Spondylosis - Treatment

Treatment

Treatment is usually conservative in nature. Patient education on lifestyle modifications and nonsteroidal anti-inflammatory drugs (NSAIDs), Physical Therapy, Chiropractic manipulative therapy (CMT), and Osteopathic manipulation treatment (OMT)have been shown to manage such conditions. Other alternative therapies such as massage, trigger-point therapy, yoga and acupuncture may be of limited benefit. Surgery is occasionally performed.

Many of the treatments for cervical spondylosis have not been subjected to rigorous, controlled trials. Surgery is advocated for cervical radiculopathy in patients who have intractable pain, progressive symptoms, or weakness that fails to improve with conservative therapy. Surgical indications for cervical spondylosis with myelopathy (CSM) remain somewhat controversial, but "most clinicians recommend operative therapy over conservative therapy for moderate-to-severe myelopathy." (Baron, M.E.)

Physical therapy may be effective for restoring range of motion, flexibility, and core strengthening. There is no evidence for the effectiveness of osteopathic or chiropractic care. Rarely, can chiropractic care to the cervical spine results in vascular emergencies like carotid artery dissection. Decompressive therapies (i.e. manual mobilization, mechanical traction) may also help alleviate pain. However, physical therapy and chiropractic cannot "cure" the degeneration, and some people view that strong compliance with postural modification is necessary to realize maximum benefit from decompression, adjustments, and flexibility rehabilitation.

It is often argued, however, that the cause of spondylosis is simply old age, and that posture modification treatment is often practiced by those who have a financial interest (such as Worker's Compensation) in proving that it is caused by work conditions and poor physical habits. Understanding anatomy is the key to conservative management of spondylosis.