Spondyloarthrosis is a degenerative spine disorder. Learn about causes, symptoms, and evidence-based treatment options to reduce pain and improve mobility.
What is Spondyloarthrosis?
Spondyloarthrosis, also known as spinal osteoarthritis, is a degenerative condition that affects the facet joints of the spine. These joints, located between the vertebrae, allow for flexibility and movement while maintaining spinal stability. Over time, wear and tear on these joints can lead to cartilage degradation, inflammation, and the development of bone spurs (osteophytes), which contribute to pain and stiffness.
Biomechanically, spondyloarthrosis alters the normal function of the spine. As the cartilage that cushions the facet joints breaks down, the bones may rub against each other, causing friction and inflammation. This can reduce spinal mobility, affect posture, and lead to nerve compression if bone spurs impinge on nearby nerve roots.
Anatomically, spondyloarthrosis primarily affects the:
- Facet joints: Located at the back of the spine, these joints guide and limit spinal movements.
- Intervertebral discs: Although primarily a joint disorder, disc degeneration often accompanies spondyloarthrosis, leading to reduced disc height and further joint stress.
- Ligaments and muscles: The surrounding soft tissues may become strained due to altered spinal mechanics, leading to muscle spasms and ligament stiffness.
- Nerve roots: In advanced stages, bone spurs can narrow the spinal canal (spinal stenosis) or compress nerve roots, causing radiating pain.
Spondyloarthrosis can occur in any part of the spine but is most commonly found in the cervical (neck) and lumbar (lower back) regions, where mobility and load-bearing are greatest.
What is the difference between spondyloarthrosis and spondyloarthritis?
While the terms sound similar, spondyloarthrosis and spondyloarthritis refer to fundamentally different spinal disorders.
Spondyloarthrosis: a degenerative mechanical condition
Key features
- Caused by joint wear and cartilage loss
- Non-inflammatory in origin
- Localized joint changes with no systemic involvement
- Typically affects older adults
- Often managed conservatively with physical therapy
Spondyloarthritis: an inflammatory rheumatic disease
Key features
- Autoimmune disorder affecting joints and entheses
- Common subtypes include:
- Ankylosing spondylitis
- Psoriatic arthritis
- Reactive arthritis
- Involves systemic symptoms such as:
- Fatigue
- Morning stiffness lasting >30 minutes
- Elevated inflammatory markers (CRP, ESR)
A comparative review published in SAGE Open Medicine emphasizes the importance of distinguishing between mechanical and inflammatory back pain to ensure proper management (SAGE Journal, 2024).
Incidence
Spondyloarthrosis is one of the most common forms of spinal degeneration, especially prevalent in older adults due to the natural aging process.
How Common Is Spondyloarthrosis?
- Age-related prevalence: Studies suggest that up to 80% of individuals over 60 show radiographic evidence of spondyloarthrosis, though not all experience symptoms.
- Gender differences: While both men and women are affected, women over 50 tend to report more severe symptoms, possibly due to postmenopausal changes in bone density.
- Geographic and occupational factors: People involved in physically demanding jobs, such as construction workers or nurses, show higher incidence rates due to repetitive spinal stress.
- Spinal regions affected:
- Lumbar spine: Most frequently affected due to its role in weight-bearing and mobility.
- Cervical spine: Commonly involved, leading to neck pain and headaches.
- Thoracic spine: Least commonly affected but can occur, especially in cases of spinal deformities.
Risk Factors
Several factors contribute to the development of spondyloarthrosis. Understanding these can help in early detection and prevention.
Age
Aging is the primary risk factor.
- Degenerative changes: Over time, the cartilage in facet joints naturally wears down, leading to spondyloarthrosis.
- Reduced hydration: Aging decreases the water content in intervertebral discs, leading to disc height loss and increased stress on facet joints.
Genetic Predisposition
Family history plays a role.
- Inherited joint structure: Certain individuals may inherit spinal structures that predispose them to faster cartilage degeneration.
- Collagen disorders: Genetic conditions affecting connective tissues can accelerate joint wear.
Occupation and Lifestyle
Repetitive strain on the spine increases risk.
- Physically demanding jobs: Heavy lifting, repetitive bending, or prolonged standing can stress facet joints.
- Sedentary lifestyle: Lack of physical activity weakens spinal support muscles, increasing joint stress.
- High-impact sports: Activities like gymnastics or football can lead to repetitive spinal microtraumas.
Obesity
Excess body weight adds strain to the spine.
- Increased load: The lumbar spine bears the brunt of extra weight, accelerating joint wear.
- Inflammatory factors: Adipose tissue releases inflammatory cytokines, potentially worsening joint degeneration.
Previous Spinal Injuries
Past trauma can predispose joints to degeneration.
- Fractures or dislocations: Can alter spinal alignment, increasing stress on facet joints.
- Disc injuries: Herniated or degenerated discs can shift spinal load onto facet joints, hastening spondyloarthrosis.
What are the early symptoms of spondyloarthrosis?
Recognizing the early symptoms of spondyloarthrosis is key to initiating timely intervention. The onset of this condition is usually gradual and may be mistakenly attributed to normal aging or poor posture.
Morning stiffness and spinal discomfort
One of the most common early signs of spondyloarthrosis is morning stiffness in the back, especially in the lower lumbar or cervical regions. This stiffness typically lasts less than 30 minutes and improves with movement, unlike in inflammatory conditions.
Key early indicators
- Localized pain: Felt in the neck or lower back, often described as dull and deep.
- Stiffness after rest: Discomfort that becomes more noticeable after long periods of inactivity or sleep.
- Reduced range of motion: Particularly in the lumbar spine, making bending or rotating the trunk difficult.
Localized facet joint pain
Pain associated with spondyloarthrosis tends to stay near the affected segment. For example:
- In cervical spondyloarthrosis, pain may radiate to the shoulders.
- In lumbar spondyloarthrosis, it can extend to the buttocks or thighs but usually doesn’t go below the knee.
Activity-related worsening
Unlike inflammatory disorders, spondyloarthrosis pain worsens with activity, especially with extension-based movements such as walking downhill or standing for long periods.
Symptoms
Spondyloarthrosis symptoms vary based on the spinal region affected and the severity of degeneration.
Localized Pain
- Facet joint pain: Often described as a dull, aching pain localized to the affected area.
- Cervical spondyloarthrosis: Causes neck pain, sometimes radiating to the shoulders.
- Lumbar spondyloarthrosis: Leads to lower back pain, which may worsen with activity and improve with rest.
Stiffness and Reduced Mobility
- Morning stiffness: Many individuals experience stiffness upon waking, which eases with movement.
- Limited range of motion: Turning the head or bending the back can become difficult due to joint stiffness.
Nerve Compression Symptoms
When bone spurs compress nerves, additional symptoms may occur.
- Radiculopathy: Pain radiating along a nerve path, such as down the arm or leg (sciatica in lumbar cases).
- Numbness and tingling: Especially in the limbs if nerve roots are compressed.
- Muscle weakness: Prolonged nerve compression can weaken the muscles served by the affected nerve.
Mechanical Symptoms
- Crepitus: A grinding or popping sensation during spinal movement, due to joint surface irregularities.
- Spinal instability: Advanced cases may lead to abnormal vertebral movement, causing further pain and functional limitations.
Impact on Daily Activities
- Activity limitation: Simple tasks like bending, lifting, or prolonged sitting may become painful.
- Sleep disturbances: Discomfort and stiffness can interfere with sleep quality.
- Emotional impact: Chronic pain may lead to anxiety or depression in some individuals.
Early recognition and treatment of spondyloarthrosis can help manage symptoms and prevent progression, allowing individuals to maintain mobility and quality of life.
Diagnosis
Accurate diagnosis of spondyloarthrosis is essential for effective management. The diagnostic process involves a combination of clinical evaluation, medical history assessment, imaging studies, and laboratory tests.
Clinical Examination
A thorough clinical examination includes:
- Physical Assessment: Evaluating spinal range of motion, posture, and identifying tender areas. Movement tests help determine joint stiffness and pain levels.
- Palpation: Detecting tenderness or swelling around the facet joints.
- Neurological Tests: Assessing reflexes, muscle strength, and sensory functions to identify potential nerve compression.
Medical History
Gathering a comprehensive medical history involves:
- Symptom Evaluation: Discussing the onset, duration, and nature of pain, stiffness, and functional limitations.
- Lifestyle Factors: Considering occupation, physical activity levels, and previous spinal injuries that may contribute to degeneration.
- Family History: Identifying genetic predispositions to joint diseases.
Imaging Studies
Imaging techniques are essential for confirming spondyloarthrosis:
- X-rays: Reveal joint space narrowing, bone spurs (osteophytes), and facet joint sclerosis.
- MRI (Magnetic Resonance Imaging): Provides detailed images of soft tissues, detecting nerve root compression, disc degeneration, and inflammation.
- CT Scans (Computed Tomography): Offer high-resolution images of bone structures, evaluating facet joint damage and bone spur formation.
Laboratory Tests
While primarily diagnosed through imaging, laboratory tests can rule out other conditions:
- Blood Tests: Measuring markers like C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) to exclude inflammatory arthritis.
- Genetic Markers: Testing for specific genes associated with spondyloarthropathies.
What are the best non-surgical treatments for spondyloarthrosis?
Managing spondyloarthrosis without surgery is possible in most cases. Conservative care focuses on reducing pain, improving mobility, and slowing degeneration.
Physical therapy for spinal stability
Physical therapy plays a vital role in managing spondyloarthrosis:
- Strengthening exercises for deep stabilizers (e.g., transversus abdominis, multifidus)
- Stretching routines to improve flexibility and mobility
- Postural training to optimize spinal alignment
According to a 2024 review in SAGE Open Medicine, structured physiotherapy protocols improve functional outcomes and reduce pain in patients with lumbar spondyloarthrosis (SAGE Journal).
Manual therapy and mobilization
Manual techniques such as joint mobilization, myofascial release, and trigger point therapy can:
- Relieve joint restrictions
- Enhance circulation
- Reduce muscular compensation
These therapies should be performed by licensed physiotherapists or manual therapists trained in spinal techniques.
Therapeutic exercise programs
A customized exercise plan is essential for maintaining joint health:
- Low-impact aerobic exercises (walking, cycling)
- Core stability training
- Spinal decompression techniques (e.g., supported forward bending)
Example of a weekly program
| Day | Focus | Example Exercise |
|---|---|---|
| Mon | Mobility | Cat-cow, pelvic tilts |
| Wed | Strength | Bird-dog, dead bug |
| Fri | Endurance | Walking, upright cycling |
Pain relief and supportive therapies
Heat therapy and electrotherapy
Modalities such as TENS (Transcutaneous Electrical Nerve Stimulation) or ultrasound therapy can offer short-term relief by modulating pain signals and reducing muscle tension. Heat application improves local blood flow, promotes tissue relaxation, and enhances the elasticity of surrounding soft tissues. These interventions are commonly integrated into physiotherapy protocols for spondyloarthrosis and have been associated with pain reduction and improved mobility in several clinical studies (SAGE Journal, 2024).
Anti-inflammatory support
While not curative, non-steroidal anti-inflammatory drugs (NSAIDs) or topical analgesics can help manage acute flare-ups of pain and inflammation. In addition, many patients report subjective improvement when using natural supplements such as curcumin, omega-3 fatty acids, or glucosamine sulfate. These compounds have shown potential anti-inflammatory effects and cartilage-protective properties. A 2025 review published in Scientific Reports supports the role of nutritional interventions and adjunctive therapies in managing chronic spinal degeneration (Nature, 2025).
Ergonomic and lifestyle interventions
Small daily changes can make a big difference in managing spondyloarthrosis:
Sleep on a medium-firm mattress
Use ergonomic chairs and lumbar supports
Avoid prolonged sitting or standing
Perform regular micro-breaks with gentle stretching
Chronic nature of spondyloarthrosis
Spondyloarthrosis is considered a chronic condition that progresses gradually and cannot be completely reversed. However, symptom intensity and progression vary, and many people experience significant improvement through appropriate management.
Managing spondyloarthrosis focuses on alleviating pain, enhancing mobility, and preventing further joint degeneration. A multidisciplinary approach combining medication, physical therapy, lifestyle modifications, and, in some cases, surgical intervention is often effective.
Interventional and Surgical Treatments
When conservative measures are insufficient, more invasive options may be considered.
Radiofrequency Ablation
This minimally invasive procedure uses heat to disrupt nerve fibers transmitting pain signals from affected facet joints, offering prolonged relief.
Surgical Interventions
- Spinal Fusion: In cases of severe instability, fusing adjacent vertebrae stabilizes the spine and reduces pain.
- Decompression Surgery: Removing bone spurs or thickened ligaments relieves nerve pressure, improving symptoms.
Effectiveness of Physiotherapy
A systematic review and meta-analysis by Pécourneau et al. (2022) confirmed the effectiveness of physiotherapy in managing spinal conditions like spondyloarthrosis, highlighting improvements in pain, function, and quality of life (Pécourneau et al., 2022).
Preventive Strategies
Preventing or slowing the progression of spondyloarthrosis involves proactive measures.
Regular Physical Activity
Engaging in low-impact exercises strengthens spinal support structures, maintains flexibility, and promotes joint health.
Balanced Diet
Consuming a diet rich in calcium, vitamin D, and omega-3 fatty acids supports bone integrity and reduces inflammation.
Postural Awareness
Maintaining proper posture during daily activities minimizes spinal strain and potential joint degeneration.
Early Intervention
Addressing spinal issues promptly, such as disc degeneration or minor injuries, can prevent the development or exacerbation of spondyloarthrosis.
By integrating these treatment modalities and preventive measures, individuals with spondyloarthrosis can effectively manage symptoms and maintain an improved quality of life.
Physiotherapy and Spondyloarthrosis
Physiotherapy plays a crucial role in managing spondyloarthrosis, focusing on reducing pain, improving spinal mobility, and enhancing the quality of life. Although these methods may help, it is important to note that each case is unique, and what works for one person may not work for another.
Note: The following treatment recommendations are provided by a certified physiotherapist and kinesiologist and are intended solely for informational purposes to support the treatment of spondyloarthrosis. However, each case is unique. It is strongly recommended to consult a qualified doctor or physiotherapist for an accurate diagnosis and to develop an individualized treatment plan tailored to your needs.
Benefits of Physiotherapy for Spondyloarthrosis
- Pain Relief: Targeted exercises and manual therapy can help reduce pain by improving spinal alignment and reducing joint stress.
- Increased Mobility: Stretching and mobility exercises can help maintain or restore spinal flexibility.
- Strengthening Muscles: Strengthening the core and back muscles helps support the spine and reduce the load on affected joints.
- Improved Posture: Corrective exercises can help improve posture, reducing strain on the spine and facet joints.
Recommended Exercises for Spondyloarthrosis
Pelvic Tilts
- Purpose: Strengthen the lower back and abdominal muscles.
- How to Perform: Lie on your back with knees bent and feet flat on the floor. Tighten your abdominal muscles and press your lower back into the floor. Hold for 5 seconds, then relax. Repeat 10-15 times.
Cat-Cow Stretch
- Purpose: Improve spinal flexibility and relieve tension.
- How to Perform: Start on hands and knees. Inhale and arch your back, lifting your head and tailbone towards the ceiling (cow pose). Exhale and round your back, tucking your chin to your chest (cat pose). Repeat 10-15 times.
Bridge Exercise
- Purpose: Strengthen the glutes and lower back.
- How to Perform: Lie on your back with knees bent and feet flat on the floor. Lift your hips towards the ceiling, squeezing your glutes at the top. Hold for 5-10 seconds, then lower slowly. Repeat 10-15 times.
Child’s Pose Stretch
- Purpose: Stretch the lower back and hips.
- How to Perform: Start on hands and knees, then sit back onto your heels while extending your arms forward. Hold the stretch for 20-30 seconds and repeat 3-5 times.
These exercises can help improve spinal health and manage symptoms, but they should be performed under the supervision of a qualified physiotherapist to ensure proper technique and safety.
How Can I Help Myself?
Managing spondyloarthrosis at home involves adopting habits and practices that may alleviate symptoms and improve overall well-being. While these strategies may help, it is important to approach them cautiously and consult healthcare professionals when necessary.
Maintain Regular Physical Activity
Engaging in regular, low-impact exercise can help maintain spinal health and reduce stiffness.
- Walking: A simple and effective exercise that promotes circulation and spinal mobility.
- Swimming: Provides a full-body workout without stressing the joints.
- Yoga or Pilates: Focuses on flexibility, balance, and core strength, which can support spinal health.
Improve Ergonomics
Making ergonomic adjustments in your daily routine can help reduce spinal strain.
- Workstation Setup: Ensure your desk, chair, and monitor are set up to promote good posture.
- Proper Lifting Techniques: Always bend at the knees and keep the back straight when lifting heavy objects.
Heat and Cold Therapy
Applying heat or cold packs can help manage pain and inflammation.
- Heat Therapy: Use a heating pad or warm towel to relax tight muscles and improve blood flow.
- Cold Therapy: Apply an ice pack to reduce inflammation and numb the area during pain flare-ups.
Maintain a Healthy Weight
Excess weight can place additional stress on the spine. A balanced diet and regular exercise can help achieve and maintain a healthy weight, reducing spinal load.
Stress Management
Chronic pain can be exacerbated by stress. Incorporating stress-relieving activities such as meditation, deep breathing exercises, or mindfulness can help manage both pain and mental well-being.
Frequently Asked Questions
1. What is spondyloarthrosis?
Spondyloarthrosis is a degenerative condition affecting the facet joints of the spine, leading to pain, stiffness, and reduced mobility. It commonly occurs due to aging and wear and tear on the spine.
2. Can physiotherapy help with spondyloarthrosis?
Yes, physiotherapy can help manage spondyloarthrosis by improving spinal mobility, strengthening supporting muscles, and reducing pain. However, it is essential to follow a personalized treatment plan designed by a qualified physiotherapist.
3. Is exercise safe for spondyloarthrosis?
Low-impact exercises such as walking, swimming, and yoga are generally safe and beneficial for people with spondyloarthrosis. Always consult a healthcare professional before starting any new exercise routine.
4. Can spondyloarthrosis be cured?
There is currently no cure for spondyloarthrosis, but symptoms can be managed effectively through physiotherapy, medication, lifestyle changes, and, in some cases, surgical interventions.
5. When should I see a doctor?
Consult a doctor if you experience persistent or worsening pain, numbness, tingling, or weakness in the limbs, as these could indicate nerve involvement requiring medical attention.
