Spondylosis is classified according to the location and severity of the degenerative changes:

1. By location:
   • Cervical spondylosis: Affects the cervical spine, often associated with neck and arm pain.
   • Thoracic spondylosis: A rarer form that affects the thoracic spine.
   • Lumbar spondylosis: The most common form, affecting the lumbar spine and can lead to back pain.
2. By severity:
   • Mild: Early stage with minimal changes and few symptoms.
   • Moderate: Significant wear of the intervertebral discs and formation of osteophytes.
   • Severe: Pronounced narrowing of the spinal canal and severe functional limitations.

The causes of spondylosis are primarily age-related but can be exacerbated by certain risk factors:

- Degenerative changes:

- Age-related wear and tear of intervertebral discs and vertebral bodies.

- Decrease in water content in the intervertebral discs, leading to loss of their cushioning function.

- Formation of osteophytes (bone spurs) in response to instability.

- Mechanical stress:

- Repeated physical stresses, heavy lifting, or prolonged sitting.

- Poor posture and non-ergonomic movements in daily life.

- Injuries:

- Consequences of spinal injuries or trauma.

- Risk factors:

- Overweight, lack of exercise, and genetic predisposition.

The symptoms depend on the location and progression of the degenerative processes:

• Back pain:
  • Chronic pain that increases with movement or exertion.
• Movement restrictions:
  • Stiffness of the spine, especially in the morning or after prolonged rest.
• Neurological symptoms:
  • Pain, numbness, or tingling in the extremities due to pressure on nerve roots.
  • Weakness or coordination problems in arms or legs.
• Crepitus:
  • Crunching noises during movements of the spine.
• Postural changes:
  • Visible postural abnormalities due to degenerative changes.

The diagnosis is made through a combination of medical history, clinical examination, and imaging techniques:

• Medical History:
  • Recording of symptoms, stress patterns, and disease progression.
• Physical Examination:
  • Checking mobility, reflexes, and neurological functions.
  • Palpation of the spine for tenderness.
• Imaging:
  • X-ray: Visualization of osteophytes, disc narrowing, and other bony changes.
  • MRI: For assessing discs, nerve structures, and soft tissues.
  • CT: Detailed visualization of bony changes.
• Electrophysiological Examinations:
  • Measurement of nerve conduction velocity in case of suspected nerve compression.

Conservative Therapy

The treatment of spondylosis focuses on alleviating symptoms, improving mobility, and preventing the progression of the disease:

• Medication Therapy:
  • NSAIDs: For pain relief and anti-inflammatory effects.
  • Muscle relaxants to relax the muscles.
  • Local injections of corticosteroids for severe discomfort.
• Physiotherapy:
  • Exercises to strengthen the back muscles and improve posture.
  • Manual therapy for mobilization and pain relief.
• Occupational Therapy:
  • Training for back-friendly behavior in daily life and at work.
• Pain Management:
  • Heat or cold therapy for relaxation and pain relief.

Surgical Therapy

In severe cases or persistent discomfort despite conservative measures, surgery may be necessary:

• Decompression: Removal of bone spurs or tissue pressing on nerves or the spinal cord.
• Spinal Fusion (Spondylodesis): Stabilization of unstable spinal segments with screws or plates.
• Disc Prostheses: Replacement of worn-out discs to restore mobility.

The following measures are suitable for preventing and alleviating symptoms:

1. Regular exercise: Promoting flexibility and stability through targeted exercises.
2. Ergonomic posture: Avoiding poor posture and non-ergonomic movements.
3. Weight control: Reducing the strain on the spine through a healthy body weight.
4. Strengthening the back muscles: Regular back training to support the spine.
5. Stress management: Avoiding tension through relaxation exercises.