In spondylosis (spinal osteoathritis), your spinal joints don't move as well as they used to because of age-related changes in your spine, similar to arthritis. This can make it very painful to move because of decreased mobility within the spine itself. Your doctor may recommend physical therapy as part of your treatment plan because a physical therapist can help you maintain and increase mobility, learn ways to reduce pain, strengthen your spinal muscles so that they better support your spine, and stretch muscles that may be increasing nerve compression in your spine.

Physical therapy involves three main components: education, passive treatments, and active treatments. A physical therapist uses passive treatments to relax you and your body and to decrease acute pain or inflammation. They're called passive because you don't have to actively participate. If you're experiencing acute pain, you'll most likely start with passive treatments as your body heals and/or adjusts to the pain. However, the goal of physical therapy is to get into active treatments. These are therapeutic exercises that strengthen your body so that your spine has better support.

Passive Treatments for Spondylosis
Your physical therapist may give you passive treatments such as:

• Deep Tissue Massage: This technique targets spasms and chronic muscle tension that perhaps builds up through daily life stress. You could also have spasms or muscle tension because of strains or sprains. The therapist uses direct pressure and friction to try to release the tension in your soft tissues (ligaments, tendons, muscles).

• Hot and Cold Therapies: Your physical therapist will alternate between hot and cold therapies. By using heat, the physical therapist seeks to get more blood to the target area because an increased blood flow brings more oxygen and nutrients to that area. Blood is also needed to remove waste byproducts created by muscle spasms, and it also helps healing.
  
  Cold therapy, also called cryotherapy, slows circulation, helping to reduce inflammation, muscle spasms, and pain. You may have a cold pack placed upon the target area, or even be given an ice massage. Another cryotherapy option is a spray called fluoromethane that cools the tissues. After cold therapy, your therapist may work with you to stretch the affected muscles.

• Electrical stimulation: This can be performed within the clinic and if extremely successful, a TENS unit can be issued to a patient for home use. E-stim stimulates your muscles through variable (but safe) intensities of electrical current. It helps reduce muscle spasms, and it may increase your body's production of endorphins, your natural pain killers. It may also drive out inflammation, bring in healing properties, relax, and re-educate the muscles involved. The e-stim unit in the clinic is of a professional standard; the equipment is relatively large. However, a smaller machine for at "at home" use is also available. Electrical stimulation is a helpful therapy.

Active Treatments for Spondylosis
In the active part of physical therapy, your therapist will teach you various exercises to improve your flexibility, strength, core stability, and range of motion (how easily your joints move). Your physical therapy program is individualized, taking into consideration your health and history. Because your PT program is so individualized, we can't say what should and shouldn't be in your plan; again, your physical therapist will decide that. But we can generally say that you may learn about body mechanics—how to move your body so that you don't increase your pain. You'll learn how to avoid positions that exacerbate your pain. You may also learn about correcting your posture and how to use good ergonomics at work.

Exercise may also be a part of your personalized program. Your physical therapist will help you develop an exercise routine that incorporates elements like range of motion exercise, strength work, and cardio. (Read the article Exercise to Relieve Spondylosis Pain for more details on exercise and how it fits into spondylosis treatment.)

The active treatment portion of physical therapy helps you learn "self-care." Self-care empowers you to take better care of your body through good habits and principles.