Physical Therapy Spine Education: Facet Osteoarthritis, Spondylosis, Stenosis & Spondylolisthesis

What Causes These Conditions?

The gradual process of bony wear and tear at the joints in the spine. Our bodies, at times, indiscriminately lay down bone in an attempt to solidify/stabilize the region. Unfortunately, this moderately alters mechanical function and can encroach upon neurologic structure if bone migrates into the foramen (where the nerve exits the spine); all potential pain producers. As well, thinning cartilage lining the surfaces of the bony joint make nerves more susceptible to compressive loading and pain. As mechanical function of the joint diminishes, there is additional mechanical stress placed on the joints of the spine, further enhancing the wear and tear process. Spondylolisthesis by definition is the displacement of one vertebra over another; sometimes there is a fracture involved.

Will it Go Away?

The condition: NO. The symptoms: commonly YES via proactive, preventive care and common sense. Surgery is initiated only if there is chronic extremity weakness, sensory change or chronic pain.

Good Things to Do:

• Prevent /minimize prolonged postures especially sitting and standing with a swayed back
  • Frequently change the angle of incline of your car seat on longer rides
  • Use a foot stool during stationary standing tasks
  • Sleep on your side with hips and knees bent and pillow between your knees
• Work on improved flexion (ie knees to chest) then motion in all directions in pain free fashion in
  • Lying, then sitting and finally standing
  • Yoga down dogs and child pose
• Do all daily tasks while balancing on one leg; from brushing your teeth to shoveling snow
  • This shifts the load from your spine to your hip joint which is a much more stable and stronger joint.
  • Helps you keep your gluteals stronger which is crucial for a healthy spine.
  • A great way to maintain balance and coordination
• When lifting
  • Drop your hips to engage your leg and gluteal muscles
  • Round your back
  • Tighten your abdominal muscles
  • Keep load close to your body, pull shoulder blades back and down to further stabilize
  • Use your legs to stand tall
• Stay Strong
  • The stronger you are thru your torso and pelvis, the better you distribute loads/shear away from your spine. Spinal musculature is postural in origin and not designed to lift large loads; this is the job for the gluteals and quadriceps. These are the muscles of lifting and transferring (ie sit to stand) and are the most important muscles of later adulthood.

Bad Things To Do:

• Allow your back to sway with prolonged standing or ie forced yoga up dogs, paint a ceiling.
• Sleep on your stomach or on your back without support under your knees
• Exercise or do chores  at a pace where you  cannot control the positioning of your spine
• Cover up your acute symptom presentation via medication. (A different scenario for chronic conditions.)