Expert: Scott F. Gillman, DC, DACBSP - 7/1/2009

Question
QUESTION: Good Afternoon and thank you for taking the time to answer my question(s). My fiance was told by his sports medicine doctor that he has LUMBAR SPONDYLOSIS without MYELOPATHY. What exactly is this and what causes it? Also, what treatments/therapy can we do at home to help him. I understand that this can be/is a degenerative disorder, (please correct me if I'm wrong) and that it usually shows up in older patients (he is 30). Is there any way to stop/slow down the degeneration and alleviate his pain when it occurs? Can this have an affect on any other parts of the body, specifically his knees and ankles as he's had pain in his left knee and right ankle as well. Again I thank you for taking the time to answer my questions.

ANSWER: Hi Crystal,

Lumbar spondylosis (Spondyl = spine; 'Osis = a bad condition of') is used to mean that there is some sort of degenerative process in the spinal joints.  THis often involves hypertrophic changes to the spine vertebra with bone spur formation, degenerative wearing away of the intervertebral discs, or a combination of both.   It has a genetic link, and it is known to begin in the early teen years.   The amount of pain and stiffness it causes varies from one person to the next.  There is no consistent pattern.  If there is any instability to the vertebrae at the degenerative location, meaning that one bone slides around on top of the other bone instead of it being held in place by the ligaments (stable), then there is greater odds of chronic pain.  When there is a lot of degenerative change and instability, and core stability exercises don't work, then surgery is the best option.  Pain from lower lumbar spine regions do often refer into the buttock and thighs.  If the spinal nerves get irritated or affected by the bone spurs or disc material, then it causes radiating pain or numbness/tingling into the calf or foot (this would be considered "sciatica").   If none of this is going on, he should just remain active, learn about "spine sparing activities," and be careful with ergonomic trunk activities, e.g. sitting too much at a computer...

'Hope this was helpful.  

Dr. G

---------- FOLLOW-UP ----------

QUESTION: Thank you for answering my questions! I have a better understanding of it now. When you say "spine sparing activities" do you mean stretching and strengthening the muscles surrounding his lumbar region? He's an avid jogger and plays basketball regularly, will these activities cause more harm?

Answer
Spine sparing activities: not bending down to put on shoes first thing in the morning; lifting using the "golfer's lift," where you  bend to pick up an object like a golfer picks up a golf ball: hold on to something (e.g. golf club), pivot on the hip with your planted leg while the other leg swings up in the air [this keeps your lower back in a straight/neutral position, sparing it from flexing forward which puts pressure on the disc]; getting out of the chair to avoid prolonged sitting and loading of the degenerated disc; tightening the abdominal muscles when doing any bending/twisting movements; etc.  

Dr. G'