Spondylosis/OA Management

• During management:

  1. triage for red flags - if there is, refer to A&E
  2. SIN factors and stage
  3. is the pain:
  4. nociceptive - noxious stimulus, inflammatory response occurring to OA, which is causing pain
  5. neuropathic - nerve involvement due to different parts of the vertebrae and vertebral joint being effected, which can cause nerve involvement with/without conduction issues
  6. nociplastic - pain has been going on for a long time
  7. can diagnosis be made - is problem specific or non specific

  
• Management - Problem List example and their suggested treatments (no neural involvement with/without nerve conduction issue):

  • Pain - low amplitude manual therapy techniques such as PAVIMS/SNAGS
  • Stiffness - high amplitude manual therapy techniques into resistance, include stretching and ROM
  • Reduced ROM - address stiffness, active exercises, active/assisted or passive exes as appropriate, passive physiologicals
  • Muscle Weakness - Muscle strengthening
  • Low Muscle Endurance - Build muscle endurance
  • Return to work/function/sport - Gradually build capacity, strength and return to function