Spondylosis is a broad term that simply refers to some type of degeneration in the spine. Most often, the term spondylosis is used to describe osteoarthritis of the spine, but it is also commonly used to describe any manner of spinal degeneration. As with many other terms to describe spinal problems, spondylosis is more of a descriptive term than it is a clinical diagnosis. Literally it can be translated to mean that one has both pain and spine degeneration, regardless of what is causing the pain or where the degeneration is occurring.
The discs act as shock absorbers between the bones of the low back. In lumbar disc degeneration (which typically occurs in people age 40 years and older), the normal gelatin-like center of the disk degenerates and the space between the vertebrae narrows. As the disc space narrows, added stress is applied to the joints of the spine causing further wear and degenerative disease. The lumbar disc may also protrude and put pressure on the spinal cord or nerve roots when the rim of the disc weakens. This is known as a herniated disc.
Nonsurgical treatment is effective in treating the symptoms of herniated discs in the majority of patients. Most back pain will resolve gradually with simple measures.
- Rest and over-the-counter pain relievers may be all that is needed.
- Muscle relaxers, Compound Topical Creams, analgesics, and anti-inflammatory medications are also helpful.
- Cold compresses or ice can also be applied several times a day for no more than 20 minutes at a time.
- After any spasms settle, gentle heat applications may be used.
- Physiotherapy for controlled exercise and stretching exercises to maintain mobility
- Weight loss can be effective to reduce the strain and pressure on the lumbar spine
Any physical activity should be slow and controlled, especially bending forward and lifting. This can help ensure that symptoms do not return, as can taking short walks and avoiding sitting for long periods. For the neck, exercises and traction may be helpful. To help avoid future episodes of pain, it is essential that you learn how to properly stand, sit, and lift.
Injections can be very helpful for this condition and they may include:
- Cortisone (Corticosteroid)
- Platelet Rich Plasma (PRP)
- Trigger Point Injections
Only a small percentage of patients with arthritis in the low back require surgery. Spine surgery is typically recommended only after a period of nonsurgical treatment has not relieved painful symptoms, or for patients who are experiencing the following symptoms:
- Muscle weakness
- Difficulty walking
- Loss of bladder or bowel control (This may indicate a very rare and serious condition called cauda equina syndrome. This condition is caused by the spinal nerve roots being compressed. It requires immediate medical attention.)
Microdiscectomy and canal enlargement: The most common procedure used to treat a single herniated disc is microdiscectomy and/or patients with central canal stenosis with a canal enlargement procedure. The procedure is done through a small incision at the level of the disc herniation and often involves the use of a microscope. The herniated part of the disc is removed along with any additional fragments that are putting pressure on the spinal nerve. Excess amount of arthritis and ligament thickening that are putting pressure on a spinal nerve can also be removed. Removing the pressure involves opening up the spinal canal. This procedure is called a laminectomy.
Spinal Fusion: Surgery for both degenerative spondylolisthesis (slipped vertebrae due to arthritis) and spondylolytic spondylolisthesis (slipped vertebrae) includes removing the pressure from the nerves and spinal fusion. Removing the pressure involves opening up the spinal canal. This procedure is called a laminectomy. Spinal fusion is essentially a “welding” process. The basic idea is to fuse together the painful vertebrae so that they heal into a single, solid bone.