Spondylosis is a general medical term that is sometimes used by health care providers to refer to various forms of spinal degeneration that accompany the natural aging process. In some cases, physicians also use the term more specifically to describe the presence of spinal osteoarthritis. This age-related condition is characterized by the deterioration of the articular cartilage in the spinal facet joints. These joints, which are located between the individual vertebrae, serve an important function in providing the spine with essential range of motion, allowing it to bend, twist and flex. The articular cartilage, a smooth, rubbery tissue that covers the ends of the bones in the joints, reduces friction and helps the bones to glide smoothly over each other. When the cartilage breaks down, painful joint damage can occur.
Spondylosis causes and risk factors
In most cases, spondylosis results from the cumulative effects of ongoing wear and tear on the spine. However, there are a number of risk factors that can increase the likelihood that a person will develop spondylosis. These risk factors include obesity, genetic predisposition, a history of traumatic injuries and participation in high-impact sports.
Specifically, spondylosis occurs when the soft tissues in the spinal anatomy — the intervertebral discs, tendons, muscles, ligaments and cartilage that lines the facet joints — naturally deteriorate over time. For instance, the intervertebral discs, which are normally saturated with water, can become dehydrated and lose their effectiveness as vertebral cushions. The cartilage in the facet joints can gradually wear away, resulting in bone-on-bone contact. This friction can cause inflammation and trigger the body’s natural protective responses, including the production of smooth bony deposits (bone spurs or osteophytes) in the affected areas. Additionally, the muscles that support the spine can weaken, while ligaments and tendons can thicken, tighten and stiffen.
Some people experience more degenerative changes related to spondylosis than others, but most have at least some signs of spinal deterioration that are readily apparent in an X-ray, MRI or CT scan by the age of 40. These findings might include bulging or herniated discs, as well as bone spur formations or calcium deposits in the vertebrae affected by degeneration.
The spine consists of 33 vertebrae, 24 of which are individually stacked to create the cervical (neck), thoracic (mid-back) and lumbar (lower back) regions, while nine fused vertebrae make up the sacrum and coccyx (tailbone). Spondylosis, which can be diagnosed in the cervical, thoracic and lumbar regions, is often classified by its location:
- Cervical spondylosis — Affects the seven cervical vertebrae (C1-C7) that make up the neck region; deterioration is common is this area, mainly because the vertebrae are highly mobile and support the weight of the head
- Thoracic spondylosis — Affects the 12 thoracic vertebrae (T1-T12); deterioration in the middle back is relatively uncommon because the spine in this area is connected to and supported by the ribcage
- Lumbar spondylosis — Affects the five lumbar vertebrae (L1-L5); degeneration is prevalent in this area of the spine because the vertebrae in the lower back support the majority of the body’s weight and facilitate a wide range of motion
- Multilevel spondylosis — Affects the spinal components in more than one region
Common spondylosis symptoms
Spondylosis does not always produce symptoms. In fact, the condition typically goes undetected unless the facet joints become painfully stiff or the spinal cord or an exiting nerve root is irritated or compressed by a bone spur or displaced disc material.
When caused by nerve compression, spondylosis symptoms can vary based on the severity and location of the neural pressure. For instance, a compressed nerve in the cervical (neck) region can produce symptoms in the upper back, shoulders, arms, hands and fingers. On the other hand, if the sciatic nerve in the lumbar region is compressed, radiating symptoms may be felt throughout the lower back, buttocks, legs, feet and toes. Independent of location, some of the most common general spondylosis symptoms include:
- Localized pain in the affected area of the neck or back
- Numbness or loss of sensation
- Muscle weakness
- Traveling pain, numbness and tingling
When caused by spinal osteoarthritis, spondylosis symptoms are usually associated with neck and back movements and exhibit as:
- Facet joint or muscle stiffness
- Localized aching in the neck or back
- Reduced range of motion in the spine
These symptoms are often worse in the morning or after a patient wakes up, but it’s common for them to improve slightly as the patient gets out of bed and starts to move about. Some patients also have difficulties standing up or develop a “hunched” posture.
Most patients are able to find sufficient relief from their spondylosis symptoms by using one or more conservative treatments. Rather than addressing the underlying cause of the symptoms, conservative treatments are designed to manage discomfort. For this purpose, over-the-counter and prescription medications can be very effective.
Some medications that are often recommended by physicians to relieve spondylosis symptoms include:
- Over-the-counter pain relievers such as acetaminophen, which can relieve pain (but do not address inflammation)
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, which can reduce inflammation that is causing pain
- Prescription pain relievers, which can address severe pain that does not respond sufficiently to over-the-counter medications
- Epidural steroid injections, which can reduce severe inflammation around a compressed nerve root while temporarily numbing the area
Because a patient with spondylosis symptoms is usually experiencing discomfort and probably would prefer to rest, engaging in physical activity and exercising might seem a bit counterintuitive. However, a physical therapist can recommend a regimen of targeted stretches and exercises, which can be very beneficial in enhancing the strength and flexibility of the spine and its supporting muscles. This, in turn, can facilitate a greater range of motion and healing. Some patients also find relief through alternative treatments like yoga and acupuncture. Of course, one or two days of taking it easy is generally acceptable if pain prohibits regular activity, but a patient should keep in mind that remaining inactive for too long can actually be harmful, possibly resulting in decreased circulation, joint stiffening and blood clots.
Surgery for spondylosis
If spondylosis symptoms are debilitating or persist after several weeks or months of conservative treatment, surgery may be recommended. However, patients who are considering surgical intervention should be aware that a highly invasive open spine procedure is not the only avenue to relief. Some patients are candidates for the advanced minimally invasive alternatives that have been perfected by the surgeons at Laser Spine Institute. Our skilled surgeons perform these procedures on an outpatient basis, so most of our patients are able to go home within hours of their surgery.
Contact Laser Spine Institute to find out how our minimally invasive procedures have helped many patients find meaningful relief from the symptoms of spondylosis.