Treatment for Cervical and Thoracic Spondylosis

Model of cervical spine showing spondylosis

Trigger points may have an impact on the development and severity of cervical spondylosis

Spondylosis is a medical term for both osteoarthritis of the spine and the general wear and tear that occurs in the joints and bones of the spine as people age

The term can be used to describe degeneration in the neck—when this occurs it is referred to as cervical spondylosis. When it occurs in the middle back it is referred to as thoracic spondylosis.

Cervical Spondylosis

The most common symptoms of cervical spondylosis are neck pain, stiffness, and headaches. There may be a headache that originates in the neck, shoulder, arms, or chest, and a grinding noise or sensation when the neck is turned.

Symptoms of cervical spondylosis tend to improve with rest. Symptoms are generally most severe in the morning and again at the end of the day.

As we age, the discs of the cervical spine in the neck gradually break down, lose fluid, and become stiffer. From age 50 onward, the discs between the vertebrae become less spongy and provide less of a cushion.

Disc Degeneration and Trigger Points

Bones and ligaments get thicker, encroaching on the space of the spinal canal. By the time they reach their 60s, around 90% of the population will have some degree of cervical spondylosis.

Posture, employment, lifestyle choices, and certain exercise regimes can also have an impact on the development and severity of cervical spondylosis.

If cervical spondylosis results in pressure on the spinal cord (cervical stenosis), it can damage nerves—a condition called cervical myelopathy— leading to pain and/or pins and needles in the arms and legs, a loss of feeling in the hands and legs, a loss of coordination and difficulty walking, muscle spasms, and abnormal reflexes.

Cervical spondylosis is usually diagnosed through a physical examination, X rays, CT scans, and MRI. Most problems caused by cervical spondylosis will settle down, although they may reoccur at a later stage.

Treatment

Treatment may include the use of nonsteroidal anti-inflammatory drugs, corticosteroid injections, the short-term use of cervical collars, physiotherapy or chiropractic treatment, hot and cold therapy, exercise, and firm pillow support.

In a small number of cases where conservative treatments have failed then surgery may be recommended, and in around one in ten cases a person can go on to develop long-term (chronic) neck pain.

Thoracic Spondylosis

As the thoracic spine doesn’t work as hard as the lumbar or cervical spine, degeneration tends to begin elsewhere before affecting the thoracic spine.

However, this is not always the case, as spondylosis can affect any part of the spine.

Common symptoms of thoracic spondylosis include: pain and stiffness in the mid-back, particularly in the morning after getting out of bed; tingling or numbness in the legs, arms, hands, or feet; muscle weakness; and a loss of coordination or difficulty walking.

For cases of thoracic spondylosis, treatment is usually conservative. Rest, lifestyle or work-habit changes, pain-relieving medications, physiotherapy, chiropractic or acupuncture treatments, and trigger point therapy are usually effective.

Only in the most severe cases would surgery be indicated.

Trigger Point Therapy

Trigger point therapy can help in reducing pain, to allow the muscles to settle back to normal functioning, and to prevent the problem spreading to other areas as the client stiffens up in response to pain and overcompensates by using a different set of muscles.

In cases of cervical spondylosis we usually look to treat trigger points in the upper trapezius, levator scapulae, semispinalis capitis, splenius cervicis, and sub-occipital muscles.

For thoracic spondylosis we look at levator scapulae, serratus anterior, infraspinatus, rhomboids, multifidi, latissimus dorsi, scalenes, and rectus abdominis.

Trigger point therapy should target the natural "holding patterns" that the body will trigger in response the injury.

This will often address the stiffness issues and provide increased and less painful range of motion.

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