Spondylosis is a condition of degeneration that can occur in any of the three parts of the spine: the cervical spine, referring to the neck; the thoracic spine, or the area between the neck and low back; and the lumbar spine, referring to the low back. It most commonly causes symptoms in the cervical and lumbar spine.
Causes
Spondylosis is caused by degenerative changes to the spine due to osteoarthritis. Osteoarthritis is part of the normal aging process; however, frequent lifting, smoking and certain postures potentially can predispose an individual to the condition. Spondylosis can affect the intervertebral discs, facet joints, bones and ligaments. The intervertebral discs are located in between the vertebrae. As the discs degenerate, narrowing between the vertebrae, disc bulging or herniation into the spinal canal can occur. These changes to the discs can lead to various neurological symptoms, including weakness and pain. Loss of cartilage or cushioning and extra bone formations known as osteophytes also can lead to pain. The ligaments can thicken and lose their function in supporting the spine.
Cervical Spondylosis Symptoms
Cervical spondylosis can present at any age, but most commonly occurs between ages 40 and 50. Symptoms include numbness, neck pain, arm pain and arm weakness. Morning stiffness of the neck is common. Range of motion may be limited as well. If an osteophyte is present in the front of the spine, it can cause difficulty swallowing. Myelopathy is a condition in which there is compression on the spinal cord, it is a medical emergency and typically associated with weakness, trouble with walking, loss of balance and incontinence of urine and/or stool.
Cervical Spondylosis Treatment
Treatment for cervical spondylosis is aimed at pain relief. Initial treatment of cervical spondylosis without nerve compression symptoms includes anti-inflammatory medications, physical therapy and lifestyle modifications. Epidural steroid injections can be tried for symptoms relief. Some patients report successful relief with alternative therapies such as chiropractic care, massage and acupuncture.
Surgery can benefit patients with neurological symptoms, severe pain, progressive symptoms and weakness. The goal is to provide relief of symptoms by removing all bony or soft tissue structures that might be compressing the nerves. The procedure may involve a fusion of the vertebral bodies or removing a part of or the entire intervertebral disc.
Lumbar Spondylosis Symptoms
Lumbar spondylosis typically affects people over age 40. Low back pain and morning stiffness are very common complaints. Prolonged periods of sitting can exacerbate the pain, as can lifting and bending. Other symptoms include shooting pains down the leg or into the groin, numbness and weakness.
Symptoms of low back pain may be related to more than just physical changes to the spine. Dr. Scott Kinkade, of the University of Texas Southwestern Medical School in Dallas, explains that psychosocial factors--such as psychological distress and depression, litigation, job dissatisfaction and reliance on passive treatments--can lead to the development of chronic back pain.
Lumbar Spondylosis Treatment
Treatments for lumbar spondylosis are aimed at symptom relief. Initially patients can try anti-inflammatory medications and physical therapy. Epidural steroid injections often can provide relief. Acupuncture, deep tissue massage, chiropractic care and other manipulation therapies often provide relief for patients.
A surgeon may fuse the vertebrae, remove the entire intervertebral disc or a portion of it or remove osteophytes or portions of the bone. Spinal surgery often involves placing metal hardware in the bone.
References
- Wheeless' Textbook of Orthopaedics: Cervical Spondylosis
- "Expert Guide to Sport Medicine"; Dr. Matthew Davis, Dr. Peter Davis, Dr. David Ross (eds); 2005
- "AAOS Comprehensive Orthopaedic Review"; Dr. Jay Lieberman; 2008
- American Family Physician: Evaluation and Treatment of Acute Low Back Pain
