Build a healthy spine to avoid lumbar spondylosis

Bonoshree Choudhury (name changed), a retired schoolteacher from Kolkata, was diagnosed with lumbar spondylosis — a form of low back pain — two years ago.

Choudhury, 65, who stays alone in her flat in the city, finds her condition to be an impediment in her life. “The pain in the back does not let me function normally. I mostly stay at home,” she tells Happiest Health. 

Dr Ishwar Keerthi, consultant spine surgeon, Kasturba Medical College Hospital, Mangaluru, says age-related degeneration of the spine is medically termed as spondylosis. “If it affects your lower-back it is known as lumbar spondylosis,” Dr Keerthi says.

Pain specialists say age-related degeneration of the spine is a common disorder that should not be ignored since people these days are living busy lives where physical activity is minimal.

The 2009 study ‘Lumbar spondylosis: clinical presentation and treatment approaches’ said low back pain affects approximately 60–85 per cent of adults during some point in their lives.

It said the symptoms are mild and subside within six weeks in 90 per cent cases. However, chronic low back pain, defined as pain symptoms persisting beyond three months, affects an estimated 50 per cent of the population.

Dr Keerthi says doctors regularly deal with patients who have lumbar spondylosis. “It is an age-related wear and tear,” he says.

Doctors say lumbar spondylosis could lead to radicular pain (pain that radiates from your back and hip into your legs through the spine) and muscle atrophy (thinning of muscle mass) from hip to the toes.

Outlining the progressive cycle of degeneration involved in lumbar spondylosis, Dr Lohith G, an orthopaedic surgeon working in Shivamogga, Karnataka, tells Happiest Health, “It starts with disc degeneration which leads to joint degeneration, ligamentous changes and, in the worst cases, deformity.”

Causes and early signs of lumbar spondylosis

While age is the main cause of lumbar spondylosis, Dr Lohith G says, “Heavy muscular activities such as unscientific exercises, heavy sports and manual labour can increase the chances of lumbar spondylosis. Additionally, post spinal trauma, heavy alcohol dependence, high BMI (body mass index) and hereditary inheritance can also spur the chances of developing lumbar spondylosis.”

He says you must visit an orthopaedic or a neurosurgeon if:

• your lower back feels stiff or there is a slight pain constantly despite administering over-the-counter analgesics
• you have difficulty in passing urine and stools
• you have paraesthesia (a heightened/altered sensation to pain in your lower back/legs)
• you have radiculopathy (a pain that starts at lower back and travels to lower limbs)

With age, our body usually develops different kinds of pains in various parts. However, doctors advise not to ignore unexpected back pain, back pain caused by coughing and experience of back pain while raising your legs, to name a few.

Preventive measures

“One must quit smoking, maintain a healthy body weight, consume vitamin- and mineral–rich food, and avoid heavy physical work or exercise,” Dr Lohith G says. “The key to a healthy spine is regular exercise.”  He also gives some exercise tips:

• practise stretching and flexibility exercises regularly
• practise aerobic exercises like walking or swimming
• educate yourself about good posture and body mechanics

Alternative medicine such as yoga and naturopathy can also prevent degeneration of the spine. The Central Council of Research in Yoga and Naturopathy, New Delhi, largely recommends regular exercises and a balanced diet as a solution for relief from low back pain. It is advisable to practise these exercises under the supervision of a trainer.

• Bending exercises: Forward-backward bending exercises and twisting movements can strengthen muscles of the low back and spine.
• Yoga: Some yoga poses that can relieve low back pain include tadasana (mountain pose), urdhwa-hasta uttanasana (raised-hands pose), kati-chakrasana (standing spinal twist), ardha-chakrasana (half-wheel pose), konasana (sideward stretching of the spine), ardha matsyendriyasana (seated-twist pose), marjari asana (cat pose), gomukhasana (cow pose), uttana mandukasana (extended frog pose), matsayasana (fish pose), bhujangasana (cobra pose), shalabhasana (locust pose), dhanurasana (bow pose), makarasana (crocodile pose) and shavasana (corpse pose).
• Meditation and breathing: Practising meditation (mindfulness) can help to relieve the pain. Similarly, regulated and controlled breathing techniques (also known as pranayama) can largely help to strengthen the spine and abdominal muscles. These could include nadishodhana pranayama (alternate nostril breathing), suryabhedana pranayama (warming breathing pattern that activates right nostril) and bhramari pranayama (humming-bee breathing).
• Therapies: Hydrotherapy — steam bath, hot-hip bath, local application of steam to the spine, hot spinal spray, alternate hot and cold compress to the low back — induces thermic and mechanical effect to the lumbar region and relieves pain. Mud therapy and sunbath (i.e., exposure to sunlight) can also help relieve low back pain. Massage therapy too plays a role in relaxing the muscles of the back (lumbar region).
• Balanced diet: Alongside exercise, diet plays a crucial role in relieving low back pain. A wholesome meal with healthy intake of calcium, phosphorus, vitamin D can help strengthen the spine muscles.

Doctors also prescribe good spine rest, analgesics and muscle relaxers as part of the lumbar spondylosis treatment.

 (Inputs by Dr Chethana BS)