Spondylosis

Overview

Spondylosis refers to age-related degeneration of the vertebral column, affecting the intervertebral discs and facet joints. This condition involves the gradual deterioration of spinal structures and may occur in the cervical (neck), thoracic (mid-back), or lumbar (lower back) regions of the spine, with cervical and lumbar being the most commonly affected areas. The degenerative changes typically include disc desiccation (drying), disc height loss, osteophyte (bone spur) formation, and facet joint arthritis.

Spinal discs are specialized structures that act as shock absorbers between vertebrae, providing flexibility and allowing for movement. Over time, these discs lose water content and elasticity, becoming less effective at cushioning the vertebrae. The facet joints, which connect the vertebrae and allow for spinal movement, develop wear and tear in their cartilage. These changes can lead to narrowing of the spinal canal or neural foramina (openings where nerves exit the spine), potentially resulting in nerve compression.

Spondylosis affects approximately 85% of people over the age of 60, though many remain asymptomatic. It represents the most common cause of spinal cord dysfunction in older adults. The condition develops gradually as part of the natural aging process but can be accelerated by factors such as genetics, previous spinal injuries, repetitive stress on the spine from occupational activities, sports, or obesity. While spondylosis itself cannot be reversed, its symptoms can often be managed effectively through conservative treatments including physical therapy, pain management, and lifestyle modifications.

Symptoms

The symptoms of spondylosis vary widely depending on the location and severity of the degeneration, with many individuals experiencing no symptoms at all despite radiographic evidence of the condition. When symptoms do occur, they commonly include:

In Cervical Spondylosis (Neck):

  • Neck pain and stiffness, often worse in the morning or after periods of inactivity

  • Headaches, particularly at the base of the skull

  • Grinding or popping sensation with neck movement

  • Referred pain into the shoulders or between the shoulder blades

  • Radiating pain, numbness, or tingling in the arms and hands if nerve compression is present

  • In severe cases, difficulty with fine motor skills or walking if spinal cord compression occurs

In Lumbar Spondylosis (Lower Back):

  • Localized lower back pain that may worsen with movement

  • Morning stiffness that improves with activity

  • Pain that radiates into the buttocks or thighs

  • Sciatica symptoms including pain, numbness, or weakness extending down one or both legs

  • Neurogenic claudication (pain with walking that resolves with rest) in cases with spinal stenosis

  • Rarely, bowel or bladder dysfunction in severe cases with significant nerve compression

The pain associated with spondylosis is typically described as dull or aching and tends to fluctuate in intensity. It may be exacerbated by certain activities, prolonged positions, or weather changes. Some patients report periods of flare-ups followed by relative improvement.

Diagnosis

Diagnosing spondylosis involves a comprehensive approach combining clinical evaluation with appropriate imaging studies:

Clinical Assessment:

  • Detailed medical history focusing on pain characteristics, functional limitations, and progression of symptoms

  • Physical examination assessing range of motion, neurological function, muscle strength, and specific provocative tests

  • Evaluation of posture and gait patterns that may indicate compensatory mechanisms

  • Neurological screening to identify any sensory changes, reflex abnormalities, or motor weakness

Imaging Studies:

  • Plain X-rays: Often the initial imaging study, revealing disc space narrowing, osteophyte formation, and facet joint arthritis

  • Magnetic Resonance Imaging (MRI): Provides detailed visualization of soft tissues including discs, ligaments, and potential nerve compression

  • Computed Tomography (CT): Offers superior bone detail, helpful for evaluating complex bony changes or planning surgical interventions

  • CT Myelography: May be used when MRI is contraindicated or to better visualize nerve root compression

  • Electromyography (EMG) and Nerve Conduction Studies: Help confirm nerve involvement and distinguish between radiculopathy and peripheral neuropathy

The diagnostic process aims to not only confirm the presence of spondylosis but also rule out other potential causes of symptoms such as tumors, infections, or inflammatory conditions. Additionally, clinicians must determine whether the radiographic findings correlate with the clinical presentation, as imaging abnormalities often exist in asymptomatic individuals.

Treatment

At MetroPain, we assess each patient’s condition individually.

As leaders in pain management, we aim to provide advanced, innovative and evidence-based treatments tailored to suit the patient.

Our treatment pathway involves exploring our comprehensive array of available conservative and interventional treatment options. Our goal is to reduce your pain and improve your quality of life, enabling you to Live Better.

Treatment of spondylosis focuses on symptom management, functional improvement, and preventing further progression of the condition. The approach is typically tiered, beginning with conservative measures and progressing to more invasive options only if necessary:

Conservative Management:

  • Activity modification to avoid pain-provoking positions or movements

  • Physical therapy focusing on:

    • Specific exercises to improve posture, flexibility, and core stability

    • Manual techniques to increase mobility and reduce muscle tension

    • Ergonomic education to minimize spinal stress during daily activities

  • Pain management with:

    • Over-the-counter medications including NSAIDs or acetaminophen

    • Topical analgesics for localized pain relief

    • Heat or cold therapy to reduce pain and inflammation

  • Assistive devices such as cervical pillows, lumbar supports, or braces for temporary support

Interventional Treatments:

  • Prescription medications including muscle relaxants or short-term stronger analgesics

  • Epidural steroid injections or facet joint injections to reduce inflammation around affected nerves

  • Medial branch blocks or radiofrequency ablation for facet joint-related pain

  • Trigger point injections for associated myofascial pain

  • Acupuncture, massage therapy, or chiropractic care as complementary approaches

Surgical Options:

  • Generally considered only after conservative measures have failed and when specific surgical targets are identified

  • Procedures may include:

    • Decompression surgery to relieve pressure on neural structures

    • Discectomy for significant disc herniations

    • Foraminotomy to enlarge nerve exit pathways

    • Spinal fusion to stabilize excessive motion in severely degenerated segments

    • Artificial disc replacement in selected cases

Lifestyle Modifications:

  • Weight management to reduce spinal load

  • Regular appropriate exercise to maintain strength and flexibility

  • Ergonomic workplace adjustments

  • Smoking cessation to improve disc health and surgical outcomes if needed

  • Proper body mechanics for lifting and other activities

The majority of patients with spondylosis respond well to non-surgical approaches. Treatment plans should be individualized based on symptom severity, functional limitations, and patient goals. While spondylosis represents a natural aging process that cannot be reversed, proper management can significantly improve quality of life and maintain functional capacity.

Disclaimer 
Please note the contents contained in this Patient Fact Sheet are not intended as a substitute for your own independent health professional’s advice, diagnosis or treatment. Our specialists assess every patient’s condition individually. As leaders in pain intervention, we aim to provide advanced, innovative, and evidence-based treatments tailored to suit each patient. As such, recommended treatments and their outcomes will vary from patient to patient. If you would like to find out whether our treatments are suitable for your specific condition, please speak to your doctor at the time of your consultation.

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