Spondylosis is another name for symptomatic, degenerative arthritic changes in the spine, commonly referred to as arthritis. As our bodies age, the intervertebral disc start to lose fluid leading to collapse in disc height as well as other degenerative changes including ligaments becoming thickened and stiff and cartilage which surrounds the facet joint wearing away. In an attempt to reverse these changes, preserve stability and lessen stress our bodies increase surface area by creating bone spurs, also called osteophytes. The spurs can push on surrounding structures leading to symptoms. Some people develop spondylosis at an earlier age depending on certain risk factors including history of trauma, history of smoking, genetic predisposition, or occupations requiring hard labor.
The most frequent cause of spondylosis is a natural degeneration of the cartilage and bones of the spine as a result of excessive wear and tear, which is nearly always a natural result of aging. Extreme athletics can exacerbate this degeneration, but in nearly all cases wear and tear over the years is the cause. Over time, the discs become dehydrated and lose the ability to act as cushions between spinal bones. The painful grating of bone against bone often causes the bones to develop growths called bone spurs to replace the missing cartilage. These bone spurs can press on the spinal cord, causing painful or debilitating nerve compression.
Common causes of spondylosis include:
The quality of symptoms of spondylosis depend on the severity and location of arthritic changes. In the cervical spine, or neck, generalized aching or stiffness which is typically worse in the morning or at night are common symptoms patient experience. Pain may also present with movement and radiate into the should, head, or mid-back areas. Many describe this discomfort as muscle tightness or spasm. Cervical spondylosis may also produce headaches at the base of the skull which often radiate to the forehead called occipital neuralgia. If spondylosis is significant enough to cause pressure on surrounding neural structures patients may experience numbness, tingling, weakness or pain extending into the mid back and shoulder area and possibly into the arms. If spondylosis causes pressure on the spinal cord symptoms of myelopathy including difficulty with balance, heaviness in extremities, bowel or bladder incontinence, difficulty with fine motor skills may be present.
Thoracic spondylosis produces symptoms similar to those in the cervical spine. Patients often experience aching, stiffness, or pain in the mid back region described as a muscle spasm or tightness. If spondylosis causes pressure on the surrounding nerves there may be numbness, tingling or pain radiating into the chest, ribs, or abdominal areas known as radiculopathy. The spinal cord extends through the thoracic spine so patients may also experience symptoms of myelopathy as described above.
For patients suffering with lumbar (low-back) spondylosis the symptoms may include generalized aching, pain, or stiffness in the low back, including muscle spasms or tightness. If there is pressure on the spinal nerves you may have numbness, tingling, pain, or weakness in the legs also known as a radiculopathy. If the arthritic changes are severe enough they can lead to symptoms of spinal stenosis.
Because wear and tear on the spine due to aging is the major risk factor for spondylosis, most people over the age of 60 will suffer from some disc degeneration or damage. Risk factors for spondylosis include:
During the initial consultation with your spinal specialist, a detailed medical history as well as comprehensive physical exam is completed to better understand the patient’s specific time-line and triggers of pain. Imaging is key for the proper diagnosis of spondylosis often including x-rays taken of the affected area. CT and MRI scans may be ordered for further evaluation.