Every patient is different, and each patient’s treatment process may be unique, as well. Your care team may use a combination of techniques to treat spondylosis. At the UK HealthCare Comprehensive Spine Center, our team of experts works together to create the treatment plan that best fits your specific needs.
Most treatment for spondylosis is nonsurgical. Physical therapy for stretching and strengthening your neck and back is standard treatment, but you may also need additional modalities to help relieve pain.
Physical therapy plays a crucial role in effectively managing chronic back pain. At UK HealthCare, physical therapy is an integral part of many spine treatment plans. Our spine specialists work with therapy experts who specialize in musculoskeletal care. Together, they create a plan tailored for your unique needs.
A physical therapist can:
- Create a personalized exercise plan to enhance your flexibility and range of motion
- Strengthen your core muscles to maintain proper alignment
- Improve your posture
- Educate you on correct movement techniques and modifications to use during pain episodes, helping you to engage in your favorite activities while reducing the likelihood of recurring back pain
Ice packs can reduce swelling and pain in the first days after sciatic nerve pain begins. Apply ice to the affected area several times a day for up to 20 minutes. Place a cloth between the ice pack and your skin to avoid cold-related injuries.
After a few days of using cold therapy to reduce swelling, switching to a heating pad or heat wrap may be helpful. Apply heat to the affected area several times a day for up to 20 minutes. Switching back and forth between applying ice and heat may be helpful.
These common, over-the-counter medicines target chemicals responsible for pain, inflammation and fever, reducing their production to ease these symptoms.
If over-the-counter pain relievers haven't eased your back pain, talk with your doctor. Muscle relaxants might be an option, but they can cause dizziness and sleepiness.
Muscle knots, or “trigger points,” can cause pain that doesn’t go away with stretching, massage or other treatments. When this happens, trigger point injections may help. During this quick, outpatient procedure, you will lie or sit in a comfortable position while your provider locates the trigger point by touch. A small needle is then inserted directly into the trigger point. A small amount of local anesthetic is injected, which helps relax the muscle and relieve pain. In some cases, a corticosteroid is also added to reduce inflammation. The procedure takes only a few minutes, and patients can usually return to regular activities right away.
During this outpatient procedure, a small needle is guided into a facet joint with imaging. A steroid and pain reliever are injected to reduce inflammation in the joint to relieve pain.
Radiofrequency ablation (RFA) is sometimes used as a minimally invasive treatment option for chronic pain. Also known as radiofrequency neurotomy, this procedure targets specific nerves transmitting pain signals. A thin electrode-tipped needle is inserted near the targeted nerve with the help of imaging guidance (X-ray or fluoroscopy). This treatment uses heat to disrupt the nerve's ability to send pain signals. This can help reduce long-term pain.
Surgery is not used to treat spondylosis by itself. However, if other related findings develop (such as stenosis) and the condition severely impacts your quality of life, your doctor may recommend surgery. Several surgical approaches are used to treat spondylosis. Two of the most common procedures are microdiskectomy and spinal fusion.
A microdiskectomy, also called microdecompression, is a minimally invasive procedure that relieves pressure on the spinal nerves by removing part of one or more herniated disks.
Before surgery, you will lie face down and receive general anesthesia to help you sleep during the procedure. Your provider will make a 1- to 1.5-inch incision over the affected disk. The surgeon will then use small surgical tools to remove part of the bone covering the spine to access and remove the ruptured herniated tissue and disk fractures. The surgery usually takes about an hour. After the procedure, you’ll be observed as your anesthesia wears off. Most patients return home the same day or the next day.
This surgery is performed to stop movement between two or more vertebrae in the spine.
Before your spinal fusion, you will receive general anesthesia so that you sleep during the procedure. To perform this surgery, your surgeon may access your spine in one of three ways:
- On your back or neck above the spine: You will lie on your stomach, and your surgeon will make an incision over the area and move the muscles and tissues to the side to access the spine.
- On your side: If spinal fusion is being performed on your lower back, you may lie on your side to give the surgeon the best angle to access the spine in that area.
- On the front of the neck: If spinal fusion is on the neck, your surgeon may make an incision on the front part of your neck near the side.
The vertebrae will be fused together with:
- Bone graft placed along the back of the spine
- Bone graft material added between two or more vertebrae
- Implantable cages used between the vertebrae
The doctor may also stabilize the vertebrae with cages, plates, rods or screws until the grafts heal. The surgery usually takes three to four hours.
After your surgery, you will remain in the hospital for three or four days, and you will receive pain medicine to keep you comfortable. You may wear a back brace when you leave the hospital.
After surgery, you will need to stay off work for about four to six weeks as you recover, and you will be limited to very light activity. You may need physical therapy.
If you have tried other pain relief treatments and your spinal pain hasn’t improved, spinal fusion may work as a pain relief option. However, spinal fusion doesn’t provide pain relief for everyone, and it can increase pain.