Lumbar Spondylosis
Presented by: Group #03
Academic
Supervisors:
Dr. Arooba Nawaz
Dr. Ayesha Farooq
Dr. Gulrez Ayub
Introduction to
Lumbar Spondylosis
• Degenerative condition affecting
lumbar intervertebral discs and
facet joints
• Common after age 40, increases
with age
Osteophytes
• Characterized by disc
dehydration, osteophytes, reduced
disc height
• May lead to nerve root
compression and functional Spondylosis
impairment (Degenerative
Disc Disease)
Prevalence & Risk Factors
Aging Obesity Poor Posture Heavy Lifting
Affects 60–70% of people >60 Increased load on the spine Contributes to spinal Occupational risk for
years misalignment active individuals
Risk factors: aging, obesity, poor
posture, sedentary lifestyle, heavy lifting
More common in males and occupationally
active individuals
Biomechanics of the Lumbar Spine
Weight Support
Supports upper body weight.
Transmits loads to pelvis and legs.
Shock Absorption
Intervertebral discs absorb shock.
Distribute mechanical stress during movement.
Stability & Guidance
Facet joints guide and restrict motion.
Muscles and ligaments stabilize the spine.
Mobility
Allows flexion, extension, and limited rotation.
Greatest mobility at L4-L5 and L5-S1.
Biomechanics of Lumbar Spine
Supports upper body
Transfers loads to lower limbs
Most movement
At L4–L5, L5–S1
Discs absorb shock
Facet joints limit rotation
Ligaments and muscles
Stabilize spine alignment
Epidemiology of Spondylosis
Age & Gender Occupational Risk
Genetics Lifestyle Factors
Prevalence increases Higher in jobs with heavy Genetic predisposition Obesity and sedentary
after 40. lifting or prolonged influences susceptibility. habits are modifiable
sitting. risks.
More frequent in men
when younger.
Pathophysiology of Lumbar
Spondylosis
• Disc dehydration and reduced height leads to
abnormal load transfer
• Osteophyte formation causes joint space narrowing
• Facet arthropathy, ligament thickening leads to
spinal stenosis
• May cause nerve impingement and radiculopathy
Signs and Symptoms
Lower Back Pain Stiffness
• Persistent discomfort • Especially after rest or in morning
Radiating Pain Neurological Symptoms
• To buttocks, thighs, or legs (sciatica) • Numbness or tingling
• Muscle weakness in lower limbs
Stages of Lumbar Spondylosis Progression
Early Degeneration
Mild disc dehydration begins.
Loss of disc height.
Disc Protrusion
Disc bulges outward.
May irritate nearby nerves.
Osteophyte Formation
Bone spurs develop around joints.
Occurs on vertebrae.
Spinal Canal Narrowing
Progressive stenosis.
Leads to nerve compression.
Chronic Instability/Stiffness
Advanced degeneration.
Limited mobility, possible deformity.
Patient Overview
Patient DemographicsPresenting Complaints
Clinical Test Results
Patient Name: Mr. Ghazanfar Lower back pain radiating to the Straight Leg Raise (SLR):
Abbas left leg, with left foot numbness & Left 30°, Right 60°
Age: 62 years tingling. Patrick’s Test: Negative
Sex: Male VAS score: 7/10. SLUMP Test: Positive
General Physical Assessment
Vitals
Stable, no systemic comorbidities
Posture
Forward head, flattened lumbar curve, mild pelvic tilt
Gait
Antalgic on left side
ROM
Limited lumbar flexion, extension, lateral flexion
MMT
Grade 4/5 weakness in left hip flexors and knee extensors
Physiotherapy Assessment
Posture
Forward head, flattened lordosis, pelvic tilt
Gait
Left-side antalgic
ROM
Reduced in all lumbar directions
MMT
Weakness in left hip/knee (Grade 4/5)
Biomechanics & Posture Analysis
Forward Head Posture Flattened Lumbar Lordosis Mild Pelvic Tilt
Antalgic Gait & Reduced ROM Nerve Root Compression
Lab Investigations
MRI Findings
Straightening of lumbar lordosis
Multilevel disc desiccation & osteophytes
Disc bulges at L3–S1 causing foraminal narrowing
Notable reduction at L5–S1
Differential
Diagnosis
Distinguishing Conditions
• Lumbar disc herniation: focal nerve compression.
• Spinal stenosis: neurogenic claudication.
• Spondylolisthesis: vertebral slippage.
Other Possibilities
• Sciatica: nerve pain from various causes.
• Ankylosing spondylitis: inflammatory back pain.
• Spinal tumors/infections: localized pain.
In-Clinic Treatment
Plan
Electrotherapy (10 Manual Therapy: Traction:
min each): • Maitland Grade I–II PA Intermittent lumbar traction
• TENS – pain control mobilizations for nerve decompression
• Ultrasound – deep tissue • Myofascial release
healing • Pelvic alignment correction
• Infrared – muscle relaxation
• Hot pack – improved circulation
Electro-therapy Modalities
Ultrasound
TENS Promotes tissue healing.
Pain relief by stimulating sensory nerves. Reduces deep inflammation.
Infrared Therapy Hot Packs
Reduces pain, inflammation, muscle spasm. Deep heat for stiffness relief.
Improves circulation.
Superficial heat relaxes muscles.
Manual Therapy Techniques
Manual therapy for lumbar spondylosis focuses on spinal mobilizations. These techniques reduce stiffness and
improve mobility.
Therapeutic Goals
Application Method Promotes joint nutrition.
Spinal Mobilizations Therapist applies rhythmic pressure. Decreases muscle guarding.
Over spinous or transverse Restores functional movement.
Includes central and unilateral
PA glides. processes.
Exercise Therapy (Clinic & Home)
Stretching:
• Knee-to-chest, hamstrings, piriformis, cat-camel, child’s pose
Strengthening:
• Bridging, crunches, side-lying leg raises, wall squats
Postural Correction:
• Pelvic tilts, lumbar setting, wall posture drills
Home Exercise Plan
Daily stretching Strengthening
2x/day 4–5 days/week
Ergonomics:
• lumbar cushion
• standing breaks
• no prolonged bending
Home-guided Exercise Therapy
Stretching (in clinic + home)
Strengthening
• Knee-to-chest: 3×10 s • Pelvic bridging: 3×1
• Piriformis stretch: 3×15 s per leg • Partial crunches: 3×15
• Hamstring stretch: 3×20 s per leg • Side-lying leg raises: 3×12 per leg
• Cat–Camel: 10 slow reps • Wall squats: 8–10 reps, 10 s hold
• Child’s Pose: 3×30 s
Functional Progress & Prognosis
VAS reduced to 3/10 within 2 weeks
Improved ROM and strength (MMT 5/5)
SLR improved to 60° bilaterally
Able to perform ADLs with reduced pain
Summary
Degenerative Accurate Multimodal Education and
changes affect assessment + therapy shows home plan
function and imaging significant essential for
quality of life critical improvement long-term
success
Movement is Medicine
“Movement is medicine. Let’s restore it.”
Thank You /
Q&A
Thank you for your attention. We are now open for any questions you may
have regarding the patient's case, treatment plan, or any other related
inquiries.
