Spondylosis

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Spondylosis is the wear and tear of the discs and bones (vertebrae) of the spine. It is used to describe osteoarthritis (OA) of the spine but is also commonly used to describe any manner of spinal degeneration.

​People with spondylosis often have no symptoms.

If symptoms occur, they may include:

1. Pain and stiffness in the neck
2. Restriction of movement, which presents after a period of prolonged activity such as sitting, walking or staying in the same position for a long duration

If there is pressure on, or irritation of, the surrounding nerves of the degenerated discs, osteophytes or thickened joints, you may also experience weakness and/or numbness/tingling in the:

1. Arms – in cases of spondylosis affecting the neck or cervical spondylosis
2. Legs – in cases of spondylosis affecting the lower back or lumbar spondylosis

Intervertebral discs are like cushions between the individual vertebrae. They have a soft centre (nucleus pulposus) surrounded by a tough outer ring of fibrocartilage (annulus fibrosus).

With age and injuries, the gel-like discs lose their water content and shrink, thus reducing their shock-absorbing and stabilising properties. This increases the stress on the joints and ligaments.

Over time, the cartilage in the joints becomes thinner, and overgrowth of bone occurs leading to the formation of spurs (osteophytes). The ligaments also become less elastic and thicken with age, leading to stiffness and loss of stability.

Spondylosis usually occurs after the age of 40 years, although it may occur earlier due to factors such as:

1. Poor posture that puts a strain on the spine
2. Injuries involving the spine
3. A sedentary lifestyle
4. Being obese
5. Genetic predispositions
6. An occupation that involves repetitive heavy lifting involving the spine

​Spondylosis is usually diagnosed clinically based on history taking, physical examination and imaging tests. X-rays can measure the extent of degeneration. Magnetic resonance imaging (MRI) can examine for soft tissue problems such as disc degeneration and nerve impingement.

Initial treatment includes activity restriction, painkillers such as nonsteroidal anti-inflammatory drugs (NSAIDs) and a course of physiotherapy.

Over time, most patients with back pain can resume their occupational or recreational activities, starting with low impact aerobic exercises. Those who are unable to obtain relief via these measures, or patients with severe pressure on the nerves, may require surgical intervention.