Arthritis of the spine (spondylosis)
According to the charity Versus Arthritis, in 2021 over 8.5 million people in the U.K. were suffering with Osteoarthritis (OA). Arthritis of the spine, also known as Spondylosis, is one of the most common forms of arthritis that osteopathy can treat and manage.
So what is Spondylosis?
Spondy means spine and losis means problem. Spondylosis = a problem of the spine, specifically meaning arthritis in the spine. Injury to the intervertebral discs can occur, as well as the formation of bony spurs (osteophytes). Spondylosis it is characterised by neck pain, back pain and stiffness. This can be accompanied by nerve pain and an altered sensation such as pins and needles or numbness. This occurs when there is compression of neural structures. Spondylosis can affect all levels of the spine but notably the lumbar spine and cervical spine, which would present with lower back pain or neck pain.
What causes Spondylosis?
Spondylosis is a common ageing phenomenon which is often a direct result of wear and tear. It is likely to be common in most people after a certain age to varying degrees. Previous trauma to the spine, such as a disc bulge/herniation can lead to degeneration to the disc which results in arthritic changes to the rest of the spine. Repetitive activity/occupation can be associated with the progression of spondylosis. Genetic factors are also thought to influence osteophyte formation and disc degeneration
What happens to the spine?
Degeneration of the bones, intervertebral discs, and joints of the spine (see my blog on facet capsular irritation) causes joint spaces to narrow.
Intervertebral discs lose their ability to rehydrate as we age – this is partly why we lose height as we age.
Ligaments become laxer as structures of the spine move closer together (narrowing of the spinal canal), causing spinal instability.
This instability can lead to altered biomechanics and increased stress on vertebral bones and facet joints which is believed to influence the formation of bone growths.
These bone growths can pinch when compressed, as well as compress nerves, or disc tissue.
As the above structures approximate, this also results in the narrowing of the intervertebral foramina, where nerve roots pass through which can compress nerve roots.
Even if they are not large enough to directly pinch a nerve, bulging discs can cause local inflammation and cause the nerves in the spine to become more sensitive, increasing pain.
Clinical Presentation/characteristic
The location of these degenerate changes leads to regional tenderness and muscle spasm. Pain is often aggravated by movement. Patients suffering lumbar (lower back) spondylosis can have neurologic compression, which includes lower back pain, leg pain, numbness and altered sensation. Patients suffering with cervical (neck) spondylosis present with non-specific neck pain, vague pain and numbness into arms or loss of function. Non-specific headaches and dizziness starting at base of the skull. Symptoms may improve with sitting and lying down without compressing structures of the spine.
Treatment and intervention
***Treatment and intervention cannot reverse the arthritic changes of the spine. But it can help reduce symptoms and improve movement.
Tailored exercise is the most important intervention for almost every musculoskeletal condition, particularly chronic lower back or neck pain caused by spondylosis. A combination of aerobic exercise, muscle strengthening, and stretching exercises have been shown to be effective in the treatment of pain associated with the spine.
Osteopathic treatment is also effective and involves the use of manual therapy to manage spondylosis using mobilisation of joints, traction, and decompression of structures in the spine that reduces pain and improve mobility.
Symptoms sound familiar?
Get in touch to find out how Osteopathy can help you with your back/neck pain.
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Healthy lumbar spine