The aging spine
Age related changes in the spine include loss of height due to increasing spinal curvatures, disc degeneration and occasionally vertebral collapse. These can occur in the facet joints, sacroiliac joints and intervertebral discs. Osteoporosis should also be considered in the older patient as well. Patients may have a combination of several structural problems as above but appropriate imaging is also helpful. Spondylosis refers to degenerative age related change within the spine. Symptoms can include neck and back pain, brachalgia or sciatica. Osteoporotic vertebral compression fracture may include sudden acute back pain and there may be loss of height with a forward curve in the thoracic area. Treatment can include physical therapy (Pilates, yoga, chiropractic, osteopathy, exercise based physiotherapy etc.) and optimisation of medication.