Spondylosis: Symptoms, Causes and Treatment

Overview

Spondylosis is an umbrella term that simply refers to some type of degeneration in the spine. As people age, their bones, discs, cartilage and ligaments change. Bone spurs may develop, discs may dry and crack, cartilage may wear out and ligaments may thicken, which can cause inflammation and pain.

These age-related degenerative changes are all forms of spondylosis. In a more narrow sense, it refers to spinal osteoarthritis, which is common and usually not serious. Spondylosis can occur in the cervical spine, thoracic spine, or lumbar spine. Lumbar spondylosis and cervical spondylosis are the most common.

Over 80% of people over the age of 40 have evidence of spondylosis on X-ray studies. According to the Arthritis Foundation, spondylosis affects about 75% of individuals over the age of 60.

Causes

Spondylosis is caused by wear and tear changes on the components of the spine. It is an aging phenomenon. Therefore, the major risk factor for developing spondylosis is age. Symptoms are often reported between the ages of 20 and 50. With age increasing, the bones and ligaments in the spine will wear, leading to bone spurs.

Also, the intervertebral discs may degenerate and weaken, which can cause disc herniation and bulging discs. Besides, it is partly related to genetic predisposition and injury history. Genetics is a potential risk factor for spondylosis. If many people in a family have spondylosis, there is an increasing possibility for their children to develop spondylosis.

Spinal injury is another factor for spondylosis. Injuries can cause intervertebral discs to herniate. In addition, osteoarthritis is more likely to occur in injured joints, which can take years to develop.

Symptoms

Generally, spondylosis does not cause obvious symptoms. In fact, lumbar spondylosis is present in 27%-37% of people without symptoms. When symptoms occur, they commonly include neck or back pain or stiffness. Pain can result from a bulging or herniated disc that impinges (pinches) a spinal nerve. Stiffness can occur after periods of inactivity or rest, such as waking up after a nap.

When compression from spondylosis affects the cervical spinal cord, it is called cervical spondylosis. Symptoms of cervical spondylosis include:

  • Tingling and numbness in the arms, hands, legs or feet
  • Weakness in the muscles of the arms, shoulders, legs, feet and hands
  • Lack of coordination and difficulty walking
  • Loss of bladder or bowel control

Diagnosis

To
diagnose spondylosis, the doctor may also order the following diagnostic
procedures:

  • X-rays – It can detect bone spurs or loss of disc height and show thickening of facet joints and narrowing of the intervertebral disc spaces.

  • Magnetic resonance (MR) scan- It provides a detailed image of the spinal cord and surrounding nerves. This diagnostic procedure can help identify if a nerve is being compressed.

  • Computed tomography (CT) scan- It can visualize the spine in greater detail and can diagnose a narrowing of the spinal canal when it is present. If there is a concern that spondylosis has begun to compress nerve tissue in the spine, the doctor may order a CT scan to evaluate whether the nerve signals are traveling properly to the muscles.

Treatment

There
are both non-surgical and surgical treatments for spondylosis. In general,
non-surgical measures are effective in treating the symptoms. Non-surgical
options include:

  • Pain medications, such as analgesics, anti-inflammatory drugs, and muscle relaxants
  • Physical therapy, such as ice or heat therapy, massage and ultrasound
  • Weight control, which can help reduce pain
  • Strengthening exercises, which can help improve spinal flexibility, build strength and endurance
  • Improving and maintaining good posture

However, if spondylosis has caused compression of the spinal cord or spinal nerve roots, it is necessary to relieve the pressure by having surgery. The type of surgery varies depending on the cause of the spinal cord compression, which includes:

  • Discectomy to remove a herniated disc
  • Laminectomy to remove bone spurs or remove the lamina, which is a part of the vertebra
  • Laminoplasty to open the space for nerve tissue by changing the position of the lamina
  • Spinal fusion to fuse a segment of the spine by using a transplanted bone with or without instruments

Keywords: spondylosis.

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