Spondylosis: Symptoms, Causes & Treatment

Spondylosis is age-related wear and tear of the vertebrae and the discs between them in the spine. This degeneration can compress nearby nerves and lead to symptoms such as localized spinal pain, tingling, numbness, or weakness in an arm or a leg.

Spondylosis is also called spinal osteoarthritis. It can develop in any part of the spine, but it is more common in the neck or lower back due to natural aging, excess weight, or poor posture.

Treatment for spondylosis is guided by an orthopedic specialist. The doctor may recommend pain relievers, anti-inflammatory medications, physical therapy, or, in some cases, surgery.

Main symptoms

The main symptoms of spondylosis are:

• Back or neck pain

• Difficulty moving the arms or legs

• Pain that may spread to the arms or legs

• A stiff neck

• Headache at the back of the head

• Tingling or numbness in the arm or leg

• Difficulty walking or standing for long periods

Symptoms of spondylosis depend on which part of the spine is affected. They occur most often in the neck and lower back, but the thoracic spine can also be involved, and some people have no symptoms in the early stages.

As the condition progresses, symptoms may develop gradually. In more advanced stages, spondylosis can lead to reduced movement in the arms or legs, a sudden strong urge to urinate, or loss of bladder control.

It is important to see an orthopedic specialist as soon as spondylosis symptoms appear, so the condition can be properly diagnosed and treated.

Confirming a diagnosis

Spondylosis is diagnosed by an orthopedic specialist based on symptoms, health history, lifestyle habits, and a physical exam. The doctor may assess movement, muscle strength, and whether there is difficulty walking or raising the arms or legs, for example.

To confirm the diagnosis, the doctor may order imaging tests, such as an X-ray, CT scan, or MRI, to evaluate the vertebrae and check for nerve compression.

The doctor may also order electromyography to help rule out other conditions that can cause nerve compression, such as peripheral neuropathy, myopathies, or motor neuron disease.

Possible causes

Spondylosis is caused by wear and tear of the vertebrae and intervertebral discs in the spine. This can lead to nerve compression and cause symptoms.

Some factors can increase the risk of developing spondylosis, such as:

• Older age, especially after age 40

• Congenital spinal malformations

• Blows or trauma to the spine

• Herniated disc

• Dehydration of the intervertebral discs

• Bone spurs on the vertebrae

• Sports that place stress or strain on the spine, such as gymnastics, soccer, or weightlifting

In addition, stiffness in the ligaments between the intervertebral discs can also cause spondylosis. This can make it difficult to move the neck and may lead to pain or tingling.

Main types

The types of spondylosis are classified according to the region of the spine affected and include:

1. Lumbar spondylosis

Lumbar spondylosis occurs in the lower back. It usually affects the L4 to L5 vertebrae, but it can also affect the L5 to S1 vertebrae.

This type of spondylosis can cause compression and inflammation of the sciatic nerve. It may lead to lower back pain that spreads to the buttock or one leg, or a feeling of electric shocks, tingling, or burning in the buttock or leg, for example.

2. Cervical spondylosis

Cervical spondylosis is one of the most common types of spondylosis. It occurs in the neck and most often affects the C4 to C6 vertebrae.

This type of spondylosis can occur at any age, including in younger people, due to cell phone or computer use, for example. It may cause inflammation and compression of the nerves in the cervical spine, called cervical radiculopathy, or compression of the spinal cord, called cervical myelopathy.

Cervical spondylosis can lead to difficulty moving the arms or hands, or loss of movement in these areas.

3. Thoracic spondylosis

Thoracic spondylosis affects the middle part of the spine (mid-back) and is the least common type of spondylosis.

It often does not cause symptoms. When symptoms occur, they may include mid-back pain, stiffness, or, in some cases, radiating pain around the chest or muscle spasms.

Treatment options

Treatment for spondylosis should be managed by an orthopedic specialist. It usually begins with medications to relieve pain and reduce inflammation in the spine.

Medications your doctor may recommend include:

• Pain relievers, such as acetaminophen

• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen

• Muscle relaxants, such as cyclobenzaprine

• Anticonvulsants, such as gabapentin

• Oral corticosteroids, such as prednisone or prednisolone

• Opioids, such as tramadol

• Corticosteroid injections into the affected vertebra, such as hydrocortisone, administered by a doctor

Physical therapy sessions are also recommended to help stretch and strengthen the muscles in the affected area, which can significantly improve symptoms.

In rare cases, when symptoms do not improve with medication or physical therapy, surgery may be recommended. According to the American Academy of Orthopaedic Surgeons, surgery aims to relieve pressure on the spinal cord or affected nerves.