Osteopathic Management of Spondylosis (Intervertebral Disc Degeneration)

Spondylosis

Spondylosis is a broad term meaning degeneration of the spinal column from any cause. In the more narrow sense it refers to spinal osteoarthritis, the age-related wear and tear of the spinal column. The degenerative process in osteoarthritis chiefly affects the vertebral bodies, the neural foramina and the facet joints (facet syndrome). If severe, it may cause pressure on nerve roots with subsequent sensory or motor disturbances, such as pain, paresthesia, and muscle weakness in the limbs.

When the space between two adjacent vertebrae narrows, compression of a nerve root emerging from the spinal cord may result in radiculopathy (sensory and motor disturbances, such as severe pain in the neck, shoulder, arm, back, or leg, accompanied by muscle weakness). Less commonly, direct pressure on the spinal cord (typically in the cervical spine) may result in myelopathy, characterized by global weakness, gait dysfunction, loss of balance, and loss of bowel or bladder control. The patient may experience shocks (paresthesia) in hands and legs because of nerve compression and lack of blood flow.

Osteopathic Treatment

Osteopathic treatment cannot cure the condition, but can be an intervention to help manage the pain and mobility issues associated with spondylosis.

The aim of osteopathic treatment is to improve joint range of motion and reduce any pain associated with spondylosis. It has been shown that vertebral mobilization techniques in cervical spine (neck) can be effective for these objectives. Four mobilization techniques can be applied, these include Anterior-Posterior Unilateral Pressure (APUP), Posterior-Anterior Unilateral Pressure (PAUP),  Cervical Oscillatory Rotation (COR) and Transverse Oscillatory Pressure (TOP). Treatment with APUP and PAUP achieve faster pain relief results in unilateral cervical spondylosis than rotation or transverse process oscillatory techniques (Egwu, 2008). Though no studies are currently available for the application of these mobilization techniques for thoracic and lumbar regions of the spine in relation to spondylosis.

Please do bare in mind, there is very limited evidence to support the application of manual therapies for spondylosis.

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Reference List

Egwu MO (2008). Relative Therapeutic Efficacy of some Vertebral Mobilization Techniques in the Management of Unilateral Cervical Spondylosis; A Comparative Study. J Phys Ther Sci 20:103-108

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