What is spondylosis?

Spondy= spine and losis= degeneration.

Spondylosis literally means degeneration of the spine. Terms such as spondylosis, degenerative disc disease and osteoarthrosis are synonymous terms that are frequently and erroneously used as a diagnosis of spinal origin pain. To patients such a diagnosis is alarming. Fortunately these radiological conditions are typically age related changes and do not constitute diagnoses. They correlate poorly with pain and are not uncommonly present in the asymptomatic population. Spondylosis cannot be used as a diagnostic label for somatic referred back pain.

Radiological features

The degenerative process can involve some or all of the components of the intervertebral joint segment. Disc space narrowing, marginal osteophytes, foraminal stenosis and facet joint degeneration/sclerosis are components of spondylosis.

Clinical ramifications

Spondylosis and synonymous terms do not generally cause back and referred pain. Indeed, there is no way of knowing if these processes are causing back pain. However, more severe forms of spondylosis can contribute to canal stenosis symptoms. That is, the gradual growth of bony spurs into the spinal canal particularly around the nerves as they exit the spine can cause problems due to pressure on these nerves. Back pain on walking in more elderly patients may be contributed to by canal stenosis.Radicular pain (true sciatica) due to compression of lumbar nerve roots is perhaps a more common symptom associated with spondylosis.

Physical examination findings

Spondylosis does not have any proven typical features. Older people tend to become stiffer, but it is unclear if spondylitic changes are associated with movement restriction.

Treatment

Because spondylosis is a radiological diagnosis and not associated with symptoms there is no specific treatment.However, there are some extremely important ramifications for the patient with such changes. These patients are not infrequently told that they have “spondylosis” and that there is nothing that can be done for them. Patients should understand that this is not the case. It is possible to find the cause of pain and to do something about it. Spondylosis does not confer any predictive news about the likelihood of past, present or future back pain. In a minority of cases there may be some future problem with canal stenosis.

Furthermore, even if the concept had some validity, there is not much that can be done anyway. There is no evidence that products such as glucosamine have any role to play in the prevention of ‘spondylosis’.

The good news is that degeneration is generally not a bad thing. It is part of life, and the body can adapt to the process. There is no evidence to suggest that spinal degeneration (spondylosis) means that life is over. On the contrary, evidence suggests that exercise is good even for the person with degeneration. Use it or lose it!