Spondylosis vs Spondylitis

When discussing back pain and spinal disorders, terms like spondylosis and spondylitis often surface, causing confusion due to their similar-sounding names. However, these conditions differ significantly in their nature, causes, and treatments. This blog aims to provide a clear understanding of each condition, its causes, symptoms, and treatment options.

What is Spondylosis?

Spondylosis refers to a degenerative disorder that affects the spine. It is commonly known as spinal osteoarthritis and involves the wear and tear of spinal discs and joints. This condition primarily affects the elderly as the spine deteriorates with age, but certain lifestyle factors can accelerate its progression.

Areas Commonly Affected

  • Cervical Spondylosis: The neck region leading to pain and stiffness that can extend to the arms and head.
  • Thoracic Spondylosis: This part involves the middle of the spine; it is less common because this spinal segment is less involved in motion.
  • Lumbar Spondylosis: Affects the lower back, causing pain and limited mobility that can impede daily activities.

Spondylosis Causes

  • Aging: Natural degenerative changes in the spine are the primary cause of spondylosis.
  • Occupational and Lifestyle Factors: Heavy lifting, driving, or prolonged periods of sitting or standing can exacerbate spinal wear.

Spondylosis Symptoms

  • Pain and stiffness increase over time, particularly after long periods of inactivity or overuse.
  • Muscle spasms and weakness in the limbs if nerve compression occurs.

Diagnosing Spondylosis

  • Clinical Examination: The clinical examination focuses on identifying pain points along the spine, assessing the range of motion, and evaluating nerve function. Doctors look for areas of tenderness, stiffness, and any limitations in movement that suggest spinal joint deterioration.
  • Advanced Imaging: Advanced imaging techniques such as X-rays, MRI, and CT scans are crucial for confirming a diagnosis of spondylosis. These methods provide detailed views of the spine’s structure, revealing degenerative changes like bone spurs, disc space narrowing, and other signs of joint wear that are not detectable through a physical exam alone.

Treatment Options

  1. Conservative Treatments: Conservative methods include using ice packs to reduce inflammation and heat therapy to relax and soothe stiff muscles and joints. Over-the-counter pain relievers, such as NSAIDs, are commonly used to manage pain and reduce inflammation, providing relief from the symptoms of spondylosis.
  2. Interventional Therapies: When conservative treatments are insufficient, interventional therapies such as injections may be recommended. These can include corticosteroid injections to reduce inflammation and pain around the spinal nerves or joints. Hyaluronic acid injections may also be used in some cases to help lubricate and cushion joints, providing pain relief and improved mobility.

What is Spondylitis?

Spondylitis is an umbrella term for inflammatory diseases that affect the joints and bones of the spine and other areas. This condition results in chronic back pain and stiffness and can lead to severe complications like fusion of the spine if left untreated.

Focus on Ankylosing Spondylitis

The most prevalent form of spondylitis, ankylosing spondylitis, is a chronic inflammatory disease primarily affecting the spine and sacroiliac joints. It can lead to some vertebrae fusing together, severely restricting flexibility and posture.

Spondylitis Causes

  • Genetic Predisposition: Particularly the presence of the HLA-B27 gene.
  • Immune System Dysfunction: An overactive immune response can lead to inflammation in the joints.

Spondylitis Symptoms

  • Persistent pain and stiffness in the back, buttocks, and hips, especially noticeable in the morning or after rest.
  • Systemic symptoms like fatigue and eye inflammation can also occur.

Symptom Progression

Spondylitis symptoms can worsen without proper management, potentially leading to joint damage and decreased range of motion, unlike spondylosis, which progresses more predictably with age.

Diagnosing Spondylitis

  • Inflammatory Markers: Blood tests such as the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are commonly used to measure inflammation levels, which are often elevated in cases of spondylitis. Testing for the HLA-B27 gene is also crucial, as its presence is commonly associated with ankylosing spondylitis, though not exclusive to the condition.
  • Imaging Over Time: Initial diagnostic imaging often starts with X-rays to detect structural changes in the spine and joints. MRI is used for its superior ability to detect early signs of inflammation and is critical for monitoring the disease’s progression over time, influencing ongoing treatment decisions.

Treating Spondylitis

  1. Regular Monitoring: Regular follow-ups are essential to assess how the condition is responding to prescribed treatments. This monitoring typically includes clinical evaluations, routine blood tests to check inflammation levels, and periodic imaging to observe any progression or improvement. Adjustments to medication or therapy are made based on these findings.
  2. Surgical Options: In cases where spondylitis leads to severe joint damage or significant spinal deformity, surgery may be considered to relieve pain, restore function, or correct alignment. Common procedures include spinal fusion or joint replacement, depending on the areas most affected by the disease. Surgical intervention is usually a last resort after other treatments have failed.

Managing Life with Spondylosis or Spondylitis

Daily Management

Living with spondylosis or spondylitis involves adopting daily practices that minimize pain and maintain as much mobility as possible. Effective management centers on proactive lifestyle adjustments, appropriate physical activities, and the use of therapeutic aids. Here’s a closer look at some of these strategies:

Ergonomic Adjustments

  • Adjustable Desks: Using standing desks or adjustable workstation setups can help reduce the strain on the spine by allowing the user to alternate between sitting and standing positions.
  • Ergonomic Seating: Chairs that provide proper lumbar support and promote good posture can significantly reduce back pain. Features to look for include adjustable height, adequate seat depth, and backrest angle.
  • Monitor Height and Keyboard Placement: Screens should be at eye level and keyboards placed in a manner that allows the forearms to be parallel to the floor, preventing undue strain on the neck and shoulders.
  • Supportive Furniture: Investing in good quality mattresses and pillows that support the natural curve of the spine can improve sleep quality and reduce symptoms. Couches and chairs should also encourage a good sitting posture.

Supportive Devices

  • Back Braces: These can help stabilize the spine and reduce pain by restricting unnecessary movements that aggravate symptoms. They are particularly useful in periods of severe pain flare-ups.
  • Neck Collars: For those with cervical spondylosis, neck collars can provide temporary relief by taking some of the load off the neck muscles and stabilizing the spine.
  • Walking Aids: Canes, walkers, and rollators can assist those with spondylitis who experience significant mobility issues. These devices help maintain balance and reduce the risk of falls by providing additional support.

Physical Therapy

Physical therapy is a cornerstone of managing spondylosis and spondylitis. Regular sessions with a physical therapist can teach patients exercises specifically designed to strengthen the muscles that support the spine, improve flexibility, and reduce pain. Techniques may include:

  • Stretching Exercises: To improve flexibility in the spine and reduce stiffness.
  • Strengthening Exercises: Focusing on core muscles to provide better spine support.
  • Pain Relief Techniques: Such as heat or cold therapy, ultrasound, or TENS (Transcutaneous Electrical Nerve Stimulation).

Regular Check-ups and Monitoring

Regular medical appointments are crucial to monitor the progression of the disease and adjust treatment plans as needed. For those with spondylitis, particularly, monitoring inflammation levels and the condition’s impact on the body can dictate changes in medication or physical therapy routines.

Key Takeaways

Understanding the distinctions between spondylosis and spondylitis is crucial for effective management and treatment. Each condition requires a different approach, tailored to the nature of the disease and the individual’s specific circumstances. It’s important for patients to consult healthcare professionals to obtain a precise diagnosis and appropriate treatment plan, ensuring the best possible outcomes.


What is spondylitis and what causes it?

Spondylitis is an inflammatory disease that primarily affects the spine and other joints. It can be caused by autoimmune disorders (where the immune system attacks the body’s own tissues), genetic factors, and sometimes, preceding infections.

What is spondylosis and who does it affect?

Spondylosis is a degenerative condition that affects the spine’s joints and discs. It’s commonly associated with aging and tends to affect people over the age of 50, but it can also occur in younger individuals due to genetic predisposition or lifestyle factors such as heavy physical activity or previous spinal injuries.

What is the difference between spondylosis and spondylitis?

Spondylosis and spondylitis are both spinal conditions but differ significantly. Spondylosis is a degenerative disorder often termed spinal osteoarthritis, characterized by the wear and tear of spinal discs and vertebrae, leading to pain and stiffness. Spondylitis, however, is an inflammatory condition affecting the spinal joints and potentially leading to spine fusion, causing severe pain and stiffness that improves with activity. Treatment for spondylosis focuses on symptom management and slowing degeneration, whereas spondylitis treatments aim to reduce inflammation and prevent joint damage.

Dr. Charles A. Gatto is a board-certified, fellowship-trained orthopedic spine surgeon who specializes in all aspects of spine surgery.


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