Have you been diagnosed with wear and tear lumbar spondylosis?

Have you been diagnosed with lumbar spondylosis?

Ross Hauser, MD
You have lower back pain, you go to your general practitioner who sees you have low back pain and sends you on to a low back pain specialist.  The specialist may diagnose you with lumbar spondylosis (age-related wear and tear of the spine) and suggest a conservative care treatment of therapy, rest, varying medications, perhaps chiropractic in order to see if you respond well enough that more drastic measures are not needed.

Before you continue, do you have a question about lumbar spondylosis? You can get help and information from our Caring Medical staff.

But what if you have been trying to manage your lumbar spondylosis with conservative care, you are not responding, and now you are being recommended to more aggressive treatments such as spinal surgery? One option is to better understand your problem of lumbar spondylosis and explore non-surgical options for it. That is what we will do in this article, hopefully, help you understand lumbar spondylosis and the non-surgical options for it.

Lumbar spondylosis has many diagnostic terms

The problem with a diagnosis of lumbar spondylosis is that lumbar spondylosis is really not a diagnosis, it is a description of problems of the lumbar spine.

In their heavily cited 2009 paper, “Lumbar spondylosis: clinical presentation and treatment approaches.”, Dr. Kimberley Middleton of the University of Washington and Dr. David Fish of the David Geffen School of Medicine at UCLA give this description of the many diagnostic terms surrounding lumbar spondylosis. Here are some learning points of their research:

Inconsistent treatment results:

Inconsistent diagnosis: What is causing the back pain? “Anybody’s guess”

The bottom line is lumbar spondylosis is a degenerative condition that prevents the lumbar spine from doing its job of bearing the tremendous loads and carry the weight of the body from the lower back to the head. The lumbar spine, in conjunction with the hips, is also responsible for the mobility of the trunk. It is not surprising, then, that the most common diagnosis given to people who have low back pain other than lumbar spondylosis is degenerative disc disease (DDD).

Back pain may only be a loose hinge in the facet joint

The term degeneration denotes deterioration, the whole vertebral joint goes from a healthy state to an unhealthy or weakened one. Generally, when this occurs, the degenerated or deterioration is comprehensive, meaning it encompasses all the structures within the spine. That is the discs, the ligaments, the vertebral structure, etc.

It is logical then that treatment for a comprehensively degenerated joint or for degenerative disc disease should be geared towards comprehensive regeneration of the deteriorated tissues. At the beginning is the treatment idea is the spinal ligaments.

When the spinal ligaments are injured and weak, abnormal loading across the vertebral joint occurs, abnormal loading causes accelerated degeneration.

Disc Deterioration Process vs Degenerative Door Cascade

The Hinge is the Facet Joints

In other words, when the hinges of the spine become loose or wears out with normal use over time, symptoms develop. You may get a diagnosis of lumbar spondylosis

Using our “hinge model”, we can understand that when the ligaments fail, the joint cannot handle the management of weight load or stress bearing load. You put a lot of weight on a floor that is not reinforced to handle that weight, the floor bends and stress is put on the supporting structures, stretching them beyond capacity.

Normal Cabinet Opening Force on Hinge

spinal ligament repair

The weakened bridge shows “stretching,” the injection shows where Prolotherapy is given, at the ligament attachments to the bone. The end result, a strengthened and supported bridge.

When symptoms do develop, they are most often complaints of low back pain and stiffness, or feelings of numbness and weakness in the legs, which worsen with standing or walking and improve with sitting or lying down.

Clinical symptoms may also arise after activities involving extremes of motion such as:

Prolotherapy for back pain

Spinal ligament laxity fails into the realm of Prolotherapy treatments. Prolotherapy is an in-office injection treatment that research and medical studies have shown to be an effective, trustworthy, reliable alternative to surgical and non-effective conservative care treatments. There is plenty of research to support the use of Prolotherapy for back pain (especially lumbar pain), here are some of the research summaries.

Citing our own Caring Medical and Rehabilitation Services published research on Prolotherapy results for low back pain. We followed 145 patients who had suffered from back pain on average of nearly five years, we examined not only the physical aspect of Prolotherapy, but the mental aspect of treatment as well.

If our study, mentioned above, was solely based on getting 75% of patients off their pain medications, that would be wildly successful in itself. But the fact that Prolotherapy was able to strengthen the patient’s spines and decrease overall disability and return these people to a normal lifestyle. That is not pain management, that is a pain cure.

The first step in determining whether Prolotherapy will be an effective treatment for you

The first step in determining whether Prolotherapy will be an effective treatment for the patient is to determine the extent of ligament laxity or instability in the lower back by physical examination. The examination involves maneuvering the patient into various stretched positions. If weak ligaments exist, the stressor maneuver will cause pain. Pain here is an indicator that Prolotherapy can be very effective for the patient.

Do you have a question about lumbar spondylosis? You can get help and information from our Caring Medical staff.

1 Middleton K, Fish DE. Lumbar spondylosis: clinical presentation and treatment approaches. Current reviews in musculoskeletal medicine. 2009 Jun 1;2(2):94-104.

2 Watson JD, Shay BL. Treatment of chronic low-back pain: a 1-year or greater follow-up. J Altern Complement Med. 2010 Sep;16(9):951-8. doi: 10.1089/acm.2009.0719.

3 Wilkinson HA. Injection therapy for enthesopathies causing axial spine pain and the “failed back syndrome”: a single blinded, randomized and cross-over study. Pain Physician. 2005 Apr;8(2):167-73.

4 Hauser RA, Hauser MA. Dextrose Prolotherapy for unresolved low back pain: a retrospective case series study. Journal of Prolotherapy. 2009;1:145-155. [JOP/CMRS]

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