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Best Physiotherapy for Spondylosis In Delhi NCR.

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What is Spondylosis ?

Spondylosis is a general term for age-related “wear and tear” affecting the spinal disks and joints, essentially a form of osteoarthritis of the spine. It is a very common condition, especially as people age, with an estimated 90% of adults over 60 experiencing it. While many people with spondylosis remain asymptomatic, it can lead to various symptoms if the degenerative changes cause nerve compression or other issues.

Causes of Spondylosis

The primary cause of spondylosis is the natural aging process. As we get older, several changes occur in the spine:-

  • Dehydrated Disks: The intervertebral disks, which act as cushions between the vertebrae, begin to dry out and shrink. This reduces their cushioning ability and can lead to more bone-on-bone contact.
  • Herniated Disks: Cracks can develop in the outer layer of the spinal disks, allowing the soft inner material to bulge or “herniate.” This can press on the spinal cord or nerve roots.
  • Bone Spurs (Osteophytes): In an attempt to stabilize the degenerating spine, the body may produce extra bone, forming bone spurs along the edges of the vertebrae. These spurs can also pinch nerves.
  • Stiff Ligaments: The ligaments that connect the bones of the spine can stiffen and thicken with age, reducing spinal flexibility.

Other contributing factors and risk factors include:-

  • Occupation: Jobs involving repetitive neck or back movements, awkward positioning, or heavy lifting can put extra stress on the spine.
  • Previous Injuries: Car accidents, falls, or other spinal traumas can predispose individuals to spondylosis.
  • Genetics: Some people may be born with a genetic predisposition to weaker vertebrae or spinal structures.
  • Smoking: Smoking has been linked to increased neck and back pain and can contribute to disk degeneration.
  • Poor Posture: Chronic poor posture can place abnormal stress on the spine, leading to degenerative changes.
Symptoms of Spondylosis
Symptoms vary depending on which part of the spine is affected (cervical/neck, thoracic/mid-back, or lumbar/lower back) and whether nerves or the spinal cord are compressed. Many people with spondylosis have no symptoms at all. When symptoms do occur, they can include:-Common Symptoms:
  • Pain: Localized pain and stiffness in the neck or back, which may worsen with movement, coughing, or sneezing.
  • Reduced Range of Motion: Difficulty moving the neck or back, with decreased flexibility.
  • Crepitus: A grinding, clicking, or popping sound or feeling in the spine when moving.
  • Muscle Spasms: Involuntary contractions of the muscles around the affected area.
  • Headaches: Especially with cervical spondylosis, headaches may originate at the back of the neck.
Symptoms of Nerve Compression (Radiculopathy): If bone spurs or herniated disks compress nerve roots, you might experience:
  • Radiating Pain: Pain that travels from the neck into the shoulders, arms, and hands (cervical radiculopathy) or from the lower back into the buttocks and legs (lumbar radiculopathy/sciatica).
  • Numbness or Tingling: “Pins and needles” sensations in the arms, hands, legs, or feet.
  • Weakness: Muscle weakness in the affected limbs.
  • Loss of Sensation: Decreased sensation to touch, temperature, or vibration.
Symptoms of Spinal Cord Compression (Myelopathy – more severe): If the spinal cord itself is compressed, particularly in the cervical spine, symptoms can be more serious and include:
  • Lack of Coordination: Difficulty with fine motor skills or an unsteady, jerky gait.
  • Difficulty Walking: Problems with balance and coordination, leading to an unsteady walk.
  • Global Weakness: Weakness in all four limbs.
  • Loss of Bladder or Bowel Control: In severe cases, this is a medical emergency requiring immediate attention.
Advanced Physiotherapy

Physiotherapy plays a crucial role in managing spondylosis, aiming to alleviate pain, improve function, and prevent further degeneration.

Manual Therapy

Manual therapy involves hands-on techniques performed by a physiotherapist to mobilize joints, release tight muscles, and improve soft tissue flexibility. Manual therapy techniques for spondylosis include:-

  • Soft Tissue Mobilization/Massage: Gentle to firm pressure applied to muscles and connective tissues to relax tight muscles, reduce inflammation, improve blood flow, and alleviate pain. This can include effleurage, petrissage, and deep tissue massage.
  • Joint Mobilization: Gentle passive movements applied to specific spinal joints to restore normal joint play, reduce stiffness, and improve range of motion. These are typically low-velocity, oscillatory movements within the joint’s available range. Examples include:-
  • Posteroanterior (PA) Glides: Pressure applied to the spinous processes or facet joints in a posterior-to-anterior direction.
  • Unilateral Posteroanterior (UPA) Glides: Similar to PA glides but applied to one side of the vertebral segment.
  • Lateral Glides: Used to improve side-bending movements.
  • Trigger Point Release: Applying sustained pressure to hypersensitive spots (trigger points) within muscles to reduce pain and muscle tension.
  • Myofascial Release: Techniques aimed at releasing tension in the fascia, the connective tissue that surrounds muscles and organs, to improve flexibility and reduce pain.
  • Manual Traction: The therapist manually applies gentle pulling force to the neck or lower back to decompress spinal structures, enlarge neural foramina (where nerves exit), and reduce pressure on nerves.

Pain-Relieving Exercises:-

  • Chin Tucks: Gently tucking the chin towards the chest to stretch posterior neck muscles and strengthen deep neck flexors, improving posture.
  • Neck Retractions and Extensions: Controlled movements to improve neck mobility.
  • Range of Motion (ROM) Exercises: Gentle exercises to move the spine through its full, pain-free range, including flexion, extension, lateral flexion, and rotation of the neck and trunk.

Strengthening Exercises:

  • Deep Neck Flexor Strengthening: Targeting the muscles at the front of the neck to support the cervical spine.
  • Scapular Stabilization Exercises: Strengthening muscles around the shoulder blades to improve upper back posture and support the neck.
  • Core Strengthening (for Lumbar Spondylosis): Exercises for abdominal and back muscles to provide spinal stability.
  • Dynamic Cervical/Lumbar Strengthening: Using resistance bands or light weights to build muscle strength and endurance.
  • Flexibility and Stretching: Stretching tight muscles in the neck, shoulders, chest, hips, and hamstrings to improve overall flexibility and reduce muscle imbalances.

Postural Correction and Ergonomics:

  • Education: Teaching patients about proper sitting, standing, lifting, and sleeping postures.
  • Ergonomic Advice: Recommendations for adjusting workstations, computer setups, and daily activities to minimize spinal strain.

Modalities

These are often used to complement manual therapy and exercise, providing symptomatic relief:

  • Heat Therapy: Hot packs, moist heat, or warm towels to relax muscles, reduce stiffness, and improve blood circulation.
  • Cold Therapy: Ice packs or cold compresses to reduce inflammation and numb acute pain, especially during flare-ups.

Electrotherapy:

  • Transcutaneous Electrical Nerve Stimulation (TENS): Uses low-voltage electrical current to block pain signals.
  • Interferential Current (IFC): Similar to TENS but uses higher frequency currents that penetrate deeper.

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