Common Conditions
Spondylosis of the spine
Spondylosis refers to age-related degenerative changes in the spine including: the vertebrae, intervertebral discs, facet joints, and ligaments. These changes are a natural part of the aging process and often develop gradually over time in everyone. While many people with lumbar spondylosis may not experience symptoms, others may have pain, stiffness, or limited mobility. Spondylosis can affect any region of the spine but is most common in the lumbar and cervical regions.
What causes spondylosis?
The primary cause of lumbar spondylosis is the natural wear and tear of the spine that occurs with aging. Other contributing factors include:
- Degeneration of intervertebral discs: Over time, the discs lose hydration and elasticity, reducing their ability to act as shock absorbers between the vertebrae.
- Facet joint arthritis: The facet joints at the back of the spine that connect the vertebrae can become inflamed, degenerate and thickened (hypertrophic) with time.
- Ligament thickening: Ligaments supporting the spine may thicken and lose flexibility over time, contributing to stiffness and contribute to spinal stenosis.
- Genetic predisposition: A family history of spine-related conditions may increase the likelihood of developing spondylosis.
- Repetitive stress: Occupational or recreational activities that involve heavy lifting, bending, or twisting can accelerate age related degeneration, especially in the lumbar region.
- Injury: Previous spinal injuries may contribute to accelerated or more severe degeneration.
- Combination of above: Spondylosis is frequently multifactorial due to any combination of the above.
Common symptoms of spondylosis
Symptoms can vary depending on the severity of the degeneration and whether nerves are affected. Common signs include:
- Spine pain: A dull, aching pain in the spine, which may worsen with prolonged activity or sitting.
- Stiffness: Reduced flexibility in the spine, especially in the morning or after periods of inactivity.
- Radiating pain: If nerve compression occurs, pain may radiate into the limbs.
- Numbness or tingling: Sensations in the hands or feet, often due to nerve involvement.
- Weakness: In severe cases, compression of spinal nerves may cause muscle weakness in the limbs.
Diagnosis of spondylosis
Diagnosis of spondylosis begins with a detailed medical history and physical examination. A doctor will ask about the nature of your spine pain, stiffness, or any symptoms that may suggest nerve involvement, such as limb pain, numbness, or weakness. Your specialist will examine your posture, spinal flexibility, and neurological function.
Imaging studies are often used to confirm the diagnosis. As spinal spondylosis is common and frequently seen without symptoms, imaging studies should be used with caution. These studies may include:
- X-rays to detect signs of arthritis, alignment issues, or disc space narrowing.
- MRI scans to assess soft tissues such as discs and nerves, especially if there are signs of nerve compression.
- CT scans may be used in some cases for detailed views of bony structures.
These tests help identify the extent of degenerative changes and guide appropriate treatment.
Management of spondylosis
Treatment for lumbar spondylosis focuses on managing symptoms and maintaining spinal health as the condition cannot be reversed. Options include:
- Conservative measures:
— Activity modification: Avoiding activities that aggravate symptoms and adopting good posture to reduce strain on the spine.
— Weight loss: This will reduce the degree of spinal loading. - Medications:
— Over-the-counter pain relievers such as paracetamol or ibuprofen.
— Muscle relaxants or prescription medications for severe symptoms. - Physical therapy:
— Exercises to strengthen the spinal supporting muscles (e.g. core muscles), improve flexibility, and improve posture.
— Stretching routines to reduce stiffness and promote mobility. - Injections: Corticosteroid injections into the affected area can provide temporary relief from inflammation and pain.
- Surgical options: Surgery may be considered in severe cases where nerve compression or spinal instability significantly affects mobility or quality of life. Procedures may include decompression surgery or spinal fusion.
