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Spondylosis (aka Facet Disease)

Pain and stiffness, difficulty bending over that worsens over time, are all hallmark symptoms of a degenerative spinal condition called spondylosis. Although it is not known what exactly causes the condition, the aging process is thought to play a big part. As time marches on, joints, ligaments, and intervertebral discs can wear down and undergo changes that disrupt normal spinal structure and function. This inevitably results in pain and restriction of movement.

Small joints called “facets” are the victims in spondylosis – wear and tear, arthritis and age ravage these facets causing pain in the spine.  Spondylosis literally means stiffening of the vertebrae as a result of degenerative changes to the spine. It can occur in the neck (cervical spine), upper and middle back (thoracic spine), or lower back (lumbar spine). Neck and back spondylosis are the most common.

Spondylosis (aka Facet Pain or Facet Disease) is often used interchangeably with osteoarthritis and degenerative joint disease, but they are in fact distinct conditions (which may occur together) with different treatment protocols. Recognizing this is crucial. Fortunately, the doctors at the Ainsworth Institute of Pain Management are experts in identifying and treating spondylosis.

What is Spondylosis?

Facet Arthropathy SpondylosisSpondylosis is a degenerative condition affecting facets, the bones and joints of the spine. The degenerative process usually begins in the disc. With advancing age, discs can lose water content, causing them to erode or collapse. Loss of the protective cushion between the vertebrae results in bone rubbing against bone. This can cause excessive wear and tear on adjacent spinal structures, leading to the development of bony spurs (osteophytes).

As the condition progresses, osteophytes can exert pressure into the foramina and even into the spinal canal affecting the spinal cord, compressing the spinal nerves and restricting joint movement. Advanced spondylosis can also cause thickening of the spinal ligaments, contributing to nerve compression and pain.

What are the Symptoms?

Spondylosis Facet Disease Facet Related PainSymptoms of spondylosis will vary, depending on the area of the spine affected. Pain and stiffness are common. Alterations in spinal alignment may cause nerve compression and deformity. Over time, widespread degenerative changes lead to spinal instability. Symptoms commonly associated with spondylosis include:

 Back pain/stiffness, especially upon waking
 Difficulty bending over
 Numbness, weakness in the buttocks/legs
 Gait abnormalities
 Loss of bowel and/or bladder control (uncommon)

What are the Causes?

Spondylosis can affect anyone, but as mentioned above, age is thought to be the key contributing factor to its development. As you grow older, your spinal discs dehydrate, shrink, develop bone spurs or show other signs of osteoarthritis. Degenerative changes like bone spurs develop when spinal discs disintegrate and bone begins to rub directly against bone.

What are my Treatment Options?

Spondylosis Facet PainSurgery is not always required to treat spondylosis. Non-surgical care targets condition management and relief of symptoms.

Typical interventions include:
 Medication
 Physical Therapy
 Bracing

Most patients respond well to a multidisciplinary treatment approach that includes medication and physical therapy. For patients with persistent pain, interventional pain management procedures may provide relief for months at a time.

Interventional Pain Management Treatments

Medial Branch Block – This procedure is considered by many to be the gold-standard in diagnosing spondylosis.  A small amount of local anesthetic is placed onto the nerves that transmit pain from the facets.  By numbing the nerve of a painful facet, the pain from spondylosis should be temporarily relieved, thus telling your doctor which facet is causing the pain.

Radiofrequency Ablation (RFA) – Once the painful facet is identified, radio waves are then applied to the nerve transmitting pain from it, subsequently stunning it and stopping the pain.

Lumbar Epidural Steroid Injection – This procedure is basically the same as what a woman will receive during childbirth to eliminate pain.  Under fluoroscopic guidance, your physician will place a small needle into the epidural space and inject a small amount of medication to eliminate the pain.

Transforaminal Epidural Steroid Injection – This procedure is similar to the one above; however, in this case the medication is focused directly onto the nerve fibers that make up the sciatic nerve – the result is more medication delivered to the affected area.

Surgery:
If non-surgical treatments fail, or pain becomes unrelenting, surgery may be recommended. Decompression surgery involves the removal of tissue or bone to relieve pressure on the nerves. In cases of spinal instability, spinal fusion is often the best treatment option. Early and appropriate treatment is key to managing this disorder and minimizing loss of function.

Schedule an Appointment Today

The doctors at the Ainsworth Institute of Pain Management specialize in treating spondylosis. Dramatic improvements in pain and quality of life are a single phone call away. Schedule an appointment today with one of our board certified pain management experts to discuss what options for treatment may best suit your needs.

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