From the Guidelines
Spondylytic or degenerative changes on the spine refer to the natural wear and tear process that occurs in the spine as we age, involving breakdown of spinal discs, development of bone spurs, and potential narrowing of the spinal canal. These changes can lead to symptoms such as back pain, stiffness, reduced flexibility, and in some cases, nerve compression resulting in radiating pain, numbness, or weakness in the limbs. According to the American College of Physicians and the American Pain Society 1, treatment typically involves a combination of pain management with medications like acetaminophen or NSAIDs, physical therapy to strengthen supporting muscles, and lifestyle modifications including weight management and proper ergonomics. Some key points to consider include:
- Degenerative changes on lumbar imaging are usually considered nonspecific, as they correlate poorly with symptoms 1.
- Nonspecific low back pain is pain occurring primarily in the back with no signs of a serious underlying condition, and degenerative changes are a common finding in this condition 1.
- Maintaining good posture, regular exercise, and proper body mechanics can help slow the progression of degenerative changes 1. It's essential to note that while degenerative changes are a natural part of aging, they can be managed and their progression slowed with appropriate treatment and lifestyle modifications. In terms of specific management, a combination of pain management, physical therapy, and lifestyle modifications is typically recommended. Heat or cold therapy can provide temporary relief, and in severe cases, steroid injections or surgery might be considered. Overall, the goal of treatment is to manage symptoms, improve function, and enhance quality of life.
From the Research
Definition of Spondylytic Changes
Spondylytic changes refer to degenerative changes in the spine, which can lead to a range of symptoms and conditions. These changes can occur in the intervertebral discs, end plates, bone marrow, facet joints, and spinal canal 2.
Causes and Symptoms
The pathogenesis of degenerative changes in the spine represents a biomechanically related continuum of alterations, which can be identified with different imaging modalities 2. Spondylytic changes can cause back pain, neurogenic symptoms, and physical function limitations, particularly in elderly men 3. The symptoms can include:
- Back pain
- Radiculopathy (leg pain)
- Paresthesias (numbness or tingling)
- Weakness in the lower extremities
- Difficulty walking or performing daily activities
Diagnosis and Management
Diagnosis of spondylytic changes can be made using imaging modalities such as magnetic resonance imaging (MRI) or computed tomography (CT) myelography 4. Management of spondylytic changes can include nonoperative treatment, such as analgesics, NSAIDs, epidural steroid injections, and physical methods like bracing and flexion strengthening exercises 5. In some cases, surgical treatment may be necessary, particularly for patients with moderate to severe disease 4.
Related Conditions
Spondylytic changes can be associated with various conditions, including:
- Degenerative spondylolisthesis (DS), which is a disorder that causes the slip of one vertebral body over the one below due to degenerative changes in the spine 5
- Cervical spondylotic myelopathy (CSM), which is a neurologic condition that develops insidiously over time as degenerative changes of the spine result in compression of the cord and nearby structures 4
- Ankylosing spondylitis (AS), which is a systemic inflammatory rheumatic disease involving spinal and sacroiliac joints 6