Spondylosis
What is spondylosis?
Spondylosis (spinal osteoarthritis) is a degenerative disorder. It is the general
wear and tear that occurs in the joints and bones of the spine as people get
older. It may cause loss of normal spinal shape and function.
Although aging is the primary cause, the location and rate of change is
different from person to person.
Spondylosis may affect the cervical (neck), thoracic (mid-back), or lumbar
(low back) regions of the spine.
Causes
To better understand the causes of spondylosis, it is useful to know a little
more about the structure of your spine.
Your spine is made up of vertebrae, discs, muscles and nerves. Vertebrae are
the ridge-shaped sections of bone that make up the structure of your spine,
and protect the nerves.
The vertebrae are supported and cushioned by discs full of gel and water that
are tough and flexible.
As you get older, the discs dehydrate, become thinner and become harder.
They then provide less support to the vertebrae resting on the discs.
Your body compensates for this by producing small lumps of extra bone to
better support your spine and stiffen the spine. The extra bone is known as a
bone spur or osteophyte. Osteophytes can cause the spine to become too
rigid leading to the symptoms of stiffness and pain.
Changes in bone structure can also compress nearby nerves and blood
vessels, which cause symptoms of more widespread pain.
Outlook
Spondylosis is an age-related condition. It is estimated that nearly all
men and women will have signs of cervical Spondylosis on an X-ray by
the time they reach the age of 70.
Only some people have symptoms related to spondylosis. Others have
very marked signs on an X-ray and have no symptoms at all.
Around 90% of people with spondylosis will only experience episodes
of stiffness and pain.
Pain usually comes and goes, with flare-ups followed by symptom-free
periods. Some people develop chronic (long-lasting) pain.
Areas affected
Cervical (neck)
The complex anatomy and large movements in the neck make this area of the
body susceptible to degenerative change. Neck pain from spondylosis is
common. The pain may spread into the shoulder or down the arm. If your pain
is localised to your neck you may benefit from the exercises shown in our
information leaflet cervical spondylosis.
Thoracic (mid-back)
The thoracic spine is less commonly affected due to its reduced movement. If
there is spondylosis in this region the shape of the mid back can round to the
appearance of a hunchback, this is called a kyphosis.
Lumbar (low back)
Spondylosis often affects the lumbar spine in people over the age of 40. Pain
and morning stiffness are common complaints. Usually many levels are
involved. The lumbar spine carries most of the body's weight. Therefore, when
degenerative changes affect its structure you may get pain with activity such
as walking and standing or after long periods of rest.
Other symptoms
If a bone spur (osteophyte) causes a nerve to be pinched or irritated, the
entire length of the nerve can be affected. Depending on the nerve, you may
feel pain travelling into the arms or legs. You may also experience some pins
and needles or numbness in the part of the body that the nerve travels too.
This more commonly affects the neck and lower back.
More severe symptoms
Spondylosis can be more serious if it affects the size of the spinal canal. This
is called stenosis and can interfere with the signals that travel between your
brain and the rest of your body.
If it is not treated, it can lead to long-term problems.
Symptoms can include:
a lack of co-ordination, for example you may find tasks such as
buttoning a shirt increasingly difficult
heaviness or weakness in your arms or legs
problems walking
problems controlling your bladder and bowel
If you develop any of these symptoms you should seek urgent medical
attention.
You are more likely to suffer from spondylosis if:
You are over 40 years of age
You are overweight as this puts extra load on the joints
You have had a prior injury. Trauma makes a person more susceptible
to developing spondylosis.
You have a poor posture and are inactive. This can load the joints,
muscle and ligaments incorrectly over long periods leading to early
degenerative changes.
Diagnosis
Spondylosis is usually suspected if there are typical symptoms of pain and
stiffness. It may also be considered as a cause of radiating arm pain and
problems with the hands or legs.
Various tests, which are outlined below, can be used to rule out other
conditions and confirm the diagnosis:
Physical examination by a physiotherapist or doctor
X-ray
MRI
Treatment
Exercise and lifestyle changes
Low-impact aerobic exercises such as swimming or walking
Correcting your posture when standing and sitting
The long-term use of any brace or collar is not recommended as it can make
your symptoms worse due to more stiffness.
Physiotherapy
A physiotherapist can mobilise joints and soft tissue as well as giving
exercises to reduce stiffness and improve posture.
For further information on back and neck care please see our video you and
your back.
Pain relief
Correct pain medication or the use of a transcutaneous electrical nerve
stimulation (TENS) machine may be beneficial. You should seek advice from
your GP regarding pain medication.
Surgery
In some severe cases surgery may be suggested by your consultant.
This is always a last resort.
