LUMBAR SPODYLOSIS

Lumbar spondylosis, as shown in the image below, describes bony overgrowths (osteophytes), predominantly those at the anterior, lateral, and, less commonly, posterior aspects of the superior and inferior margins of vertebral centra (bodies). This dynamic process increases with, and is perhaps an inevitable concomitant, of age.

Spondylosis deformans is responsible for the misconception that osteoarthritis was common in dinosaurs.[1] Osteoarthritis was rare, but spondylosis actually was common.

Lumbar spondylosis usually produces no symptoms. When back or sciatic pains are symptoms, lumbar spondylosis is usually an unrelated finding.

Past teleologically misleading names for this phenomenon are degenerative joint disease (it is not a joint), osteoarthritis (same critique), spondylitis (totally different disease), and hypertrophic arthritis (not an arthritis).

Causes/risk factors
umbar spondylosis appears to be a nonspecific aging phenomenon. Most studies suggest no relationship to lifestyle, height, weight, body mass, physical activity, cigarette and alcohol consumption, or reproductive history. Adiposity is seen as a risk factor in British populations, but not Japanese populations. The effects of heavy physical activity are controversial, as is a purported relationship to disk degeneration.
Lumbar spondylosis occurs as a result of new bone formation in areas where the anular ligament is stressed.

PRESENTATION
Lumbar spondylosis usually produces no symptoms. When back or sciatic pains are symptoms, lumbar spondylosis is usually an unrelated finding. Lumbar spondylosis is usually not found unless a complication ensues.

Other problems to consider include the following:

Spondyloarthropathy
Spinal stenosis
Diffuse idiopathic skeletal hyperostosis
Fibromyalgia
Postural disturbance
Aortic aneurysm
Psychogenic rheumatism
Ischial bursitis
Trochanteric bursitis
Hip arthritis
Spondylolisthesis
Osteoporosis[6]
Compression fracture
Neoplasia
Hemangioma
Infectious spondylitis
Endocarditis
Disk disease.

Treatments

How is spondylosis treated?

Spondylosis is not curable, but in many cases the symptoms may decrease or stabilize on their own. Treatment is aimed at relieving pain to help you participate in as many of your normal activities as possible, and occasionally surgical treatment may be required to prevent permanent nerve or spinal cord damage.

You may be prescribed a round of physical therapy or a short course of a painkiller or muscle relaxant. Surgery is only required if conservative treatments fail or if you have worsening signs of nerve compression.

Traditional short-course pain medications for spondylosis

The most common short-course pain medications for spondylosis include:

Celecoxib (Celebrex)
Diclofenac (Voltaren)
Hydrocodone (Vicodin, Lortab)
Ibuprofen (Advil, Motrin)
Indomethacin (Indocin, Indocin SR)
Naproxen (Aleve, Naprosyn)
Oxycodone (Percocet, Roxicet)
Muscle relaxants

Your medical practitioner may prescribe a muscle relaxant instead of a traditional pain relieving medication. These include:

Carisoprodol (Soma, Vanadom)
Cyclobenzaprine (Fexmid, Flexeril)
Methocarbamol (Robaxin)
Nerve pain medications

Some medications focus specifically on nerve pain and include:

Duloxetine (Cymbalta)
Gabapentin (Neurontin)
Pregabalin (Lyrica)
Other drugs for chronic pain

In addition to NSAIDs and muscle relaxants, several other specific drugs have been found particularly effective for chronic pain and include:

Carbamazepine (Carbatrol, Equetro, Tegretol)
Phenytoin (Dilantin, Phenytek, Di-Phen)
Nonsurgical pain interventions

In cases of uncontrolled pain, steroid and anesthetic delivery procedures can help relieve chronic pain without requiring surgery. These procedures include:

Corticosteroid injection, usually cortisone (Celestone, Kenalog)
Neck brace or lumbar orthopedic device
Physical therapy
Traction (in severe cases)
Surgical interventions

In cases of uncontrolled pain, loss of movement, loss of sensation, or loss of bladder or bowel control, surgery to take pressure off spinal nerves or the spinal cord may be immediately necessary.

What you can do to improve your spondylosis

In addition to following your treatment regimen as prescribed by your medical practitioner, you may also be able to reduce your pain and increase mobility by:

Applying ice or heat
Attending physical therapy as recommended
Practicing exercises as advised by your medical practitioner
Taking all of your medications as prescribed
Wearing a cervical collar (in some cases)
Complementary treatments

Some complementary treatments may help some people to better deal with spondylosis. These treatments, sometimes referred to as alternative therapies, are used in conjunction with traditional medical treatments. Complementary treatments are not meant to substitute for traditional medical care. Be sure to notify your doctor if you are consuming nutritional supplements or homeopathic (nonprescription) remedies as they may interact with the prescribed medical therapy.

Complementary treatments may include:

Acupuncture
Biofeedback
Massage therapy
Nutritional dietary supplements, herbal remedies, tea beverages, and similar products
Yoga
What are the potential complications of spondylosis?

Complications of untreated or poorly controlled spondylosis can be serious. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of spondylosis include:

Adverse effects of treatment
Chronic, debilitating pain
Diminished overall quality of life
Fecal incontinence
Inability to participate in work or recreational activities
Permanent disability (rare)
Progression of symptoms
Urinary incontinence.