Spondylosis (Spinal Arthritis): Reduce Back and Neck Pain

The structural components of the spine affected by spondylosis include the intervertebral discs, facet joints, and ligaments. As biochemical changes occur, collagen - a key structural component of the intervertebral disc - is affected by the loss of water content. Discs may weaken and wear out causing a reduction in disc height and an increase in the risk for disc bulging and herniation.

The loss of disc height affects the function of the facet joints. As the facet joints degenerate, the cartilage covering joint surfaces erodes. In an effort to repair itself, the body forms bone spurs (osteophytes). Joints enlarge (called hypertrophy) causing osteoarthritis or degenerative joint disease. Degenerative changes in the spine also cause the spine's ligaments to thicken and lose some strength.

Typical Symptoms
Pain (e.g. low back pain) is a common symptom and sometimes pain radiates from one area into another. For example, in cervical spondylosis - pain may spread from the neck into the shoulder or arm. Headaches at the back of head may develop and some patients report a loss of balance. Bone spurs may cause nerve compression leading to neurologic dysfunction such as extremity (arm, leg) weakness. Morning stiffness is another common symptom. Sitting and activities associated with manual labor (repetitive movements) may aggravate pain.

Untypical/Rare Symptoms
In rare situations, cervical osteophytes may make swallowing difficult. If the spinal cord is compressed, the patient may experience a loss of bladder or bowel control. If any of these symptoms develop, contact your physician immediately.

Treatment Goals
Most cases of spondylosis are mild and require little if any treatment. In more aggressive forms of the disease, especially in the cervical spine, the goal of treatment is to relieve pain and prevent spinal cord and nerve root injury. The more common non-surgical treatments are summarized below.

Acupuncture Acupuncture is a popular treatment used to help alleviate back and neck pain. Tiny needles, about the size of a human hair, are inserted into specific points on the body. Each needle may be twirled, electrically stimulated, or warmed to enhance the effect of the treatment. It is believed that acupuncture works (in part) by prompting the body to produce chemicals that help to reduce pain.

Bed Rest
Severe cases of spondylosis may require bed rest for no more than 1-3 days. Long-term bed rest is avoided as it puts patient at risk for deep vein thrombosis (DVT, blood clots in the legs).

Brace Use Temporary bracing (1 week) may help relieve symptoms, but long-term use is discouraged. Braces worn long-term weaken the spinal muscles and can increase pain if not constantly worn. Physical therapy is more beneficial as it strengthens the muscles.