(ĐTĐ) – The word “spondylosis” means a stiffening or fixation of the vertebrae in the back and neck due to a disease process. Spondylosis is the degenerative changes such as degenerating discs and bone spurs. Quite often, these changes are called osteoarthritis. Spondylosis can occur anywhere on the spine: cervical (neck), thoracic (upper/mid back), and lumbar (low back). However, the most common is cervical and lumbar.
Individuals with thoracic spondylosis rarely experience symptoms. Lumbosacral spondylosis occurs in both the lumbar and the sacral areas of the spine. The sacral area is just below the lumbar spine, between the buttocks. Those who are experiencing spondylosis in multiple areas will be diagnosed with multilevel spondylosis.
Causes and Risk Factors for Spondylosis
Spondylosis is a phenomenon among the aging population. As we age, bones and ligaments in the spine wear down, which leads to bone spurs, known as osteoarthritis. Additionally, the intervertebral discs weaken and degenerate, leading to bulging and herniated discs.
Symptoms of spondylosis are typically reported first between the ages of 20 and 50. According to x-ray studies, over 80 percent of people over 40 have evidence of spondylosis. The rate of spondylosis occurrence is related in part to a genetic predisposition and history of injuries.
Signs and Symptoms of Spondylosis
Many individuals who have x-ray evidence of spondylosis do not have any symptoms at all. Believe it or not, spondylosis in the lower back – or lumbar spondylosis occurs in 27 to 37 percent of people without any symptoms ever being present. Spondylosis does cause back and neck pain in some individuals because of pinched nerves. This is caused by bone spurs on the facet joints or bulging discs, which causes the holes where nerve roots exit the spinal canal to narrow.
Even if a bulging disc isn’t large enough to cause a pinched nerve, it can cause local inflammation and cause the nerves in the spine to become sensitive- which increases pain. Additionally, herniated discs can cause the ligaments in the spine to be pushed on, which can cause pain. Chronic pain can result if new nerves and blood vessels are caused to grow from this pressure. Due to the pain, the spine may splint itself, which will cause regional tenderness, trigger points, and muscle spasms.
Findings, such as decreased disc space, calcium deposits, and bone spur formation on the upper or lower portions of the vertebrae, which are characteristic of spondylosis can be seen with x-rays.
Symptoms of spondylosis include the following local pain in the area of the spondylosis (typically the back or neck). If you’re experiencing a pinched nerve due to a herniated disc, you could have pain shooting into your limbs. Back pain that can be attributed to a bulging disk gets worse with long periods of standing, sitting, or bending forward and typically is helped by frequently changing positions and short periods of walking.
Pain in the back because of osteoarthritis typically gets worse with standing or walking and can be relieved by bending forward. If you have a pinched nerve, you may experience tingling and numbness, and if the nerve is severely pinched, you could experience weakness of the affected extremity.
If you have a herniated disc pushing on your spinal cord can cause injury to the spine, called myelopathy. Myelopathy symptoms include weakness, numbness, and tingling. For example, if you have a herniated disc in your cervical spine that is large enough to exert pressure on the spine, it could cause weakness, tingling, and numbness in your arms and your legs.
When Should You Seek Treatment for Spondylosis?
Due to the fact that the diagnosis of spondylosis is made through MRI, CT, or plain film x-ray, individuals who have this diagnosis have already sought help from their physician. Following are some reasons for re-evaluation from your physician:
- Pain isn’t being managed with the currently prescribed treatments
- Acute nerve dysfunction development, such as limb weakness
- Loss of control of your bowels or bladder when you have acute neck or back pain can point to a more serious dysfunction of the nerves and should immediately be evaluated at the ER.
- Groin numbness, known as “saddle anesthesia”- could be indicative of a more serious nerve dysfunction and should be evaluated immediately at the ER.
- Back or neck pain causes weight loss or a fever higher than 100 degrees Fahrenheit.
Diagnosis of Spondylosis
Your physician can diagnose you with spondylosis through the use of MRI, CT, or plain film x-rays. The x-rays will show any bone spurs on the vertebrae, thickening of the joints that connect the vertebrae to each other, and any narrowing of the spaces in between the vertebrae. CT scans can get a better visualization of the spine and therefore can find whether or not there is a narrowing of the spinal canal. MRI scans can be quite expensive, however, they do show the greatest detail of the spine and can visualize- if present- the degree of disc herniation. Additionally, an MRI is able to visualize the vertebrae, facet joints, nerves, and ligaments in the spine and therefore can be used to diagnose a pinched nerve.
Treatment of Spondylosis
Currently, due to the degenerative nature of the process of spondylosis, there is no treatment available to reverse it. Treatments of spondylosis target the pain in the neck and back caused by spondylosis. Therefore, treatment is very similar to that of typically back and neck pain treatments. Treatments available for this include: self-care, medication, physical therapy/exercise, chiropractic/acupuncture, injections, and even surgery.
After a course of treatment, your physician will most likely want to follow up with you to see how successful the treatment is/has been. Typically, it is unnecessary for any follow-up imaging such as MRI, CT, or x-ray. However, there is an exception- any change in symptoms that could affect the therapy such as new onset pain down one arm or new onset sciatica.
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