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Spondylarthrosis: Causes, Symptoms & Treatment
Spondylarthrosis is a degenerative condition affecting the small facet joints of the spine, causing back pain, stiffness, and reduced mobility.
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Spondylarthrosis is a degenerative condition affecting the small facet joints of the spine, causing back pain, stiffness, and reduced mobility.
What is Spondylarthrosis?
Spondylarthrosis is a degenerative joint disease affecting the small joints of the spine, known as facet joints or zygapophyseal joints. These joints connect the individual vertebrae and are responsible for the flexibility and stability of the spine. In spondylarthrosis, the protective cartilage covering these joints gradually breaks down, leading to pain, stiffness, and restricted movement. The condition can affect any segment of the spine, but most commonly involves the lumbar spine (lower back) and the cervical spine (neck).
Causes
Spondylarthrosis is primarily caused by age-related wear and tear. Additional contributing factors include:
- Age: The risk increases significantly after the age of 50.
- Poor posture and overuse: Long-term incorrect loading of the spine, such as poor sitting habits or heavy physical labor.
- Obesity: Excess body weight puts additional stress on the facet joints.
- Intervertebral disc degeneration: Disc wear or herniation alters the load distribution on the facet joints.
- Genetic predisposition: A familial tendency is well recognized.
- Physical inactivity: Weak back muscles increase joint strain.
Symptoms
Symptoms of spondylarthrosis tend to develop gradually and worsen over time. Common signs include:
- Back pain, especially in the morning or after periods of rest (start-up pain)
- Stiffness of the spine after waking up or prolonged sitting
- Improvement with movement but worsening with overexertion
- Radiating pain into the buttocks, thighs, or shoulders depending on the affected region
- Reduced range of motion, for example when bending or rotating the torso
- In advanced stages, possible nerve compression causing numbness or tingling in the arms or legs
Diagnosis
Spondylarthrosis is diagnosed using a combination of clinical and imaging methods:
- Physical examination: Assessment of mobility, pain points, and reflexes.
- X-ray: Reveals joint space narrowing, bone spurs (osteophytes), and sclerosis.
- Magnetic resonance imaging (MRI): Provides detailed visualization of cartilage, ligaments, and nerve structures.
- Computed tomography (CT): Offers precise information about bony changes.
- Blood tests: Used to exclude inflammatory conditions such as rheumatoid arthritis.
Treatment
Spondylarthrosis cannot be cured, as cartilage loss is irreversible. The goal of treatment is to relieve symptoms, maintain mobility, and slow disease progression.
Conservative Treatment
- Physiotherapy and exercise: Strengthening of back muscles and improvement of spinal flexibility.
- Heat therapy: Promotes blood circulation and relieves muscle tension.
- Pain medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or diclofenac for short-term pain relief.
- Injection therapy: Corticosteroid or hyaluronic acid injections directly into the facet joint can reduce pain and inflammation.
- Weight management: Reducing excess body weight to relieve joint pressure.
Interventional and Surgical Treatment
- Facet joint denervation (radiofrequency ablation): A minimally invasive procedure in which the pain-transmitting nerve fibers of the facet joint are treated with heat.
- Spinal fusion (spondylodesis): In severe cases, surgical fusion of the affected vertebral segments may be required.
References
- Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie (DGOOC) - Guidelines on Degenerative Spinal Disorders (2022).
- Kohn, M. D., Sassoon, A. A., Fernando, N. D. - Classification in Brief: Kellgren-Lawrence Classification of Osteoarthritis. Clinical Orthopaedics and Related Research (2016).
- World Health Organization (WHO) - Musculoskeletal conditions. https://www.who.int/news-room/fact-sheets/detail/musculoskeletal-conditions (2023).
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