The Spondylosis , Also known as Degenerative Disc Disease, osteoarthritis or vertebral arthritis is a degenerative condition, that is, with progressive deterioration of irreversible consequences.
This pathology is characterized mainly by the wear of the discs that are between the vertebrae of the column. Such loss of volume causes episodes of pain or even ongoing pain that can become disabling.
The vertebral discs are formed by a fibrous ring and a nucleus pulposus. They are those that support the column by providing natural cushioning to maintain different postures, allow movement and decrease the impacts caused by displacement and activities as simple as changing posture.
Types of spondylosis according to the zone
All intervertebral discs suffer wear throughout life, therefore, spondylosis can be named according to the area in which it occurs:
Cervical spondylosis (for the cervical vertebrae) C1 to C7
It is characterized by headache, shoulders and neck, being a common suffering of athletes and gymnasts who endure more stress in this area. If degeneration results in the understanding of the cervical nerves, it is called cervical myelopathy, with the most common symptoms being:
- Numbness of muscles around the area.
- Decreased reflexes.
- Difficulty walking.
- Muscle spasms.
- Loss of control of urination and bowel movement.
Thoracic spondylosis for the thoracic vertebrae (T1 to T12)
These vertebrae rarely show wear and tear, since the chest is designed to provide protection to the vital viscera that it houses, such as the heart, lungs and liver, so this area of the spine does not carry much weight.
The anomalies discovered in this area are due mainly to age, poor posture, cosmetic surgeries with breast volume greater than anatomically recommended, continuous use of a computer or heavy work.
Lumbar spondylosis (for the lumbar vertebrae) L1 to L5
Symptoms in this area are not predominant, although the vertebrae support most of the body weight, patients diagnosed with lumbar spondylosis do not present symptoms for this pathology and are discovered when doing general tests for other conditions.
Most of the pains in this area have other origins, even when disc wear is demonstrated.
Of the few cases diagnosed for lumbar spondylosis, more than 60% are women. Apparently this wear is directly related to the gestation period, since it is this area that supports the weight of the product.
In general the first structures to wear out are the cervical intervertebral discs and then the lumbar discs.
The wear is nothing more than the loss of turgor and volume of the intervertebral discs, which causes the vertebrae to approach one another, often in unnatural positions. Over time, aging and normal human movements, this situation is aggravated.
Each movement of the body causes vibrations that can affect the spine when the wear of these structures is severe, since the spine is the main protection of the bone marrow and spinal nerves.
The spinal nerves originate in the bone marrow and innervate the whole body, allowing the nerve impulses to effect movements reach each corner. In addition, they can also receive stimuli that later travel in the opposite direction, with the objective of bringing information from the sensations to the brain .
Predisposing factors for spondylosis
Spondylosis is a process that occurs with aging, so it is an insurmountable reality.
Throughout life, the body is exposed to stress and pain that cause changes in the spine. These changes modify other structures and the latter in turn to others, which causes a chain-worn reaction. Among the main causes of this suffering are:
Age
During development, growth and adult life, the bones are de-calcified and dehydrated, losing volume and firmness.
The aging process can lead to bone loss of up to 30%, in addition to demineralization, calcification of the discs, loss of elasticity of the ligaments and functions of the joints.
Bone growth
As the discs wear out, the spine is increasingly exposed to sudden movements, so the body tries to compensate for this situation by allowing calcifications and bone growth to provide stability. Unfortunately, these new structures can compress or injure a nerve and aggravate the situation.
Bad nutrition
As mentioned earlier, decalcification is a major factor in spondylosis, and during pregnancy a woman may lose the most bone mass by not having a supply of minerals suitable for the formation of the baby.
Added to this is the decalcification and demineralization caused by lactation and the number of pregnancies that a woman has during her reproductive life.
Genetic predisposition
It is possible to have predisposition to this condition, so it is important to know if a family member suffers or suffered from this disease.
Habits
Smoking can cause or accelerate disc wear. It is known that Smoking Causes dehydration of the discs, which causes an accelerated loss of the damping cartilage.
He alcoholism And the little resting prevalent in the present time, have allowed to be diagnosed a greater number of cases in ages more and more earlier.
Injuries
Symptoms of spondylosis can occur in a range of age from 20 to 50 years. However, it is estimated that about 30% of the population suffering from it is asymptomatic, so they only discover it when they are examined for other diseases, most of them being impact injuries suffered during accidents.
Some studies conclude that there is a relationship between the increase in the speed of motor transport and this disease, and that a large percentage of patients who suffered car accidents showed a degeneration at an early age.
The loss of natural curvatures is considered a predisposing element to spondylosis.
In the following image we can see the degenerative progression of spondylosis.
The first image shows the normal thickness of the discs, the second a slight loss of volume and the third an ankylosing spondylosis in which there is already ossification and settlement of the vertebrae.
According to statistics, spondylosis can progress to a stage of disabling pain in the range of 1 to 7 years.
symptom
Pain in areas near the worn out area, caused by stenosis of the duct through which the nerve roots of the bone marrow or compression of a nerve in certain positions or during prolonged activity.
Even if the stenosis or nervous compression is not present, the inflammation or hernia of the intervertebral discs can provoke headache , Back pain or immobility of the affected area, which causes muscle spasms and a crisis of pain.
In some cases, the compression of a nerve root can cause pain in the extremities innervated by it, which is known as radiculopathy.
Radiculopathy can also cause limb cramps and numbness or even loss of sensation. When a radiculopathy not only damages a nerve root, but also the spinal cord , Is known as myelopathy.
Diagnosis
Diagnosis of severe spondylosis can be made by an X-ray, as wear or disc herniation will be easily visible. On the contrary, mild spondylosis can only be diagnosed by a Magnetic resonance or Computed Axial Tomography , In which a doctor or specialist can define if the wear of the discs is the cause of the pain.
When to seek medical help
- When pain is not treatable with light treatment.
- Weakness in one or more extremities
- Loss of control of urination or bowel movement.
- Loss of sensitivity in the genitals.
- Pain in the back or neck associated with weight loss or fever greater than 37.5 ° C.
Treatment
Treatment for spondylosis includes:
- Analgesics and anti-inflammatories.
- Rehabilitation therapy.
- Treatments to lose weight.
- Acupuncture.
- Surgery.
- Change of habits.
Prevention
- Maintain good posture when sitting or standing.
- Do not lift heavy objects or do it properly.
- Keep a healthy weight.
- Do not smoke or drink too much alcohol.
- Exercise periodically.
- Eat healthy .
Disease Statistics
As we can see in the picture above, all humans are prone to spondylosis, although the odds of presenting characteristic symptoms increase between 40 and 60 years, being more frequent in men than women.
This is due to the type of activities normally performed by each gender since, despite the fact that equality is now considered a premise, it is still the male population that usually perform jobs that entail greater physical wear and tear.
The following graph shows the time of disease before diagnosis, in the data we can see that most of the population is diagnosed between the first and fourth year of suffering.
From the above we assume that the main symptom was pain and that most patients in these ranges could not continue their daily activities because of this, which led them to seek medical treatment.
Rehabilitation
Treatment for spondylosis rarely becomes surgical, as these procedures are of high risk and most of the results are comparable to the physical therapies administered as an alternative.
People with spondylosis should take the following physical recommendations into account:
Maintain or increase joint movement
In this way the calcification of the joints is avoided, avoiding the reduction of the movement that leads to the sedentarism and this to increase the calcification, which becomes a vicious circle appreciable in the adults as they advance in age.
Do stretching to stretch muscles
He stress Of current life is reflected in conditions such as gastritis and continuous muscle tension, which causes contractures that change the body's natural posture, it is also necessary to reduce the use of computers or purchase office equipment appropriate to the physical characteristics of each individual.
Maintaining a balanced diet
Weight gain causes an increase in the load on the vertebrae, so it is recommended to minimize overweight.
Exercise the muscles of the back to favor the posture
Consult with a physiotherapist or specialist to know exercises that facilitate the maintenance of healthy posture or accessories such as girdles or supports customized to the needs and level of spondylosis of each individual.
Increase area circulation to increase recovery process
Treatments with suction cups and temperature changes have proven to be efficient for spondylosis, since relaxing the back muscles will favor their natural curvatures.
Acupuncture
Within alternative medicine we find that treatments with acupuncture have been shown to cause an improvement in the pain of patients, however it is still debated whether the benefit has psychological causes, such as placebos, or physical.
Surgery
Laminectomy
A little recommended treatment. It is indicated in patients with disabling pain not treatable with drugs or in danger of being cut in a nerve or spinal cord.
The risk of surgery is justified by the possibility of a Paresthesia Which, unfortunately, will not allow the patient to increase his quality of life.
Surgery consists of increasing the size of the spinal canal to provide more space to the spinal cord and nerve roots, in order to avoid a marrow section or reduce the pain of compression to a minimum.
Replacing discs
The intervertebral disc replacement procedure is experimental and there are still no conclusive results.
It consists, as its name says, of replacing the disc worn by a prosthesis with the natural consistency of the disc, allowing the decompression and avoiding the domino effect that normally appears with these deformations.
References
- Are There Home Remedies for Spondylosis? Excerpted from emedicinehealth.com.
- What Is Spondylosis? Excerpted from nspineuniverse.com.
- Lumbar Spondylosis. Excerpted from emedicine.medscape.com.
- Cervical Osteoarthritis (Cervical Spondylosis) Extracted from webmd.com.
- Spondylosis (Spine Arthritis) Excerpted from physioworks.com.au.
- Surgery for degenerative lumbar spondylosis. Extracted from cochrane.org.