Lumbar Spondylosis
Lumbar spondylosis is when natural aging and gradual deterioration process of the spine occurs. It’s normally caused by the development of arthritis in the spine that causes the discs and vertebrae to gradually wear down over time. Very few people actually experience chronic symptoms even though most people have some form of spondylosis later in life.
This condition is normally associated with several other spine conditions. This condition can normally lead to other spine conditions like herniated discs, spinal stenosis and bone spurs. If you start to notice other symptoms such as chronic pain and difficulty twisting or bending, it’s important to consult your physician to determine if you’ve developed a different spine condition.
The lumbar region is the lower back portion of the spine. It supports and stabilizes the majority of the body’s weight. The vertebrae becomes compressed and places pressure on the discs and joints as the body undergoes repetitive lifting and twisting motions, accompanied usually by weight gain over time.
This condition affects the lumbar vertebra in the lower back. It is characterized by the formation of small bony prominences called osteophytes that compress the nerve fibers.
What Causes Lumbar Spondylosis?
It’s mainly caused by ageing. Certain biological and chemical changes cause tissues throughout the body to degenerate as people age.
Though it can occur in people who are obese and those who smoke and have limited physical activity, it is a typical change that is associated with ageing.
The vertebrae and intervertebral discs degenerate with ageing in the spine. These discs are cushion like structures that act as shock absorbers between the vertebral bones.
One of the structures that form the discs is called annulus fibrosus. It is made up of the 60 or more tough circular bands of collagen fiber (lamellae). Collagen fibers along with water and proteoglycans form the soft, gel-like center part of each disk. The center part is known as the nucleus pulposus and is surrounded by the annulus fibrosus.
Risk factors for developing lumbar spondylosis
- Age: The healing ability of the body decreases as people age and developing arthritis at an older age can make the disease progress faster. People above 40 years of age are more prone to developing the condition.
- Obesity: puts excess load on the joints as the lumbar region carries most of the body’s weight. This makes the person more prone to the disease.
- Sitting for prolonged periods: Being seated in one position for a prolonged period of time puts pressure on the lumbar vertebrae.
- Prior injury: Trauma makes a person more susceptible to developing this condition.
- Family history: This condition may be inherited.
SYMPTOMS OF LUMBAR SPONDYLOSIS
Symptoms of lumbar spondylosis may be experienced by those associated with each of the various aspects of the disorder:
- Disc herniation
- Sciatica
- Spinal stenosis
- Degenerative spondylolisthesis
- Degenerative scoliosis
Pain experienced that’s associated with disc degeneration may be felt locally or the surrounding area in the back.. This is known as referred pain because the pain is not felt at the site of origin. Lower back arthritis may be experienced as pain in the buttock, hips, groin, and thighs. It’s important to be aware of any bowel or bladder incontinence or numbness in the perianal area. They could represent an important massive nerve compression needing surgical intervention.
TREATMENT OPTIONS AVAILABLE FOR LUMBAR SPONDYLOSIS
Effective pain relief can be found through conservative treatment methods by many patients. Conservative treatments are treatments that are non-surgical. The goal is to relieve pain by reducing the pressure placed on the vertebrae of the spine. The deteriorating joints near the vertebrae won’t compress against them and cause the growth of bone spurs or further joint deterioration if the vertebrae are lengthened and stretch,. Examples include yoga and stretches, physical therapy and chiropractic care.
Another type of conservative therapy is pain medication. They could come in the form of over-the-counter medication, prescription pain killers or steroid injections. It’s important to consult your physician before starting or changing a treatment plan. Most conservative therapies can be combined to treat your pain and symptoms more effectively.
You may want to consider a surgical treatment option if you have already tried several months of conservative therapy and have not noticed any decrease in your pain and symptoms. Surgery usually relieve pain by removing a portion of or the entire damaged component of the spine. This can be performed through a highly invasive traditional open back surgery or a minimally invasive spine surgery.
DIAGNOSING LUMBAR SPONDYLOSIS
Physical examination: Reveals the patient’s health and general fitness. It includes a review of the patient’s medical and family history. Lab tests such as a complete blood count and urinalysis are ordered. The physical exam may include:
- Palpation (exam by touch): To determine spinal abnormalities, areas of tenderness, and muscle spasm.
- Range of Motion: To measure the degree to which a patient can perform movement of flexion, extension, lateral bending and spinal rotation.
- Neurologic evaluation: To assess symptoms including pain, numbness, paresthesias (e.g. tingling), extremity sensation and motor function, muscle spasm, weakness and bowel/bladder changes. Particular attention may be given to the extremities. A CT Scan or MRI may be necessary if there’s evidence of neurologic dysfunction.
X-rays and Other Tests
- X-rays: May indicate a loss of vertebral disc height and the presence of osteophytes. However, it’s not as useful as a CT Scan or MRI.
- CT Scan: May help to reveal bony changes sometimes associated with spondylosis. MRI: A sensitive imaging tool capable of revealing disc, ligament, and nerve abnormalities.
- Discography: This seeks to reproduce the patient’s symptoms to identify the anatomical source of pain. This technique is considered controversial.
- Facet blocks: Work in a similar manner as Discography. Both of these techniques are considered controversial.
The patient’s symptoms are compared to the findings to formulate a diagnosis and treatment plan. The result will provide a baseline from which the physician can monitor and measure the patient’s progress.