Spinal osteoarthritis, or spondylosis, is age-related change in the spine: the small facet joints at the back of each level lose cartilage, discs dry out and lose height, and bony spurs form along the vertebral edges. It is most common in the neck (cervical spondylosis) and the lower back (lumbar spondylosis), the most mobile regions.
These changes are close to universal on scans after the age of 60 and in most people cause little or no trouble. Problems arise in two ways. The joints themselves may become painful and stiff, or the thickened joints, ligaments and spurs narrow the channels for the nerves and spinal cord, causing lumbar spinal stenosis, trapped nerve roots or, in the neck, cervical myelopathy. Treatment is directed at symptoms and nerve function, not at the appearance of the scan.
Symptoms
- Aching and stiffness in the neck or lower back, worse in the morning and after inactivity
- Low back pain on standing or arching backwards, eased by sitting or bending forwards
- Reduced ability to turn the head, sometimes with a grating sensation
- Headaches starting at the back of the head
- Arm or leg pain, tingling or numbness in a nerve root pattern
- Heaviness, aching or cramping in both legs on walking that is relieved by sitting or leaning on a trolley (neurogenic claudication)
- Clumsy hands, difficulty with buttons, unsteady walking or urinary urgency, which are signs of spinal cord compression in the neck
Causes and risk factors
Ageing and inherited factors explain most of the variation between people. Additional contributors are previous spinal injury or surgery, heavy manual work, smoking, obesity and, for the neck, occupations involving sustained awkward head postures. When discs lose height, more load passes to the facet joints, which enlarge in response. A vertebra may slip forwards on the one below (degenerative spondylolisthesis), most often at L4-L5 in women over 50, which adds to narrowing of the canal.
How it is diagnosed
- History and neurological examination: Walking pattern, reflexes, power, sensation and hand function, including tests for spinal cord involvement.
- X-rays: Show disc height loss, spurs, facet joint arthritis and slippage; flexion and extension views assess instability.
- MRI: Shows compression of nerves or the spinal cord and is needed for persistent limb symptoms or any sign of myelopathy.
- CT scan: Shows bony detail for surgical planning or when MRI is contraindicated.
- Diagnostic facet or medial branch blocks: Short-acting anaesthetic injections that identify painful facet joints before radiofrequency treatment.
- Nerve conduction studies and vascular tests: Help separate nerve root compression from peripheral neuropathy, and spinal from arterial causes of leg pain on walking.
Treatment options
- Exercise and staying active: Walking, cycling (well tolerated in stenosis because of the flexed posture), strengthening and flexibility work.
- Pain relief: Anti-inflammatories if suitable, with attention to stomach, kidney and heart risks in older adults. Long-term opioids are discouraged.
- Physiotherapy and posture advice: Including workstation changes for neck symptoms. Soft collars only for brief periods.
- Epidural or nerve root steroid injections: May ease limb pain for weeks to months in radiculopathy; benefit in stenosis is modest.
- Radiofrequency ablation of facet joint nerves: For facet pain confirmed by test blocks, with relief typically lasting 6 to 12 months.
- Decompression surgery: Lumbar laminectomy for stenosis that limits walking despite non-surgical care; it helps leg symptoms much more than back pain.
- Fusion: Added when there is instability or significant spondylolisthesis, not routinely.
- Cervical surgery: Anterior discectomy and fusion, disc replacement or posterior decompression for myelopathy or persistent arm pain. Myelopathy is usually operated on promptly because lost function may not return.
When it is urgent
Seek emergency care locally for numbness around the saddle area, new bladder or bowel problems, leg weakness or foot drop, or rapidly worsening hand clumsiness and unsteady walking. Severe new back pain after a minor fall in an older person may be a fracture. Back pain with fever, or with unexplained weight loss, needs prompt medical assessment.
Travelling to Türkiye for treatment
Living with spondylosis is mostly about exercise and pacing at home. A trip can be useful for a thorough assessment with MRI and a second opinion, especially if you have been advised to have a fusion, for image-guided injections or radiofrequency treatment within a clear plan, or for planned decompression surgery. Decompression typically needs 7 to 10 days on site and fusion somewhat longer. If you have signs of cervical myelopathy, do not postpone assessment for the sake of travel plans.
Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.
الأسئلة المتكررة
Is spondylosis the same as a slipped disc?
No. Spondylosis is gradual wear of joints and discs. A slipped disc is a specific herniation that may occur along the way.
My MRI report sounds alarming. Should I worry?
Terms such as degeneration, bulge and spur describe common age-related findings. What matters is whether they match your symptoms and examination.
Will I end up in a wheelchair?
That is very unlikely. Most people manage with exercise and occasional pain relief. Surgery is effective when nerves are truly compressed.
Is cycling or walking better for stenosis?
Cycling is often more comfortable because leaning forwards opens the spinal canal. Walking tolerance can be built gradually, using rests.
Can spinal arthritis be reversed?
No, but symptoms often improve and frequently do not track the scan findings over time.