Spondylosis: What It Actually Means

By: Peter F. Ullrich, Jr., MD

Spondylosis refers to a situation where there is degeneration of the spine. It could describe degeneration in the neck (cervical spondylosis) or degeneration in the lower back (lumbar spondylosis). Patients are often confused by the term because, like many other spine terms, doctors tend to use the term spondylosis differently. For example, doctors may use the term in any of the following ways:

To refer to general back pain in which there is degeneration of the spine but no known cause of back pain
As an “umbrella” term to describe any patient who has both degeneration of the spine and lower back pain
To describe osteoarthritis in the spine, either cervical osteoarthritis or lumbar osteoarthritis
To refer to lumbar or cervical degenerative disc disease.

Because of its broad definition, the term is more useful to describe MRI and X-ray findings than it is as a diagnosis identifying the cause of a patient’s pain.

Article continues below

Spondylosis is not Clinical Diagnosis

Degeneration of the spine is a natural phenomenon that occurs as people age. In fact, it is more common for people over age 60 to have degeneration of the spine, called spondylosis, than not. It is important to note that evidence of spondylosis on an MRI or a computed tomography scan (CT scan) does not mean that the patient’s neck or back pain is being caused by the degeneration.

The real problem with the term spondylosis, especially when it is used as a diagnosis, is that it does not address what specifically is creating the patient’s pain. For example:

There could be spinal stenosis, an abnormal narrowing of the spinal canal, that is creating leg pain when the patient walks.
The patient may have pain from osteoarthritis of the facet (spinal) joints, causing back pain during times of high activity.
The pain could be caused by degenerative disc disease, a degenerated disc that becomes dehydrated and loses some of its function, causing low back pain or neck pain, and possibly leg pain or arm pain.

These examples are only a few of the many possible contributors to a patient’s pain.

The treatments for each the above conditions are vastly different, and thus just saying there is spondylosis, or degeneration of the spine, does not give the doctor or the patient any direction in how to treat the pain. Most doctors arrive at a diagnosis by combining findings of:

The patient’s medical history, which focuses on a complete description of the pain and other symptoms, the pain’s location, severity, and any activities or positions that improve or worsen the pain
A physical exam, which can further isolate the cause of the pain
When warranted, further tests to confirm the diagnosis, which may include one or a combination of a radiographic test (such as an MRI scan, CT scan or X-ray), or an injection to a specific area of the spine to see if it eases the pain.

After arriving at a confirmed diagnosis for the cause of a patient's pain (rather than just the finding that there is degeneration in the spine, which may or may not be causing the pain), physicians then usually use more specific terms for the diagnosis (such as degenerative disc disease, osteoarthritis, or spinal stenosis) because those terms more effectively describe what is causing the pain.

Spondylosis Questions

As with many other spine terms, spondylosis is more of a descriptive term than it is a diagnosis. Literally it can be translated to mean that one has both back pain and spine degeneration, regardless of what is causing the pain or where the degeneration is occurring. In order to better focus their back pain treatment, patients should ask their treating physician several questions for clarification about which part of the spine is degenerating. For example:

If it is degeneration of the discs, it is likely to be degenerative disc disease. See What is Degenerative Disc Disease?.
If it is degeneration in the facet joints, then it is likely to be osteoarthritis. See Osteoarthritis of the Spine.

Patients should also ask whether or not any related conditions, such as stenosis of the spine, require attention. If a person can get these questions answered, he or she may get a better idea as to what exactly is causing their pain.