Mediscene

Spondylosis: All about that common pain

By Smriti Daniel

The staff at any Physiotherapy Unit will be well acquainted with patients who complain of spondylosis – the painful condition is a degenerative joint disease that is often the result of the natural wear and tear inflicted on the vertebrae of the spine over time. However, of late some doctors have begun to notice increasing numbers of young people being diagnosed with the condition.

The culprit? Bad posture and physically stressful jobs, says Chartered Physiotherapist Gopi Kitnasamy who speaks to Mediscene about the common causes of the condition, how to ease the pain with home remedies and lifestyle choices, and finally what distinguishes spondylosis from spondylitis.

Spondylosis: The degenerative joint disease

Unfortunately, this degenerative joint disease is a common one, reveals Mr. Kitnasamy. Reflecting time-related wear and tear on the vertebrae (bones) of the neck and back, it can cause significant discomfort and even limit mobility greatly. It can adversely affect the functioning of the cartilage. These pillow-like tissues are credited with easing movement. Placed between vertebrae, they cushion movement between the neck and back, but spondylosis can lead to abnormal growths on them known as burn spurs.

There are three types of spondylosis. Cervical spondylosis affects the cervical spine of the neck. Thoracic spondylosis affects the thoracic spine of the mid and upper back, and lumbar spondylosis affects the lumbar spine of the lower back.

Spotting the symptoms, receiving a diagnosis:

Pain in the neck and shoulder are among the first symptoms. A stiff neck that appears to grow progressively worse over time should be treated with caution. Accompanying this, patients often complain of pain radiating to the bottom of the skull or to the shoulder and down the arm which they often describe as ‘stabbing’ or ‘burning'. However, it need not always be dramatic, many patients complain of a dull aching sensation.

Along with pain, cervical spondylosis can be accompanied by parathesias (a sensation of tingling, prickliness or numbness) and muscle weakness in the neck, shoulders, arms and hands – described as having ‘numb, clumsy hands'. Unfortunately, the condition has no cure, says Mr. Kitnasamy, explaining that its progress can however be slowed down considerably with medication and physiotherapy.

Patients should take their treatment seriously – the damage done is often irreversible.
The degenerative changes in the spine of people with spondylosis can begin as early as 30 years of age, though for most symptoms will not arise until they are into their forties. Middle age is itself considered a risk factor for spondylosis, reveals Mr. Kitnasamy. In addition, a neck or back injury, a herniated disc, or spinal stenosis can also put you at greater risk.

To diagnose spondylosis, a thorough medical history is the first step. Your doctor is likely to put you through a complete physical and neurological examination, he explains, beginning with an evaluation of the flexibility of the neck and back. Your reflexes, ability to register sensation and pain, movement, balance, coordination, vision, and hearing are also examined. Imaging tests, such as X-rays, will help your physician determine how much damage, if any, there is to your joints.

In some cases, the spine can become painful as they put pressure on spinal nerves, and in some cases the spinal cord. This pressure often produces weakness, numbness and/or incontinence of either the bowels or the bladder.

Living with Spondylosis:

Treatment is usually conservative in nature, reveals Mr. Kitnasamy. Nonsteroidal anti-inflammatory drugs (NSAIDs) combined with different lifestyle choices have been proven to help. Surgery itself is considered only occasionally, in cases where the spondylosis is particularly severe. Treatment of cervical spondylosis must be aimed at relieving pain and irritation to spinal cord and nerves which is why it’s common to use a neck brace to immobilize the neck in acute stage, while cervical traction therapy and epidurals are also sometimes involved.

Some simple measures can make a life with spondylosis much easier to live. Both hot and cold compresses can offer relief, and along with medications can help you better manage pain. Mr. Kitnasamy recommends that those with spondylosis sleep on firm beds that are neither too hard nor too yielding. Do with or without a pillow, but create something in the shape of a roll that can be used to support your neck.

Those who are overweight will find that shedding a few kgs will ease some of the stress and discomfort. With the help of a therapist, you can find ways to correct your posture and exercises that help you limber up. These exercises will be aimed at helping you improve mobility while simultaneously stretching soft tissues and strengthening the muscles surrounding the spine.

Spondylosis vs. Spondylitis:

Also known as Spondyloarthritis or Spondyloarthropathy, Spondylitis is the name given to a group of chronic or long lasting diseases. Forms of inflammatory arthritis that primarily affect the spine, these can also affect the joints and organs. The best known in the the group of diseases in the spondylitis family is Ankylosing Spondylitis (AS).

Found primarily in young adults it causes inflammation of the spinal joints that can lead to severe, chronic pain and discomfort. The problem with detecting the condition is the fact that it develops silently, coming into prominence once the condition has fully developed – at which time the amount of pain and suffering it causes can be significant.

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