What is spondylosis?
Spondylosis is a wearing down or degeneration of the spine caused by wear and tear on the joints. Deterioration most frequently involves the cartilage and bones in either the cervical spine (joints of the neck), sometimes referred to as cervical spondylosis, or the lumbar spine, sometimes referred to as lumbar degenerative disc disease. Spondylosis can also affect the middle section of the spine, called the thoracic spine.
Degeneration of the spine is most commonly caused by normal wear and tear, which is why it is far more common for people over age 60 to have symptoms of spondylosis. However, degeneration can begin as early as age 30, and there are many cases of lumbar symptoms appearing by age 40. This degeneration can be associated with several other phenomena, such as spinal stenosis (abnormal narrowing of the spinal canal), osteoarthritis of the spinal joints, or degenerative disc disease, in which the disc dries out (becomes dehydrated) and loses functionality.
Spondylosis cannot be cured, but pain management and physical therapy, and in some cases surgery, can improve your mobility and comfort.
Spondylosis is not life threatening, but in some cases it can lead to nerve damage that can be debilitating. Seek immediate medical care (call 911) for serious symptoms of nerve compression, such as loss of sensation in the limbs or shoulders, a complete loss of balance, or loss of bladder or bowel control. Also seek immediate care for serious symptoms, such as abnormal sensations or sudden weakness or numbness on one side of the body, paralysis, and changes in level of consciousness.
Seek prompt medical care if you are being treated for spondylosis but mild symptoms recur or are persistent.
What are the symptoms of spondylosis?
Symptoms of spondylosis include spinal pain and stiffness in the back or neck that gets worse over time, occasional headaches, and, in some cases, pain in your shoulders and arms. This pain can sometimes be quite severe.
If a nerve is compressed, you may also feel tingling or other abnormal sensations in the shoulders, arms or legs. You may also experience weakness in the arms and legs, loss of sensation, loss of balance, and loss of bladder or bowel control.
Common symptoms of spondylosis
You may experience spondylosis symptoms daily or just once in a while. At times any of these symptoms can be severe:
- Back or neck pain that may or may not radiate to the limbs
- “Foot drop” (foot involuntarily slapping the ground; caused by leg weakness)
- Headache (especially with cervical spondylosis)
- Herniated disc
- Muscle spasms
- Neck pain and stiffness (in cervical spondylosis)
- Nerve problems that cause pain, numbness or tingling in the arms, shoulders or legs
Symptoms that might indicate a serious condition
In some cases, spondylosis can be a serious condition that should be immediately evaluated in an emergency setting. Its symptoms may also mimic those of stroke or other serious conditions . Seek immediate medical care if you, or someone you are with, have any of these serious symptoms of nerve compression including:
- Abnormal sensations, numbness, or weakness on one side of the body
- Impaired balance and coordination
- Loss of bladder or bowel control
- Loss of sensation in the arms, shoulders or legs
- Muscle weakness in the arms or legs
What causes spondylosis?
The most frequent cause of spondylosis is a natural degeneration of the cartilage and bones of the spine as a result of excessive wear and tear, which is nearly always a natural result of aging. Extreme athletics can exacerbate this degeneration, but in nearly all cases wear and tear over the years is the cause. Over time, the discs become dehydrated and lose the ability to act as cushions between spinal bones. The painful grating of bone against bone often causes the bones to develop growths called bone spurs to replace the missing cartilage. These bone spurs can press on the spinal cord, causing painful or debilitating nerve compression.
Common causes of spondylosis
Common causes of spondylosis include:
Because wear and tear on the spine due to aging is the major risk factor for spondylosis, most people over the age of 60 will suffer from some disc degeneration or damage. Risk factors for spondylosis include:
- Advancing age
- Past injury to the spine or neck
How is spondylosis treated?
Spondylosis is not curable, but in many cases the symptoms may decrease or stabilize on their own. Treatment is aimed at relieving pain to help you participate in as many of your normal activities as possible, and occasionally surgical treatment may be required to prevent permanent nerve or spinal cord damage.
You may be prescribed a round of physical therapy or a short course of a painkiller or muscle relaxant. Surgery is only required if conservative treatments fail or if you have worsening signs of nerve compression.
Traditional short-course pain medications for spondylosis
The most common short-course pain medications for spondylosis include:
- Celecoxib (Celebrex)
- Diclofenac (Voltaren)
- Hydrocodone (Vicodin, Lortab)
- Ibuprofen (Advil, Motrin)
- Indomethacin (Indocin, Indocin SR)
- Naproxen (Aleve, Naprosyn)
- Oxycodone (Percocet, Roxicet)
Your medical practitioner may prescribe a muscle relaxant instead of a traditional pain relieving medication. These include:
- Carisoprodol (Soma, Vanadom)
- Cyclobenzaprine (Fexmid, Flexeril)
- Methocarbamol (Robaxin)
Nerve pain medications
Some medications focus specifically on nerve pain and include:
Other drugs for chronic pain
In addition to NSAIDs and muscle relaxants, several other specific drugs have been found particularly effective for chronic pain and include:
- Carbamazepine (Carbatrol, Equetro, Tegretol)
- Phenytoin (Dilantin, Phenytek, Di-Phen)
Nonsurgical pain interventions
In cases of uncontrolled pain, steroid and anesthetic delivery procedures can help relieve chronic pain without requiring surgery. These procedures include:
- Corticosteroid injection, usually cortisone (Celestone, Kenalog)
- Neck brace or lumbar orthopedic device
- Physical therapy
- Traction (in severe cases)
In cases of uncontrolled pain, loss of movement, loss of sensation, or loss of bladder or bowel control, surgery to take pressure off spinal nerves or the spinal cord may be immediately necessary.
What you can do to improve your spondylosis
In addition to following your treatment regimen as prescribed by your medical practitioner, you may also be able to reduce your pain and increase mobility by:
- Applying ice or heat
- Attending physical therapy as recommended
- Practicing exercises as advised by your medical practitioner
- Taking all of your medications as prescribed
- Wearing a cervical collar (in some cases)
Some complementary treatments may help some people to better deal with spondylosis. These treatments, sometimes referred to as alternative therapies, are used in conjunction with traditional medical treatments. Complementary treatments are not meant to substitute for traditional medical care. Be sure to notify your doctor if you are consuming nutritional supplements or homeopathic (nonprescription) remedies as they may interact with the prescribed medical therapy.
Complementary treatments may include:
- Massage therapy
- Nutritional dietary supplements, herbal remedies, tea beverages, and similar products
Complications of untreated or poorly controlled spondylosis can be serious. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of spondylosis include:
- Adverse effects of treatment
- Chronic, debilitating pain
- Diminished overall quality of life
- Fecal incontinence
- Inability to participate in work or recreational activities
- Permanent disability (rare)
- Progression of symptoms
- Urinary incontinence