Understanding Spondylosis VS Spondylitis
After back pain, neck pain is the second most common musculoskeletal complaint reported by patients. Resultantly, we hear the terms Spondylosis and Spondylitis most often from our patients as the cause of their back pain and neck pain. Sometimes people even use spondylitis and spondylosis interchangeably without understanding the difference and thereby the treatment involved to manage these spine conditions.
In this article, the spine Physiotherapists from ReLiva attempt to help you understand Spondylosis and Spondylitis, the difference between the two in terms of the symptoms, causes and treatment.
Overtime, the spine's strength and structure begin to deteriorate as a result of many years of wear and tear. The spine is susceptible to degenerative changes because :
- It bears the weight of the upper body
- It protects the spinal cord and
- It is constantly flexing / bending.
Spondylosis is a painful state of the spine resulting from degeneration of the intervertebral discs and spine related joints. Degenerative changes may occur in the cervical (neck), thoracic (mid back) and lumbar (lower back) spine and tend to worsen as an individual grows older. Many people don't have symptoms until the degeneration of the spinal column causes a secondary complication. While spondylosis can't be cured, there are many advanced treatment options available to address the changes associated with this issue.
Sometimes referred to as ‘spondyloarthritis’, it is a form of inflammatory arthritis that commonly occurs in the spine, although it can affect other joints as well. When it develops within the spine, the vertebral column becomes extremely inflamed. Pain and other symptoms often result. Occasionally vertebral bones even fuse together, forming a highly rigid spine and causing limited mobility.
Men are more likely to develop spondylitis than women.
Symptoms typically begin appearing in early adulthood, with the loss of spinal flexibility and a hunched posture being two of the most prominent hallmarks. Spondylitis is treatable when accurately diagnosed and proactively addressed.
CHARACTERISTICS, SIGNS & SYMPTOMS:
- It is a blanket term for spinal and disc degeneration.
- It may or may not result from a definitive incident.
- It usually affects lower back, middle backor causes neck pain.
- It is commonly associated with
- Reduced vertebral heights.
- Herniated discs.
SYMPTOMS : A variety of symptoms may arise depending on the location, severity and nature of the underlying problem.
- Reduced spaces between vertebrae may cause pinched nerves. This will characterize with:
- Weakness in the affected area and associated limbs.
- Tingling and pins-and-needles sensations in the affected area and associated limbs.
- Limited range of motion.
- Stiffness in spinal joints.
- The feeling that bones are ‘grinding’ against one another.
- Typically does not result from a single definitive incident (trauma etc.).
- It involves inflammation in the spinal joints.
- It may cause stiffness and pain anywhere from the neck through the lower back and buttocks.
- It is commonly associated with
- Bony fusion, which may affect daily activities.
- Compression fractures.
- The most affected joints are the sacroiliac joints, followed by the hip and shoulder joints.
- The pain and symptoms may last for more than 3 months at a stretch.
SYMPTOMS : A variety of symptoms may arise depending on the location
- Discomfort that is worse in the morning or after long periods of inactivity.
- Gets better with movement and exercise.
- Progressive loss of spinal flexibility.
- Sensation of rigidity.
- Hunched or stooped posture.
- Other systemic features may include vision problems, eye inflammation, redness, swelling etc.
HOW TREATMENT DIFFERS:
Treatment for Spondylitis and a few helpful Tips:
Physiotherapy is an essential part in the treatment of Spondylitis. It aims to alleviate pain, increase spinal mobility and functional capacity, reduce morning stiffness, correct or prevent postural deformities, and improve the psychosocial status of the patients. All of these goals are achieved by:
- Exercise routines with postural correction to delay, and possibly stop the progression of the disease. Spinal extension exercises are the key component and should be done twice daily.
- Encouragement and support as self-worth in young patients understandably diminishes with the progression of postural deformity.
- Posture exercises with upper back hyperextension (performed with avoidance of lumbar hyperextension).
- Proper sleeping posture on a solid, flat bed without pillow.
- Frequent sleeping or lying in prone position.
- Education in self-management to discourage therapist dependence.
- Breathing exercises to increase or maintain rib cage excursion, as well as instruction in abdomino-thoracic breathing.
- Range of motion exercises for hips and knees to prevent flexion limitation and contractures.
- Periodic rest periods with avoidance of fatigue.
- Bracing or corseting (combined with exercises).
- Manual mobilization to improve chest expansion, posture and spinal mobility.
- Hydro / Aquatic therapy / Swimming: Warm water provides a relaxation effect to the tight musculature around the back. Buoyancy of water allows stretching to feel easier than on land. There is a reduction of pain while stretching/exercising as water provides shock absorption. It is easier to stay upright as effect of gravity is reduced in water. Effort required is reduced due to upward thrust of the water. In waist high water, body weight is half of what it would be on land.
- Aerobic exercises.
- Incentive spirometry.
- Inspiratory muscle training.
Treatment for Spondylosis and a few helpful Tips:
- Patient education: Educating the patient includes reviews of lumbar anatomy, explanations of the concept of posture, ergonomics and giving appropriate back exercises.
- Exercise therapy: Aerobic exercise, muscle strengthening, and stretching exercises. Core muscle strengthening exercises in particular, together with the strengthening of the gluteus maximus and flexibility training of the lumbar spine is an effective rehabilitation approach.
- Traction: The traction forces open the intervertebral space and decrease spine lordosis. This temporary spine realignment relieves (theoretical) mechanical stress, nerve compression, adhesions and disrupts pain signals.
- Manual therapy: Joint mobilizations, manipulations and soft tissue release techniques.
- TENS: Is a frequently used therapeutic modality to give an immediate reduction in pain symptoms following the therapy.
- Lumbar back support: To limit spine motion, stabilize, correct deformity and reduce mechanical forces.
- McKenzie exercises: Focuses on extension, and has promising results concerning the prevention of further degeneration of the lumbar spine.
Either of the 2 conditions is best dealt with, under the guidance of a physiotherapist.
At ReLiva, we want you to stay pain-free and get back to participating in the activities you enjoy as fast as possible. Get relief. Call +91 992099 1584 to speak to us today so we can connect you with a physiotherapy specialist in your area.
This article is contributed by Dr. Carol Johnson (PT). Dr Carol is a Masters in Musculoskeletal Physiotherapy. She is very popular among her patients for her positive demeanor and effective treatment. She can be found at one of the ReLiva clinics.