LUMBAR SPONDYLOSIS

What is spondylosis?

Spondylosis is another word for osteoarthritis of the spine, a condition that usually develops with age, and is the result of normal “wear and tear” on both the soft structures and bones that make up the spine. Although any part of the spine may be affected, spondylosis is more frequently seen in the spine’s highest and lowest sections – the cervical (neck) and lumbar (low back) areas, respectively.because mobility is more at these joints . The condition is less commonly found in the thoracic spine (middle portion), possibly because the rib cage serves to stabilize this area and make it less subject to the effects of wear and tear over time.

Lumbar

lumbar spine is the lower back region of your spinal column or backbone. It consists of five bones (L1-L5). Other structures in or around your lumbar spine are your intervertebral disks, spinal cord and nerves, muscles, tendons and ligaments

lumbar Spondylosis

Lumbar spondylosis is a condition caused by degeneration of the lumbar disc or facet joints. It is a degenerative condition affecting discs, vertebral bodies, and associated joints of lumbar vertebrae. Spondylosis is a nearly universal condition in those who reach advanced age, but it can also affect younger people.

What are the symptoms of lumbar spondylosis?

Lumbar spondylosis can have many symptoms few of these symptoms are listed below:

1.   Pain in the back or low back pain
2.   Numbness
3.   Weakness in legs
4. Radiating pain in legs
5. Radialting pain from low back to buttocks
6. Radiating pain till feets
7.   radiating  pain in the lower back, and leg while standing and walking,
8.  Disc bulging. 

leg pain and/or other signs of nerve compression are the most common symptoms. Pain or tingling symptoms that extend outward to the hip or down the leg can result from compression or inflammation of nerves, a condition referred to as lumbar radiculopathy. For example, a person may have pain in their knee and think it is injured, but later learn that this pain is caused by spondylosis that is compressing a nerve which extends down to the knee.  Irritation of the sciatic nerve in particular, is quite common, and is commonly known as sciatica

What Are The Causes Of Lumbar Spondylosis?

There are many causes of lumbar spondylosis, some of them include:

·  Old-Age,

·  Heredity,

·  Back trauma,

·  Repetitive spine loading,

·  Repetitive movements which involved  bending, lifting, twisting, and ·   wrong posture

How is spondylosis different from spondylolisthesis?

Although the names sound similar, spondylolisthesis is a condition in which one of the vertebrae (the bones that make up the spine) has moved out of place – usually in a forward direction. While this is a distinct diagnosis, spondylolisthesis may occur as a result of spondylosis, which can cause other structures of the spine move out of their normal position.

Other conditions that may result from spondylosis include:

• spinal stenosis – a narrowing of the spinal canal
• degenerative scoliosis – a sideways curvature of the spine due to osteoarthritis
• degenerative disc disease – wear and tear of the disc space

Is spondylosis serious?

Because spondylosis can affect people in many different ways, there is no single answer to this question. Many cases of spondylosis are effectively treated with physical therapy and pain relief measures. However, more immediate care if the following symptoms, which are associated with pressure on the nerves, are present:

• weakness, including foot drop (difficulty lifting the toes and forefoot off the floor)
• bladder or bowel dysfunction, especially incontinence
• changes in balance that cannot be attributed to other factors
• numbness either in a stripe-like pattern or involving the fingers
• severe pain, especially electrical or shock like pain
• pain in the arms and/or legs that has not responded after attempting other nonsurgical measures and, oral pain medications and/or spinal injections

Diagnosis Of Lumbar Spondylosis.

Physical examination: Physical examination of the patient is done thoroughly followed by the following diagnostic tests.

Magnetic resonance imaging (MRI): Magnetic resonance imaging (MRI) is used to show a detailed image of the spine and visualize the degree of disc herniation.

X-rays: X-rays are used to show bone spurs on vertebral bodies in the spine, the thickening of intervertebral disc spaces, and the thickening of facet joints.

CT scan: CT scan helps to visualize a detailed image of the spine and also checks the narrowing of the spinal cord.

Single-photon emission computer tomography (SPECT): Single-photon emission computer tomography is used to evaluate patients with spondylosis.

What Is The Physiotherapy Treatment Of Lumbar Spondylosis?

Lumbar back support : Lumbar back support is beneficial for patients suffering from lumbar spondylosis. It helps to limit excessive spine movement and reduce mechanical forces. It also helps to stabilize and correct spine deformity.

Lumbar support : Lumbar support with the help of braces is used for stabilization, reducing mechanical forces, and limiting spine movement.

Cryotherapy : Cryotherapy is used as it reduces swelling and pain.

Thermotherapy : Thermotherapy is used to promote blood flow, decrease swelling, and remove toxins

 COMBINATION THERAPY-modality at sparsh

Exercise therapy : Exercise therapy includes muscle strengthening, muscle stretching, and aerobics exercises. The exercise programs vary in intensity, duration, and frequency.

Traction therapy : Traction therapy helps to relieve chronic back pain. It helps to open intervertebral space and decreases spine lordosis.

We always have different treatment  procedures depends upon the condition so we decide Other treatment procedures after assessment .

Manual Therapy Techniques

Massage therapy : Massage therapy helps to decrease pain and swelling, breaks adhesions, and increases blood circulation.

Transcutaneous electrical stimulation (TENS): Transcutaneous electrical stimulation (TENS) gives immediate relief from pain.

Interferential therapy: Interferential therapy is used to decrease pain and inflammation.

Laser therapy : to enhance the healing process

• decreasing pain
• increasing mobility.

Kinesio-taping :

• To relieve pain in the lower back.
• To improve the range of motion
• To correct bad posture.

Strengthening exercises : Strengthening exercises are done to strengthen back and core muscles which help to support the low back.

Stretching exercises : Stretching exercises are done

• to improve the flexibility
• to increase pain-free range of motion of the back muscles.

Balance exercises : Balance exercises are taught for awareness to show the proper posture of the back while moving during various activities.

McKenzie exercises : McKenzie’s exercises focus on extension and help to prevent further degeneration of the lumbar spine

Treatment Of Lumbar Spondylosis other than physiotherapy

Medication : NSAIDS (Non- steroidal anti-inflammatory drugs), Opioid, Antidepressants, Muscle Relaxants, Epidural steroid injections, lumbar facet joint injections, SI joint injections.

Note : Medication should not be taken without the doctor’s permission.

Surgical Management : Surgery may be recommended to arrest further neurological deficits and restore function. There are various decompression surgical options such as;

·Foraminotomy,

·Facetectomy,

·  Laminectomy,

·laminotomy, or discectomy.

Spinal fusion can also be used as a stabilization technique.

Patient Education.

• the lumbar problem
• ,how he/she can correct posture,
• ergonomics,
• appropriate back exercises.

 The patient is advised to avoid activities that aggravate his condition only for specific time during treatment Patients are also advised to assess and adjust ergonomic conditions that may have exacerbated their pain, for example sitting for a long hours  in wrong posture raising a computer monitor to eye level to eliminate the tendency to hunch forward while doing office work.