Spondyloarthritis

Spondyloarthritis

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

What is spondyloarthritis?

Spondylarthrosis (also facet joint arthrosis ) describes degenerative (wear-related) changes in the small vertebral joints (facet joints), which can occur as a secondary disease of other impairments of the spine (intervertebral disc damage, erosive osteochondrosis) or as a primary disease. For claw hand overview, please visit homethodology.com.

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

As a result of permanent incorrect loading, there are also abnormal movement sequences that result in impairments of the adjacent sections of the spine. Spondylarthrosis is often accompanied by sclerosis (calcification), jagged edges in the affected vertebral joints and an increasing reduction in the joint space. Spinal canal stenosis and root compression syndrome are other typical comorbidities associated with spondyloarthritis.

Causes

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

In particular, impairments to the functionality of the intervertebral discs ( herniated discs, bulging discs) or the stabilizing ligaments as well as postural disorders ( hyperlordosis ) can cause instability and incorrect loading of the spine, which in turn result in 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 restrict the flexibility of the spine. In addition, tumors, inflammatory diseases, generalized skeletal diseases ( osteoporosis ), chronic changes in the spine ( scoliosis ), rheumatic diseases and/or deformities of the spine can promote the manifestation of spondylarthrosis.

Symptoms, Ailments & Signs

The symptoms of spondylarthrosis are primarily back pain. Their localization and the occurrence of other symptoms depend on which section of the spine is affected by the disease. The most common damage occurs in the lumbar spine, resulting in lower back pain that can radiate to the buttocks and hamstrings.

They are described as starting acutely and then slowly fading away. It can happen that the pain is also felt in the lower abdomen and groin area. Some patients complain of tingling and a slight numbness that starts in the back and also radiates. When you are at rest, these symptoms are reduced and can disappear completely.

Mobility is also limited. When the lumbar spine is affected, it is difficult to bend over and bend sideways. These movements are usually associated with pain and their execution is 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 of those affected complain of dizziness, ringing in the ears and blurred vision. Tingling is also noticeable here. Normally, all symptoms are only temporary. Only in exceptional cases does the pain persist and develop into chronic back pain.

Diagnosis & History

An initial suspicion of spondylarthrosis usually results from the pain symptoms. Since the locally occurring pain, which increases under exertion and can radiate into the buttocks and/or legs (pseudoradicular syndrome), is not disease-specific, further examinations are required to establish the diagnosis.

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

Spondylarthrosis is not always accompanied by pain and both the prognosis and the course can vary from person to person. The disease cannot be cured 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 causes very severe back pain. In many cases, this pain also spreads 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 disturbances. In most cases, the back pain occurs not only as stress pain, but also in the form of rest pain at night and can thus lead to insomnia. Mental health problems or depression can also make themselves felt.

The patients themselves suffer from significant limitations in movement and thus also in everyday life. Sporting activities are also hardly possible in many cases. Unfortunately, direct treatment of spondylarthrosis is not possible. Those affected are dependent on various therapies that can alleviate the symptoms. However, in most cases, complete healing does not occur. Spondylarthrosis usually does not affect the life expectancy of the person affected.

When should you go to the doctor?

Spondylarthrosis usually always requires medical treatment. 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 patient suffers from 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 stomach or abdomen together with numbness can also indicate spondylarthrosis and should also be examined by a doctor. Many patients also suffer from visual problems or severe headaches. If these symptoms occur, a general practitioner can be consulted in the first place. The further treatment then depends on the exact cause of the spondylarthrosis and is carried out by a specialist.

Treatment & Therapy

In the case of spondylarthrosis, the therapeutic measures depend 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) measures and relaxation exercises are used.

Depending on the specific pain symptoms present, 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 the 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, the nerves supplying the facet joints can be frozen with a cryoprobe in a minimally invasive manner to temporarily relieve pain (facet denervation). The indication for surgical intervention is generally made cautiously and only considered when all other measures have failed. Various surgical procedures are available depending on the severity of the disease.

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

Prevention

Like any other form of arthrosis, spondyloarthritis can be prevented by regular exercise and compensatory sports such as running or swimming, whereby overloading the spine should be avoided. Being overweight is another risk factor for spondylarthrosis, which is why obesity should be treated accordingly as part of therapy (exercise, change in diet).

Aftercare

In many cases, direct aftercare measures for spondylarthrosis are severely limited, and some of those affected may not even be able to use them at all. Therefore, in the case of 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, since self-healing cannot occur in this case.

Most of those affected are dependent on the measures of physiotherapy and physiotherapy. The person concerned should repeat some of the exercises at home to speed up 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 mental upsets.

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

Spondyloarthritis