Spondylosis & Stenosis

Spondylosis

Spondylosis is a condition where the bones that make up the spine (vertebrae) degenerate. Typically this degeneration forms bony projections (bone spurs) and reduces the height of the spongy discs between the vertebrae.

Spondylosis is often called spinal osteoarthritis. It can affect the neck (cervical spine), upper, mid and lower back (thoracic spine and lumbar spine). The most common area affected is that of the lumbar spine and cervical spine.

Causes

The causes of spondylosis are:

  • Age, which leads to wear and tear of spinal ligaments and bones
  • Weakened and degenerated intervertebral discs
  • Spinal cord injury
  • Genetic predisposition

Signs and Symptoms

The signs and symptoms of spondylosis include:

  • Back and neck pain due to nerve compression
  • Inflammation
  • Numbness and tingling of arms and legs
  • Muscle spasms
  • Sciatica (low back pain extending down the leg)

Sometimes, you may have spondylosis, but not show any symptoms.

Treatment

Treatment of spondylosis depends on the severity of symptoms.

Conservative therapy may include:

Medications

Self-care

You can use heat and/or ice therapy to lessen the pain. You can also use special cervical pillows to relieve neck pain while sleeping.

Exercises

Your therapist will teach you exercises to strengthen your back and stomach muscles. Regular walking and yoga will also help in relieving chronic back pain.

Adjunctive therapies

Acupuncture, which involves the insertion of very thin needles into the body, may be beneficial for back pain.
Chiropractic spinal manipulations can also be suggested to correct the spinal alignment and improve your body’s function.

Your doctor may suggest minimally invasive procedures such as steroid injection and radiofrequency denervation.

Steroids may be injected into facet joints (joints between adjacent vertebrae), epidural space (space around the spinal cord), or intervertebral disc spaces, to reduce acute pain and pain radiating into a limb.

Your doctor may also perform radiofrequency denervation technique, in which the nerves causing pain are detected and treated, to stop the transfer of pain messages.

Your doctor will suggest surgery if conservative treatment does not relieve pain from spondylosis. Spinal decompression surgery is a general term used for various procedures that are performed to relieve pressure on your nerves caused by compression.

Stenosis

Spinal stenosis is the compression of spinal nerves caused by narrowing of spinal canal and it is one of the common causes of low back pain. The symptoms includeback pain, burning or aching type of pain in buttocks that radiates to the legs (sciatica), weakness in the legs or "foot drop”. One of the causes for spinal stenosis is the ageing and other causes include Paget’s disease, achondroplasia, spinal tumors and spinal injuries. As age advances the chances of developing osteoarthritis, disc degeneration and thickening of ligaments may increase and these conditions cause spinal stenosis.

Spinal stenosis may be treated with conservative treatment approaches such as use of pain medications, physical therapy, steroid injections, or acupuncture. In chronic cases, surgery may be required to treat the condition.

Nonsurgical Treatment

  • Physical therapy: Physical Therapy involves stretching exercises, massage, and lumbar and abdominal strengthening.
  • Anti-inflammatory medications: Non steroidal anti-inflammatory drugs (NSAIDs) initially provide pain relief and also reduce swelling.
  • Steroid injections: Cortisone steroid injections are given around the nerves or in the "epidural space” to decrease swelling and pain.
  • Acupuncture: Acupuncture can be helpful in cases where the pain is less severe.
  • Chiropractic manipulation: Chiropractic manipulation can be done in some cases but not when there is co-existing osteoporosis or herniated disc because these cases increase the symptoms or cause injuries.

Surgical Treatment

Surgery is considered for patients in whom the pain and weakness is causing debilitation such as inability to walk for a long time. The two main surgical procedures to treat lumbar spinal stenosis are laminectomy and spinal fusion.

  • Laminectomy: This procedure involves removal of the bone, bone spurs, and ligaments that compress the nerves.
  • Spinal fusion: In this procedure, two or more vertebrae are permanently fused together.