Spondylarthrosis

The Spondylarthrosis is one of the most common diseases of the spine, which can usually be traced back to degenerative processes. Elderly people in particular are affected by spondylarthrosis.

What is spondylarthrosis?

The symptoms of spondylarthrosis are primarily back pain. Their localization and the appearance of other symptoms depend on which section of the spine is affected by the disease.
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As Spondylarthrosis (also Facet joint arthrosis) are degenerative (wear-related) changes in the small vertebral joints (facet joints), which can occur as a secondary disease of further impairments of the spine (disc damage, erosive osteochondrosis) or as a primary disease.

In general, any section of the spine can be affected, but spondylarthrosis occurs in most cases in the area of ​​the lumbar vertebrae and manifests itself as a deep-seated axial back pain. With increasing wear and tear, the vertebral acid loses its ability to mechanically stabilize and compensate for stresses and strains on the vertebral joints.

As a result of long-term incorrect loading, abnormal movement sequences also occur, which result in impairment of the neighboring spinal column sections. Spondylarthrosis is often accompanied by sclerosis (calcification), the formation of marginal jagged edges in the affected vertebral joints and an increasing reduction in the joint space. Other typical concomitant diseases of spondylarthrosis are spinal stenosis and root compression syndrome.

causes

A Spondylarthrosis can be traced back to various causes. Various types of damage to the spine, such as injuries as a result of trauma or other diseases, can cause degenerative wear and tear on the small vertebral joints and lead to spondylarthrosis.

In particular, impairment of the functionality of the intervertebral discs (herniated or protruding discs) or the stabilizing straps as well as postural disorders (hyperlordosis) can cause instabilities and improper strain on the spine, which in turn leads to a lowering of the vertebral joints and thus a loss of stability.

To compensate for the overload, ossifications form on the vertebral joints, which also severely limit the flexibility of the spine. In addition, tumors, inflammatory diseases, generalized skeletal diseases (osteoporosis), chronic changes in the spine (scoliosis), rheumatic diseases and / or malformations of the spine can promote the manifestation of spondylarthrosis.

Symptoms, ailments & signs

The symptoms of spondylarthrosis are primarily back pain. Their localization and the appearance of other symptoms depend on which section of the spine is affected by the disease. Most commonly, the damage is to the lumbar spine, causing lower back pain that can spread to the buttocks and back of the thighs.

They are described as acutely shooting in and then slowly subsiding. The pain may also be felt in the abdomen and groin area. Some patients complain of a tingling sensation and a slight feeling of numbness that emanates from the back and also radiates. In the resting position, these complaints are reduced and can completely disappear again.

Mobility is also limited. When the lumbar spine is affected, it is difficult to bend down and tilt to one side. These movements are usually associated with pain and are only possible to a limited extent. With spondylarthrosis in the cervical spine, patients usually suffer from neck pain that can radiate into the arms. In addition, there is a headache.

Some sufferers complain of dizziness, ringing in their ears, and visual disturbances. Tingling is also noticeable here. Usually, all symptoms are temporary. Only in exceptional cases does the pain persist and develop into chronic back pain.

Diagnosis & course

A first suspicion of one Spondylarthrosis usually results from the pain symptoms. Since the locally occurring pain, which increases under load and can radiate into the buttocks and / or legs (pseudoradicular syndrome), is not disease-specific, further investigations are required to establish the diagnosis.

X-ray methods provide information about the compression of the affected bone areas that is characteristic of spondylarthrosis. The diagnosis is confirmed by further imaging diagnostic procedures such as computed tomography, in the context of which the bony changes can be shown more precisely. In the differential diagnosis, spondylarthrosis should be differentiated from certain inflammatory diseases (spondylodiscitis, spondylitis), spinal canal stenoses and spondylolisthesis.

Spondylarthrosis is not always associated with pain and both prognosis and course can vary from person to person. The disease is incurable and can only be treated symptomatically. However, in many cases the symptoms of spondylarthrosis can be reduced as part of conservative therapy, especially with consistent build-up of the back muscles.

Complications

In most cases, older people in particular suffer from the symptoms of spondylarthrosis. This leads to very severe back pain. In many cases, these pains also spread to the neighboring regions, so that pain can also occur in the neck or flanks.

The nerves in the back are also damaged, which can lead to paralysis or other sensory disorders. In most cases, the back pain occurs not only as stress pain, but also in the form of pain at rest during the night and can thus lead to insomnia. Furthermore, psychological complaints or depression can become noticeable.

The patients themselves suffer from significant restrictions in movement and thus in everyday life. In many cases, sporting activities are hardly possible either. Direct treatment of spondylarthrosis is unfortunately not possible. Those affected are dependent on various therapies that can alleviate the symptoms. However, in most cases there is not a complete healing. The spondylarthrosis usually does not affect the life expectancy of the person affected.

When should you go to the doctor?

Medical treatment is usually always necessary for spondylarthrosis. If left untreated, serious complications can occur, which in the worst case can also significantly reduce the life expectancy of the person affected. For this reason, spondylarthrosis should be examined and treated by a doctor as soon as the first complaints and symptoms appear. A doctor should be consulted if the person concerned is suffering from very severe back pain. In most cases, this pain occurs for no particular reason and does not go away on its own. They often radiate into the neighboring regions and have a very negative effect on the patient's quality of life.

Pain in the abdomen or abdomen together with numbness can also indicate spondylarthrosis and should also be examined by a doctor. Many patients also have visual problems or severe headaches. If these symptoms occur, a general practitioner can primarily be seen. The further treatment depends on the exact cause of the spondylarthrosis and is carried out by a specialist.

Treatment & Therapy

The therapeutic measures depend on one Spondylarthrosis to a large extent on the extent of wear and tear and the corresponding pain symptoms. Initially, physiotherapeutic (massages, gymnastic exercises to build up and strengthen the back muscles), electrotherapeutic (stimulation of muscle activity) and hydrotherapeutic (including Kneipp baths) and relaxation exercises are used.

Depending on the specific pain symptoms, additional drug therapy with pain plasters, non-steroidal anti-inflammatory drugs or muscle relaxants may be necessary. In addition, acupuncture, which is associated with significantly fewer side effects, can be used to treat pain. In the case of more pronounced pain, local infiltration or facet infiltration, in which crystalline cortisone is injected into the joint spaces, can be used to reduce the pain.

In addition, a cryoprobe can be used to freeze the nerves supplying the facet joints in a minimally invasive manner to temporarily relieve pain (facet denervation). The indication for a surgical intervention is generally cautious and only considered when all other measures are ineffective. Different surgical procedures are available depending on the severity of the disease.

For example, the spinal canal can be widened to reduce compression on the nerves in the affected area and thus reduce pain. Spondylodesis, in which the affected vertebral segments are stiffened, is another surgical procedure for spondylarthrosis.

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prevention

One Spondylarthrosis Like any other form of osteoarthritis, it can be prevented through regular exercise and sports such as running or swimming, whereby overloading the spine should be avoided. Obesity is another risk factor for spondylarthrosis, which is why any existing obesity should be treated as part of a therapy (exercise, change in diet).

Aftercare

In many cases, the measures of direct follow-up care for spondylarthrosis are severely limited, and some of those affected are not even available. Therefore, in spondylarthrosis, a doctor should be consulted at the first symptoms and signs of this disease in order to prevent the occurrence of other complications and complaints, as self-healing cannot occur.

Most of those affected are dependent on the measures of physiotherapy and physiotherapy. The person affected should repeat some of the exercises in their own home to accelerate the healing process. In many cases, massages are also required. The help of one's own family is also very important, as this can also prevent depression and other psychological upsets.

The disease itself does not reduce the patient's life expectancy. However, the further course of the spondylarthrosis is highly dependent on its severity, so that a general course cannot usually be given.