligaments, and intervertebral discs wear down and undergo changes that disrupt normal spinal structure and function. The exact cause of spondylosis is not known, but it is thought to develop in adults pursuant to growing older.
What are typical symptoms?
Why see a spine specialist for a diagnosis?
What are the treatment options?
The degenerative process often begins in the disc. As you age, discs can lose water content, thin, erode or collapse. Loss of intervertebral disc height may cause spinal bones to rub together and trigger the development of bone spurs (osteophytes). In turn, osteophytes may press on a spinal nerve, the cord, and/or disrupt normal movement of the facet joints. Ligaments thicken and may buckle impinging onto nerves or into the spinal canal. Trauma, injury, repetitive movement, improper posture, poor body mechanics, or being overweight can exacerbate spondylosis.
Symptoms vary and depend on where spondylosis develops.
- Back pain/stiffness, especially upon awakening
- Difficulty bending forward, backward, side-to-side, twisting
- Sensations such as burning, tingling, or pins and needles
- Sciatica, cervical radiculopathy
- Extremity weakness (arms, legs)
- Muscle spasms
- Irregular gait or limp
- Loss of bowel and/or bladder control (rare)
Spondylosis is a degenerative problem, which means it can progress and worsen. Consult an expert about your back pain with or without extremity pain, pre-existing or changing spinal disorder. An accurate diagnosis is essential to an effective and successful treatment plan.
Your medical history and physical and neurological examinations are very important. You and your doctor discuss your symptoms, when they started and treatments tried. The doctor tests your reflexes and evaluates you for muscle weakness, loss of feeling, and signs of neurological injury.
Diagnostic testing is important. Your spine specialist may order x-rays, CT scans or MRI series. Typically, x-rays are taken from your side (lateral), while standing (front and back), bending forward (flexion) and bending backward (extension). The flexion/ extension studies help your doctor to evaluate your range of motion and spinal stability.
CT scans provide more anatomical details. A MRI study is of particular value and used to assess nerve and/or spinal canal (cord) compression. Your doctor will explain the purpose of these and other tests.
Most spondylosis cases do not require spine surgery. Your doctor may combine more than one non-operative therapy to maximize the success of your treatment plan.
- Short-term bed rest
- Activity modification (restrict spinal stress, flexion, extension)
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Pain medication
- Muscle relaxants
- Spinal injections
- Physical therapy
- Short-term bracing
Your spine specialist may discuss surgical care if you experience any of the following:
- Spinal instability
- Neurologic dysfunction
- Unrelenting pain, symptoms despite non-operative treatment
Surgical treatment aims to reduce (decompress) nerve compression and stabilize the spine (stop movement). You may be a candidate for a minimally invasive spine surgical procedure to alleviate neurological dysfunction. If you have spinal instability, instrumentation and fusion may be considered to stabilize the spine and hold it firmly in place as you heal.
Most patients with spondylosis easily manage pain and symptoms without surgery. If your spine specialist discusses surgical options with you, be assured his recommendation is made with the greatest concern to your healthcare.