What is spondylosis and how does it affect the spine. What are the common symptoms of spondylosis. How is spondylosis diagnosed and treated. Who is most at risk for developing spondylosis. What lifestyle changes can help manage spondylosis symptoms.

What is Spondylosis and How Does it Affect the Spine?

Spondylosis is a broad term that refers to degenerative changes in the spine that occur as a natural part of aging. It is essentially an umbrella term used to describe pain and other symptoms resulting from wear and tear on the spinal discs and joints over time.

While often used to specifically indicate osteoarthritis of the spine, spondylosis can encompass various degenerative spinal conditions, including:

• Degenerative disc disease
• Spinal osteoarthritis
• Bone spurs
• Spinal stenosis

These degenerative changes can occur in any region of the spine but are most common in the cervical (neck) and lumbar (lower back) areas. The thoracic (mid-back) region is less frequently affected, likely due to the stabilizing effect of the rib cage.

How Does Spondylosis Develop?

As we age, the spinal discs gradually lose water content and become less flexible. This natural degeneration process can lead to:

• Disc height loss
• Bulging or herniated discs
• Increased stress on the facet joints
• Formation of bone spurs
• Narrowing of the spinal canal (spinal stenosis)

These changes can potentially irritate or compress nearby nerves, resulting in pain and other symptoms. However, it’s important to note that the presence of spinal degeneration on imaging does not always correlate with pain or functional limitations.

Common Symptoms and Signs of Spondylosis

The symptoms of spondylosis can vary widely between individuals. Some people may experience no symptoms at all, while others may have significant pain and functional limitations. Common symptoms include:

• Neck or back pain that worsens with activity
• Stiffness, especially in the morning
• Reduced range of motion
• Muscle weakness
• Numbness or tingling in the extremities
• Headaches (particularly with cervical spondylosis)

Can spondylosis cause radiating pain? Yes, in some cases, spondylosis can lead to radiculopathy – pain that radiates along the path of a compressed nerve. This can result in symptoms like sciatica in the lower body or arm pain with cervical spondylosis.

When to Seek Medical Attention

While some degree of spondylosis is normal with aging, you should consult a healthcare provider if you experience:

• Persistent or severe pain
• Neurological symptoms like numbness, weakness, or difficulty with coordination
• Changes in bowel or bladder function
• Pain that interferes with daily activities or sleep

Diagnosing Spondylosis: Tools and Techniques

Diagnosing spondylosis typically involves a combination of clinical evaluation and imaging studies. The process may include:

1. Medical history and physical examination
2. Neurological assessment
3. Imaging studies (X-rays, MRI, CT scan)
4. Electrodiagnostic tests (EMG/NCS) in some cases

What can imaging studies reveal about spondylosis? Imaging can show degenerative changes like disc height loss, bone spurs, facet joint arthritis, and spinal stenosis. However, it’s crucial to correlate these findings with clinical symptoms, as many people have degenerative changes on imaging without experiencing pain.

Differential Diagnosis

Several conditions can mimic the symptoms of spondylosis, including:

• Fibromyalgia
• Spinal tumors
• Infections
• Inflammatory arthritis (e.g., rheumatoid arthritis, ankylosing spondylitis)

A thorough diagnostic process helps differentiate spondylosis from these other conditions and guides appropriate treatment.

Treatment Options for Managing Spondylosis

The treatment of spondylosis aims to relieve pain, improve function, and prevent further degeneration. Options include:

Conservative Treatments

• Physical therapy and exercise
• Medications (NSAIDs, muscle relaxants, etc.)
• Hot/cold therapy
• Lifestyle modifications
• Ergonomic adjustments

Interventional Treatments

• Epidural steroid injections
• Facet joint injections
• Radiofrequency ablation

Surgical Options

Surgery is typically reserved for cases with severe or progressive neurological symptoms, or when conservative treatments fail to provide adequate relief. Surgical procedures may include:

• Decompression (laminectomy, foraminotomy)
• Spinal fusion
• Disc replacement

How effective is physical therapy for spondylosis? Physical therapy can be highly effective in managing spondylosis symptoms by improving flexibility, strengthening supporting muscles, and teaching proper body mechanics. Many patients experience significant pain relief and functional improvement with a consistent physical therapy program.

Lifestyle Modifications and Self-Care Strategies

In addition to medical treatments, several lifestyle changes and self-care strategies can help manage spondylosis symptoms:

• Regular exercise and stretching
• Maintaining a healthy weight
• Proper posture and ergonomics
• Stress management techniques
• Smoking cessation
• Healthy diet rich in anti-inflammatory foods

What types of exercises are beneficial for spondylosis? Low-impact activities like walking, swimming, and cycling can help maintain fitness without putting excessive stress on the spine. Specific exercises to improve core strength, flexibility, and posture are also important. Always consult with a healthcare provider or physical therapist before starting a new exercise program.

Prognosis and Long-Term Management of Spondylosis

The prognosis for spondylosis varies depending on the severity of degeneration and individual factors. While the underlying degenerative changes cannot be reversed, many people successfully manage their symptoms and maintain a good quality of life with appropriate treatment and lifestyle modifications.

Long-term management strategies may include:

• Ongoing physical therapy or home exercise program
• Regular follow-ups with healthcare providers
• Periodic imaging to monitor progression
• Adjusting treatments as needed

Can spondylosis be prevented? While some degree of spinal degeneration is a normal part of aging, maintaining a healthy lifestyle can help slow the progression and reduce the risk of developing symptomatic spondylosis. This includes regular exercise, maintaining a healthy weight, using proper body mechanics, and avoiding smoking.

Emerging Treatments and Research in Spondylosis Management

Ongoing research is exploring new approaches to treating spondylosis and its associated symptoms. Some areas of investigation include:

• Regenerative medicine techniques (stem cell therapy, platelet-rich plasma)
• Advanced imaging technologies for more precise diagnosis
• Minimally invasive surgical techniques
• Novel pain management approaches
• Wearable technology for monitoring and improving posture

What role might regenerative medicine play in spondylosis treatment? While still largely experimental, regenerative medicine techniques aim to promote tissue repair and regeneration. Early studies have shown promise in reducing pain and improving function in some patients with degenerative spine conditions, but more research is needed to establish long-term efficacy and safety.

Living with Spondylosis: Coping Strategies and Support

Coping with chronic pain and functional limitations from spondylosis can be challenging. Strategies to improve quality of life include:

• Education about the condition
• Joining support groups
• Exploring complementary therapies (e.g., acupuncture, massage)
• Mental health support (counseling, mindfulness practices)
• Assistive devices for daily activities
• Workplace accommodations

How can mindfulness practices help manage spondylosis symptoms? Mindfulness techniques, such as meditation and deep breathing exercises, can help reduce stress and tension, which may exacerbate pain. These practices can also improve pain coping skills and overall well-being. Some studies have shown that mindfulness-based stress reduction programs can lead to significant improvements in pain and function for people with chronic back pain.

In conclusion, while spondylosis is a common condition that can cause significant discomfort and functional limitations, a multidisciplinary approach to treatment can help many individuals effectively manage their symptoms and maintain a good quality of life. By understanding the condition, exploring various treatment options, and adopting healthy lifestyle habits, those affected by spondylosis can take proactive steps towards better spinal health and overall well-being.

Spondylosis: What It Actually Means

Spondylosis is a broad term that simply refers to some type of degeneration in the spine.

Spondylosis is an umbrella term used to describe pain from degenerative conditions of the spine. Watch: Spondylosis Video

Most often, the term spondylosis is used to describe osteoarthritis of the spine, but it is also commonly used to describe any manner of spinal degeneration.

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Spondylosis Is a Descriptive Term

As with many other terms to describe spinal problems, spondylosis is more of a descriptive term than it is a clinical diagnosis. Literally it can be translated to mean that one has both pain and spine degeneration, regardless of what is causing the pain or where the degeneration is occurring.

Watch: Video: What Is a Degenerative Disc and the Degenerative Cascade?

For example:

• The patient may have pain from facet joint osteoarthritis, causing pain during times of high activity or after extended inactivity
• There could be spinal stenosis, an abnormal narrowing of the spinal canal, which is creating leg pain when the patient walks
• The pain could be caused by degenerative disc disease, in which a degenerated disc that becomes dehydrated and loses some of its function. The degenerated disc can cause low back pain or neck pain, and possibly leg pain or arm pain.

These examples are only a few of the many possible contributors to a patient’s pain.

See When Back Pain May Be a Medical Emergency

In This Article:

• Spondylosis: What It Actually Means

• Answers to Common Spondylosis Questions

• Spondylosis Video

After arriving at a confirmed clinical diagnosis for the cause of a patient’s pain (rather than just the finding that there is spondylosis, which may or may not be causing the pain), physicians then usually use more specific terms for the diagnosis (such as osteoarthritis, lumbar degenerative disc disease or cervical degenerative disc disease, or lumbar spinal stenosis or cervical spinal stenosis) because those terms more effectively describe what is causing the pain.

Dr. David DeWitt is an orthopedic surgeon practicing at the NeuroSpine Center of Wisconsin, where he specializes in spine surgery. He has more than 15 years of experience evaluating and treating spine diseases and trauma.

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Lumbar and Cervical Spondylosis: Symptoms & Treatments

Spondylosis is a nearly universal condition in those who reach advanced age, but it can also affect younger people. While some people experience no symptoms, others may feel stiffness and/or pain in the neck, shoulders or between the shoulder blades.

• What is spondylosis?
• What are the symptoms?




• Are some people more susceptible?
• How is it diagnosed?
• What type of doctor treats it?
• How is it treated?
• What is the surgery for it?

What is spondylosis?

Spondylosis is another word for osteoarthritis of the spine, a condition that usually develops with age, and is the result of normal “wear and tear” on both the soft structures and bones that make up the spine.

Although any part of the spine may be affected, spondylosis is more frequently seen in the spine’s highest and lowest sections – the cervical (neck) and lumbar (low back) areas, respectively. The condition is less commonly found in the thoracic spine (middle portion), possibly because the rib cage serves to stabilize this area and make it less subject to the effects of wear and tear over time.

Illustration of cross-section of spine, dorsal (back to front) and lateral (side) views, showing its vertebral sections.

What are the symptoms of spondylosis?

People with spondylosis experience may or may not experience pain or, indeed, any symptoms at all. Those who have no symptoms may become aware of the condition only when they are being assessed for another medical issue that calls for imaging of the spine with an X-ray, MRI, or CT scan. When symptoms are present, they vary depending on the area where the condition develops and the structures that are affected, but they can include pain or limited range of motion.

Individuals with spondylosis who are otherwise without pain may experience crepitus, a feeling or sound of crunching in the spine, along with a limited range of motion. This usually is not concerning for nerve or spinal cord damage.

What are the symptoms of cervical spondylosis?

Neck pain and/or stiffness are common symptoms. In cases where spondylotic changes to the spine put pressure on adjacent nerves, patients may experience pain, numbness or tingling that extends down the arm, with or without symptoms in the neck itself. This type of nerve pain, which results from compression or inflammation of the nerve the cervical spine is known as cervical radiculopathy. Severe cases may also cause compression the spinal cord which may manifest as weakness or impaired motor function in the arms or hands, or other symptoms in a condition called cervical myelopathy.

What are the symptoms of lumbar spondylosis?

Low back pain, leg pain and/or other signs of nerve compression are the most common symptoms. Pain or tingling symptoms that extend outward to the hip or down the leg can result from compression or inflammation of nerves, a condition referred to as lumbar radiculopathy. For example, a person may have pain in their knee and think it is injured, but later learn that this pain is caused by spondylosis that is compressing a nerve which extends down to the knee. Irritation of the sciatic nerve in particular, is quite common, and is commonly known as sciatica.

Is spondylosis serious?

Because spondylosis can affect people in many different ways, there is no single answer to this question. Many cases of spondylosis are effectively treated with physical therapy and pain relief measures. However, orthopedists advise seeking more immediate care if the following symptoms, which are associated with pressure on the nerves, are present:

• weakness, including foot drop (difficulty lifting the toes and forefoot off the floor)
• bladder or bowel dysfunction, especially incontinence
• changes in balance that cannot be attributed to other factors
• numbness either in a stripe-like pattern or involving the fingers
• severe pain, especially electrical or shock like pain
• pain in the arms and/or legs that has not responded after attempting other nonsurgical measures like physical therapy, oral pain medications and/or injections

Are some people more likely to develop spondylosis than others?

Spondylosis is likely to affect most people to some degree as they age, as it is the natural result of years of the spine being subject to the forces of gravity. There may be a genetic component (an inherited tendency) to develop the condition, but research has not clearly established this link.

An association between traumatic injury to the spine and the development of spondylosis later in life has been established.

How is spondylosis different from spondylolisthesis?

Although the names sound similar, spondylolisthesis is a condition in which one of the vertebrae (the bones that make up the spine) has moved out of place – usually in a forward direction. While this is a distinct diagnosis, spondylolisthesis may occur as a result of spondylosis, which can cause other structures of the spine move out of their normal position.

Other conditions that may result from spondylosis include:

• spinal stenosis – a narrowing of the spinal canal
• degenerative scoliosis – a sideways curvature of the spine due to osteoarthritis
• degenerative disc disease – wear and tear of the disc space

How is spondylosis diagnosed?

A diagnosis of spondylosis is based primarily on information seen on images of the spine: Changes to the bones are most clearly seen on X-ray, while changes to the soft structures – including the disks that act as cushions between the vertebrae – are more clearly seen on MRI or CT scans.

Abnormalities that may be detected include bone spurs, which are small growths of extra bone, or bulging or herniated discs. Both of these findings can cause narrowing in the spinal canal and put pressure on adjacent nerves. It’s important to note that wear and tear on the spine may show up on imaging tests, without the individual experiencing any pain or discomfort.

To better understand the impact spondylosis may be having on a patient, the orthopedist may order X-rays to look at the skeleton in motion, for example when the spine and neck bend backward or forward.

What type of doctor treats spondylosis?

People should first consult their primary care physician for back and neck pain. For persistent pain or symptoms associated with pressure on the nerves, such as weakness, are best assessed by a physician who specializes in musculoskeletal medicine, such as a physiatrist (a doctor who practices physical and rehabilitative medicine), a pain management doctor or a spine surgeon.

Once a diagnosis has been made, the type of physician who may best treat a patient’s symptoms depends on individual case. For many people, a physiatrist and physical therapist can treat people nonsurgically. In cases where spondylosis-related anatomic changes require removal or release of tissue, a spine surgeon will become involved. In some cases, a physiatrist or spine surgeon may also refer the patient to see a neurologist for additional care. (Find a doctor at HSS who treats spondylosis.)

How is spondylosis treated?

Treatment for spondylosis depends on the specific set of symptoms and findings that a patient is found to have and the area of the spine that is affected. Initial measures almost always include physical therapy to strengthen the muscles that support the spine and, in some cases, epidural injections to reduce inflammation and pain. Short courses of oral pain medication, like anti-inflammatories, may also be prescribed.

Although non-operative treatment won’t change the structural effects of spondylosis – the wear and tear on tissues and the pressure on the nerves – it can provide relief while the nerve adapts to these changes in the spine anatomy. In many cases, this allows the symptoms to decrease without surgery.

What is the surgery for spondylosis?

If a person continues to have pain and debility from spondylosis after conservative measures are tried, surgical treatment may be recommended. The specific procedure needed depends on the abnormalities present in the spine, but it will generally involve addressing the area of the spine that is pressing on a nerve.

Some examples of minimally invasive surgical treatment for spondylosis include:

• removal of a bone spur in cervical spondylosis
• placement of spacers to recreate space lost by disc wear, allowing nerves to be free of compression
• removal of soft tissues that can become thickened in spondylosis that press on nerves

In some cases, a patient with spondylosis will require more extensive surgery to remove more a portion of the spine that is causing pain, and a fusion of the vertebrae, a surgery that stabilizes the bone.  Anterior cervical discectomy with fusion (ACDF surgery) is one such procedure in the neck. For low back pain or other problems associated with lumbar spondylosis, a lumbar laminectomy, with or without fusion, or various other types of lumbar fusion surgery may be appropriate.

What is the recovery time for spondylosis surgery?

Recovery time varies depending on the nature of the surgery, with minimally invasive procedures permitting a more rapid return to daily activities. Many patients will complete a course of physical therapy beginning at six weeks after their operation. Keeping the supporting muscles flexible and strong and maintaining a healthy weight are the best way to prevent further problems in the spine.

Patients are also advised to assess and adjust ergonomic conditions that may have exacerbated their pain, for example raising a computer monitor to eye level to eliminate the tendency to hunch forward while doing office work.

Are there any dietary supplements that can help treat or prevent spondylosis?

There is no evidence at this time that any particular diet or supplement will help with spondylosis. It’s always a good idea to follow a healthy diet and to use supplements with caution, as these products are not regulated by the US Food and Drug Administration (FDA).

Updated: 4/17/2023

Authors

Sariah Khormaee, MD, PhD

Assistant Attending Orthopedic Surgeon, Hospital for Special Surgery
Assistant Professor of Orthopedic Surgery, Weill Cornell Medical College

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