Spondylosis

Here is the basic anatomy of the spine to help provide education about all of the different structures and how our spine works.

The lumbar region the most commonly affected part of the spine because of the exposure to mechanical stress, however lumbar spondylosis is a complicated diagnosis.

The second most affected region is the neck, our necks move very frequently and can be subject to trauma and prolonged resting positions which may contribute towards the development of spondylosis in the neck.

Vertebrae  

There are 24 separate vertebrae in the back which are bones. They are divided into 3 sections known as the cervical, thoracic and lumbar spine and then 2 separate lower sections known as the sacrum and coccyx. Each bone is shaped slightly differently to provide a different role and function. The spine provides housing and protection for the spinal cord and nerve roots.  In spondylosis, the bones of the spine can become worn and develop osteophytes – this is the term used for jagged surfaces and spikes of bone, this limits movement and function.

Spinal Discs

These are fibro cartilage structures which sit between each of the bones in our spine. They allow multidirectional movement. They also provide shock absorption for the spine. Discs have high water content and a firm but flexible centre which allows the discs their unique movement range. The outside of the disc provides a firm structure to contain the flexible tissue, discs really are a unique piece of engineering.

Muscles

There multitude of muscles in the back which help the spine to move but also to further protect it. Deep muscles which are not visible help to stabilise and perform accessory movements are located along the length of the spine and across the spine. Larger more visible muscles at the surface such as the trapezius on the neck and upper back and latissimus dorsi sit over the surface of the back and cover a larger area.

Nerves

Nerves are the structures that operate our muscle and movement but also supply sensation and touch to our skin. The nerve roots exit from the vertebrae and then feed off through the body into their destinations.

Ligaments & Tendons

These are connective tissues which help join our body together. Tendons attach muscle to bone and are strong and elastic in nature which help to generate force and absorb load, as well as start muscle contraction. Ligaments are strong and elastic and attach bone to bone. Ligaments provide security and stability to structures.

Here are some statistics regarding spondylosis:

Roughly 84% of men and 74% of women have vertebral osteophytes – which are the small pieces of jagged bone which can develop when a smooth surface is lost, commonly at T9-10 and L3 levels.

Approximately 30% of men and 28% of women aged 55-64 years have lumbar osteophytes.

Approximately 20% of men and 22% of women aged 45-64 years have lumbar osteophytes.

There isn’t too much difference between male and female, an equal incidence of spondylosis is reported.

Studies from all over the world suggest no relation to lifestyle, height, weight, body mass, physical activity, diet or consumption of alcohol or nicotine – this would suggest it is more a typical product of ageing.

There isn’t a link between weight and body mass but interestingly, body fat levels have seen to show some correlation with increased spondylosis development. This again would suggest that extra weight without support of muscle tissue may place extra strain on the spine. Remember – muscle moves and helps us to function, fat does not aid movement.

As mentioned previously, spondylosis is not a diagnosis but more a term used to designate a collection of spinal issues, here are some of the symptoms and more specific issues that can be encountered:

Spinal stenosis

This is when the openings for nerve roots and spinal cord can become narrowed due to a build of excess bone / calcification which can lead to strangulation of the vital structures of the spine. Spinal stenosis sufferers usually report aching in the legs and nerve related symptoms when in standing or walking which resolve when sitting down.

Disc herniation

Although the discs are strong and stable, over time we can develop bulges or herniations in the discs. A lot of disc bulges will be asymptomatic and not provide an issue, however disc bulges that are larger in size or suffered with trauma can be particularly painful and can also compress nerves which will then either give upper limb symptoms if in the neck or lower limb symptoms if in the lower back. Disc herniations of the thoracic spine are rare.

Spondylolisthesis

This is when a section of the spine slips either forward or back. This will cause localised back pain but can also provide lower limb symptoms.

Lumbar Radiculopathy

This is a definition of back pain which includes lower limb symptoms. Other terms are sciatica and this is when the nerves of the lower back are compressed or aggravated, sending off pain, tingling or even producing numbness in to the lower limbs.

Stiffness / Loss of Movement

This is a more generalised symptom but a common issue with cervical spondylosis due to increased osteophyte development can be loss of range of movement and stiffness.

Physiotherapy

This is the first stop if you have symptoms relating to spondylosis. A good assessment from an experienced physiotherapist will help to gain further understanding and get a management plan for you to relieve symptoms. As part of spondylosis management treatment will be a key factor as the symptoms developed are typically loss of movement and stiffness in the spine. When the spine becomes stiff, muscles can become tight and this further adds to the restriction experienced.

An example physiotherapy session may consist of application of heat to relax muscles and reduce pain levels. Soft tissue therapy to help reduce tissue tension and improve the movement of certain joints and then application of spinal mobilisation techniques to reduce stiffness in the spine. Treatment for spondylosis should be gentle and gradual – if treating a problem which is stiff and painful, excessive manual therapy which is firm in nature could aggravate symptoms in the short term. An experienced therapist should know, due to this reason, manipulation should be avoided.

You should always be provided with exercises for spondylosis which you should perform regularly to help improve the spines movement. Performing exercises 2-3 x per day for short periods will improve stiffness and reduce pain.

Exercise

There isn’t one specific exercise which will help spondylosis. The key here is to just move as regularly as possible and do something you enjoy. Movement of all of your joints to their fullest whilst keeping your body strong will help to reduce the chances of severe spondylosis developing.

Exercises like yoga and Pilates will help you keep a good range of motion and become flexible and strong. Exercises such as strength training will help to support the spine and protect it.

Position Changes 

Our bodies can be subject to static positions for extended periods of time when we work or sit down to relax. As a rough guide, moving every 15-20 minutes to loosen off our necks, upper backs and lower backs will help to reduce spinal issues as we age.

This is important to remember if you work a full time desk job which could have you static for up to 8 hours per day, moving every hour is recommended, and take a walk on your lunch break.

One of the first lines of defence against arthritis, aside from exercise, is having a balanced diet. This can help to improve the way your body operates and reduce inflammatory type issues.

A diet which is high in sugar and processed foods can lead to weight gain and inflammation which are two factors that can aggravate and increase poor health in the body.

Supplementation is a great way to provide you with all of the things you need to get a full spectrum of vitamins and minerals in your diet to help combat poor health.

Curcumin

This is the active ingredient in Turmeric. Studies have shown that curcumin in large doses has an anti-inflammatory effect. For maximum effectiveness simply get a high strength tablet or capsule supplement. There are many available forms of turmeric supplementation, the most important aspect is the strength.

Vitamin D

We get our vitamin D from sunlight but unfortunately, modern lifestyles and weather (location dependent) do not guarantee our full daily allowance. A lack of vitamin D has been linked with arthritis, poor bone health and even hormonal issues. A year’s supply of high strength vitamin D3 in a capsule form is recommended and it is also very cheap.

Cod Liver Oil

Maintaining healthy joint surfaces imperative to avoiding arthritic pain. Cod liver oil has been shown to contribute towards healthy joints by preserving cartilage and lubricating joints. Fish oils are a popular health supplement and have been found to aid in the reduction of inflammation.

Glucosamine and Chondroitin

This joint preserving supplement may help with existing pain from arthritis. There have been findings in the research that it slows and prevents the breakdown of cartilage in order to preserve joints.

Collagen

Collagen is a vital protein made up of essential amino acids which are present in our body’s cartilage tissue. Collagen supplements are not suitable for vegetarians as they are derived from animals typically but you can get them in a variety of forms. Collagen protein powder and even coffee as well as capsule form.