When dealing with lower back spinal issues, the terminology can be confusing. While some think certain terms are interchangeable, they actually describe different types of conditions that need unique care. Do you want to learn more about a recent “spondy” diagnosis related to your lower back pain? This guide will help you understand the differences among these conditions.
So what do these words mean? Each starts with the prefix “spondy”. This refers to the vertebral or spinal column. If you were diagnosed with any of these conditions, something in your spine is abnormal. This may worry you. After all, the spine is a very important part of your body. Don’t fret, some of these conditions can be treated conservatively. Surgery may be an option for more advanced cases. While a little scary, it may be the answer to finally enjoy the life you want to live.
Let’s take a look at the 3 “Spondy” conditions.
Spondylosis
Spondylosis can affect any region of the spine. It is most common in the neck and lower back. It involves a defect in the pars interarticularis–a piece of bone attaching the facet joints at the back of the spine. This condition is a form of spinal degeneration occurring due to the natural effects of aging. As we grow older, normal wear and tear, as well as cellular changes, affect the structure of the spine. As a result, the soft tissues supporting the spine–discs, muscles, tendons, etc.–slowly begin to deteriorate.
For example, the discs protecting the spine tend to dry out and lose shape as we age. This condition, known as degenerative disc disease, puts pressure on the discs and may cause a bulging or herniated disc. When the soft gel-like layer of the inner disc breaks through the thick fibrous tissue of the outer disc, it often affects spinal joints and can compress nerves. In addition, cartilage can wear away from the joints leading to facet joint osteoarthritis.
Spondylosis, however, doesn’t only affect older people. In fact, adolescents may develop the condition. Those participating in sports requiring repeated hyperextension of the lower back are at risk. This includes gymnastics, rowing, wrestling, and track & field sports. Younger people may not have many symptoms, so the condition may not get diagnosed. It spondylosis isn’t identified and managed correctly, however, it can result in more serious problems.
Diagnosing and Treating Spondylolysis
Young athletes and older adults suffering from lower back pain may want to get checked for spondylosis. One effective diagnostic test is the one-legged hyperextension maneuver. While standing in a certain one-legged position, the lumbar spine gets stretched out. If this position causes pain it may indicate this condition. Also, X-rays, a bone scan, or MRI can help with diagnosis.
Treating spondylosis often involves conservative treatments like back braces, pain medications, and stretching exercises. If these treatments aren’t effective, surgery may be an option. Spinal decompression surgery or spinal fusion surgery can help relieve pressure on the affected area and provide much-needed stabilization.
Spondylolisthesis
When spondylosis is left untreated, it may lead to spondylolisthesis. Spondylosis involves the separation of the pars interarticularis. In contrast, spondylolisthesis is defined by a slipped vertebra. When one bone of the spine slips forward over another, it causes damage to the spinal structure. In some cases, a stress fracture may be to blame. Other times, damage to the intervertebral discs may cause this instability of the spine.
Family history and even congenital defects can contribute to this condition. It is often the result of certain sports and physical occupations. The lower back is responsible for carrying a lot of the body’s weight. Some activities make the spine more prone to developing spondylolisthesis. For example, gymnasts, football players, and weightlifters of all ages can develop this condition. Those that work in warehouses or delivering packages are also susceptible since they may bear a lot of weight on one side of the body and do a lot of bending. In addition, age-related degeneration of the spinal structures plays a role.
Some people don’t even know they have spondylolisthesis. They may discover it while getting an X-ray for an unrelated problem. Others experience low back pain, leg pain, swayback, or a protruding stomach.
Diagnosing and Treating Spondylolisthesis
If an X-ray suggests spondylolisthesis, your doctor may perform other tests or diagnostic imaging to get a better look at the problem. For example, your doctor may ask you to bend certain ways during an X-ray to see if your vertebrae are moving or unstable. A CT scan or myelogram can also determine if nerves are affected.
During a physical exam, your doctor views your posture, range of motion, and overall physical condition. In addition, the doctor will test your reflexes as well as feeling for muscle spasms and abnormal curves in your spine.
Treating this condition often starts with conservative measures. Pain and anti-inflammatory medications may prove helpful. In addition, consulting with a physical therapist or chiropractor can help reduce pain and increase mobility by using exercises or manual manipulation. A back brace may also be useful in stabilizing the area. Some people also find relief with epidural steroid injections. Your doctor injects this combination of steroids and pain medications into the affected area reducing inflammation and discomfort.
If you suffer from severe pain or haven’t responded to conservative treatments, surgery may be the next option. Spinal fusion surgery can be an effective treatment. Since it is a significant surgery, recovery times may be longer than other orthopedic procedures. By stabilizing the spine, however, it can prevent further structural damage and restore function and mobility. Depending on your condition and the surgeon’s preference, a lumbar interbody fusion can be done through the front of your body (ALIF), back (PLIF), or a combination (TLIF).
Spondylitis
Spinal conditions can also be due to arthritis. This condition, sometimes known as spondyloarthropathy, is a type of inflammatory rheumatic arthritis. Unlike other forms of arthritis, it affects areas where the ligaments and tendons attach to the bones. Though the exact cause is unknown, many people with the gene HLA B27 tend to develop the condition. In addition, some research suggests an infection can trigger this condition.
Spondylitis usually occurs in young adults between 17 and 35 years old. Symptoms include chronic pain and lower back stiffness that gets worse after resting for a long time. Many feel stiffness after waking in the morning or late at night. Over time, symptoms may reach other parts of the body. Stiffness and pain can extend to the upper spine and even the rib cage. In addition, inflammation can occur in the skin, eyes, and gastrointestinal tract.
There are many different types of arthritis that can affect the spine. For example, psoriatic arthritis is common with those who suffer from skin psoriasis. Also, reactive arthritis, occurs as a reaction to certain bacteria like Chlamydia. Another inflammatory condition, ankylosing spondylitis, may cause the vertebrae to fuse together.
Diagnosing and Treating Spondylitis
Your doctor or a rheumatologist can diagnose this condition. It usually involves a thorough physical exam including reviewing medical and family history. In addition, diagnostic imaging and blood work–testing for the gene HLA-B27–help to pinpoint this condition.
While there is no known cure for spondylitis, there are some ways to manage symptoms. For example, medications can help with pain and stiffness. Exercise and physical therapy is a great way to improve posture, increase flexibility, and decrease pain. Those with more severe cases of spondyloarthritis may benefit from surgery. When spinal structures are affected, a laminectomy or osteotomy can be beneficial. Also, severe damage may require a spinal fusion surgery where vertebrae grow together using a bone graft and other instrumentation.
Getting Help for Your Spinal Conditions
If your lower back pain is caused by issues of the spinal column and related structures, you want the best care during every step of treatment. After all, spine and spinal cord health are crucial to your everyday functioning. It’s best to choose trusted doctors with years of experience in treating spinal disorders.
The Advanced Spine Center is ready to help. Our multidisciplinary team specializes in effective conservative treatments as well as the latest minimally invasive surgeries. Looking for award-winning, experienced doctors? We have you covered. With over six decades of combined experience as well as Top Doctor and Patient’s Choice awards, you have the comfort of knowing our team has successfully treated many spine conditions for years.
Don’t let lower back issues keep you from doing what you love. Call (973) 538-0900 to schedule a consultation and start your relationship with a caring team of professionals.