Introduction
The word spondylosis comes from the Greek for vertebra ('spondylos') and literally means 'condition (or 'state') of the spinal bones'. Spondylosis is an umbrella term which describes general degenerative changes in the spine that occur naturally as we age.
It can technically apply even when there is degeneration but no related symptoms, although in practice the term is generally only used when there are symptoms.
The term spondylosis is largely interchangeable with the terms 'osteoarthritis' and 'degenerative joint disease' where these apply to the spine.
It can affect any part of the back…
- Cervical spondylosis affects the upper section of the spine at the neck.
- Thoracic spondylosis affects the middle section of the spine.
- Lumbar spondylosis affects the lower section of the spine.
Where spondylosis is affecting more than one section, it is referred to as 'multilevel spondylosis'.
Cervical spondylosis is the most common of the three, with over 8 out of 10 people over the age of 60 having the condition.
Causes
As a degenerative condition, spondylosis is caused by gradual 'war and tear' on the spine over time. The vertebrae and the intervertebral discs both degenerate – the discs dehydrate over time and lose height, providing less cushioning to the vertebrae and making bone-on-bone contact more likely.
A natural response to this degeneration is for the body to produce more bone tissue in the form of osteophytes ('bone spurs') which can themselves cause impingement of nerves and muscle tissue.
Degeneration of the spine may also be due to osteoporosis, where the bones lose their density and strength, which is also not uncommon as we age. Osteoporosis makes the vertebrae prone to compression fractures. Facet joints also degenerate, causing a condition known as 'facet joint syndrome'.
Finally, some of the muscle tissue in the spine can degenerate over time, with ligaments especially prone to progressively stiffening, making sections of the back (particularly the neck) less flexible.
There are some known risk factors for the development of spondylosis apart from age. These are…
- Repetitive motions or weight bearing involving a specific section of the back – this can be due to some types of physical occupations or to sport for example.
- Sedentary lifestyle i.e. very low levels of physical activity.
- Injury to that part of the back (or spinal surgery).
- Smoking (a risk for cervical spondylosis).
- Weight – being overweight or obese.
- Anxiety / depression.
Spondylosis can also be an inherited condition.
Symptoms
As explained above, many people actually have spondylosis without any symptoms. Where there are symptoms, these generally include…
- Stiffness of the affected part of the back, sometimes accompanied by mild pain (often more noticeable after long periods of sitting down or with certain movements, or in the morning).
- Tingling, numbness or weakness in the arms or hands (in the case of cervical spondylosis) or feet and legs (in the case of lumbar spondylosis).
- Popping or grinding feeling in the spine when moving.
- Muscle spasm.
Some more serious symptoms can include…
- Headache.
- Difficulties with balance and walking.
- Issues with bowel and bladder control.
Tests / Diagnosis
Your doctor will want to conduct a review of medical history and symptoms. This will generally involve a check of range of motion of the affected part of the spine and may also include a check to see if any pressure on the spinal nerves or spinal cord are affecting your reflexes or muscle strength.
They may ask you to walk to check for any change in gait. Imaging tests may be recommended to either rule out other causes of symptoms or to get a clearer picture of what is causing them.
These imaging tests may include x-rays, or CT or MRI scans. In some cases, either a nerve conduction study or electromyography may be recommended.