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Spondylosis


Lumbar Spondylosis
Definition :

Spondylosis is a term referring to degenerative osteoarthritis of the joints between the centra of the spinal vertebrae and/or neural foraminae. Lower back spondylosis is labeled lumbar spondylosis.

Causes :

Old age, Obesity, Sitting for prolonged periods,Prior injury, Heredity, Herniated Discs, Bulging Discs, Torn Annulus

Symptoms :

Frequent pain, Morning low back stiffness, Pain that decreases with rest or exercises, Low back tenderness or numbness, Sciatica, Weakness in low back, legs, foot, Difficulty in walking, Bowel and Bladder problems

PHYSIOTHERAPY TREATMENT
1. REST :

allows the body to heal itself, the mind and emotions to calm down, the muscles to relax and to some degree allows the inflammation in the tissues to subside.

2. RELAXATION :

eases tension in the body muscles, quietens the mind and allows mind and the body to heal. Meditation is best.

3. HEAT :

causes the small blood vessels and capillaries to dilate thus increasing the flow of blood (circulation of blood). Muscles respond best to this treatment, as the application of heat improves the flow of blood, relieves the pain /spasm and relaxes the muscles. A hot bath,sauna or a hot water shower on the aching area can relax spasm and muscle pain. You can also use a hot water bottle or an electric heat pad or infra-red lamps on the area of pain for 10-15 minutes. You can also utilise your own body heat by wrapping a scarf around the neck and a piece of woollen cloth around the waist to ease the ache.

Heat should be applied generally at least twice a day; four times a day would be more preferable. Deep heat treatment is also provided by microwave diathermy and ultrasound therapy which are safe, and very effective, but should be taken under expert guidance. Hot and cold contrast treatment is the best pain reliever - apply a towel squeezed in hot water for two minutes ; then immediately another towel squeezed in chilled water for half a minute - each application four times,and finally end with the hot towel for one minute. Ice pack is useful immediately after an injury, such as a bruise or an over-stretched ligament, blow or a fall to prevent too much inflammation and swelling. It must be applied for 2 to 3 minutes only.

4. REDUCTION OF WEIGHT

The heavier you are, the more work the back has to do. Since the excess weight is carried in the front of the stomach area, it places additional strain on the low back, as it pulls forward, making your muscles work hard to keep you upright.

5. POSTURE

Correct posture is vital for the prevention of back and neck pain. Self-assessment of poor and imbalanced posture involving the tight muscles in the low back and neck can be done while sitting, standing, lying down, lifting etc. Sleep on a hard bed with a firm but comfortable mattress. The correct pillow is important. The spine should be straight from the head to the pelvic region (no bend).

6. OCCUPATIONAL HAZARDS

CPeople with sedentary habits must realise the adverse effects of just sitting, lack of exercises, tension /stress, etc. and cultivate the habit of moving about, stretching the neck, shoulders, walking briskly/playing games /doing lot of exercises like Yoga. Avoid standing for long and bending forward with a jerk or lifting weight. As you get older, keep your spine mobile through changing postures, regular exercises, warmth and massage. You may also use neck collar and sacroiliac belt in case of severe pain of cervical and lumbar spondylosis and in the low back area. We pay a high price for sedentary living both in terms of back pain (commonly caused by inadequate musculature) and

7. TRACTION

Stretches the spine along its length and moves the vertebrae thus taking pressure off the discs. Traction can be mechanical, i.e. with the help of equipments or manual, i.e. while lying down, the other person holds both ankles, pulling lengthwise,moderately and slightly upwards ( 30 seconds of pulling and 30 seconds of remaining idle -repeat 10 times). Or , fix a rod or a piece of strong 30 mm diameter pipe on your door frame, hold in your hands and hang, stretching the whole body and spine downward ( with weight hanging on the arms). Do this 3 to 6 times, for 30 seconds each time every day.

Cervical Spondylosis
Definition :
Cervical spondylosis is chronic cervical disc degeneration with herniation of disc material, calcification and osteophytic outgrowths.

Symptoms may include :

  • Neck soreness on or both sides
  • Burning pain
  • Tingling sensations
  • Stiffness

Pain around the shoulder blades :
  • Arm complaints (pain, numbness or weakness)
  • Pain that moves around your body (for instance, down an arm)
  • Trouble walking or writing
  • Headache
  • Dizziness
  • Tiredness
  • Unintentional weight loss

It is important to treat your neck pain properly. Seek medical attention if your neck pain persists - and seek immediate attention if you have any of the emergency signs listed in the red box below.

Warning Signs :

Neck pain is one of the symptoms of meningitis, a relatively rare but very serious contagious infection. You need urgent medical care if you have neck pain with :

  • High fever
  • Sensitivity to light
  • Irritability
  • Severe tenderness with neck movement

Neck pain can also be due to injury. A severe neck injury could be life-threatening. You may need emergency medical treatment if you have neck pain with :

  • Numbness
  • Weakness
  • Tingling symptoms

PHYSIOTHERAPY :

Shortwave Diathermy - A disc or heating pad is placed over the back of the neck. The warmth obtained from the shortwave diathermy current relaxes the muscle and the pain is relieved.

Cervical Traction - Traction is a mechanical device, which supports the head and chin. It is used to relieve the nerve compression by a bone.

Posture correction - Simple postural exercises can be taught to correct the faulty position of the neck. In the more severe cases judicious use of a close-fitting cervical collar for supporting the neck (it should be worn for 1-3 months depending on progress) and rest to the neck is advisable. In the exceptional cases in which the spinal cord is constricted, decompression from front or by laminectomy may be required and thereafter it may be advisable to fuse the affected segments of the spinal column by a bone-grafting operation.. In most neck conditions, pressure on the neck causes pain and pain causes muscle spasms, setting up a cycle. The best way to break the cycle and stop the pain is to relieve both pressure and spasms. There are various approaches to achieve each of these goals. Many of them require daily applications, so they must be done by the patient at home.

Relief of pressure :

Lying down is perhaps the simplest way to relieving the neck of its heavy load. Bed rest gives the muscles a chance to recover. The duration of bed rest should be advised by the physiotherapist

Not only is spinal molding a relaxing way to start and end your body, it also reshapes your spine into its natural curves. Begin by lying on the floor or on a firm mattress with rolled-up towels under your neck and low back. Your legs may be straight or bent. Lie in this position for 15-20 minutes.

Cervical collar helps the neck muscles support the head, it also reduces neck mobility. The therapist may prescribe wearing of a cervical collar for the acute phase of neck problems and the duration of wearing it. The collar should fit snugly around the neck and be long enough to support the chin. Men can minimize irritation from the collar shaving frequently

Motivation is given to maintain the erect posture : Collars - Two types of collars can be prescribed.

Soft Collar : Soft collar is used during night times to prevent awkward position of the neck during sleep.

Firm Collar : Firm collar steadies the neck and relieve pain, especially during traveling or work. It is removed when the pain subsides.

Extension and flexion is especially helpful when you feel your neck and back stiffen. While sitting, place your hands on your knees and push down. Slowly arch your back and bend your back backward. Then slowly slump forward. Repeat this exercise 10 times.

Side bends increase your side-to-side flexibility. Start by placing your fingers together and pointing your elbows outward. Bend at the waist, tilting your body to one side as far as you can. Then bend your head and neck in the same direction. Repeat on your other side. Repeat this exercise 10 times.

This exercise increases the flexibility of your entire spine. To begin, place your fingers together and point your elbows outward. Slowly and gently twist at your waist, rotating your head and neck to the same side. Repeat toward the other side. Repeat this exercise 10 times