Spinal Osteoarthritis, Spondylosis and Wear and Tear: Understanding Your Diagnosis

Being told you have “wear and tear” spondylosis or osteoarthritis in your spine can sound worse than it actually is. These are three names for the same thing and you may see any of them on a scan report or referral letter. A lot of patients come in assuming this means their back is wearing out and decline is inevitable, when in reality these changes are an extremely common part of getting older, present in the great majority of people by their eighties, symptomatic or not.

What matters far more than what a scan shows is how your spine actually functions day to day and that’s usually something you have more influence over. If wear and tear is showing up alongside general back pain, my back pain guide covers the broader picture as an additional read.

“Leslie is always calm, friendly and professional”
“…What initially started as treatment for a specific injury has evolved into monthly maintenance appointments, which I have no doubt have helped keep my back in tip-top shape …. Leslie is always calm, friendly and professional, and I genuinely feel in very safe hands during every appointment. The clinic itself is welcoming and easily accessible on the ground floor, with plenty of free parking available, which makes visits really convenient. I have recommended Leslie to friends in the past and will absolutely continue to do so in the future. Highly recommended.”
Janine D

What is Spinal Osteoarthritis?

Spinal osteoarthritis, facet joint osteoarthritis and spondylosis are very similar terms for describing wear and tear of the spine.

However more specifically:

1.Spinal Osteoarthritis refers to arthritis of the spine, usually meaning degeneration of the facet joints, wearing of cartilage, causing inflammation and stiffness.

2. Facet Joint Arthritis is a more precise diagnosis indicating the facet joints themselves becoming arthritic and can be a significant source of back pain and discomfort.

3. Spondylosis is the broader term which describes the overall ageing process affecting disc degeneration, facet joint arthritis, bone spurs and thickening of ligaments. Over time, the cartilage cushioning these joints thins and the body responds by forming small bony changes around the joint margins. It’s essentially the same process as osteoarthritis in a knee or hip, just happening in the spine instead.

The facet joints themselves are also known as zygapophyseal joints and the wear process is sometimes described more formally as facet joint arthropathy or spondylosis deformans. The bony changes that form around worn joint margins are called osteophytes, commonly known as bone lips or spurs, while thickening of the bone just beneath the cartilage is known as subchondral sclerosis. When these changes narrow the space around the spinal cord or nerve roots, the result is called spinal stenosis, a related but distinct condition that can sometimes develop alongside long-standing osteoarthritis and occasionally produces its own separate set of symptoms.

What Causes Spinal Osteoarthritis

Age is the biggest factor, these changes become more common the older we get, but it isn’t purely about the your age. Previous injuries, years of heavy manual work, genetics and carrying significant extra weight can all accelerate wear on the spine’s joints. Repetitive postures, such as prolonged sitting with poor support, can contribute over time too, though the link between any single activity and osteoarthritis is rarely straightforward.

Symptoms of Spinal Osteoarthritis

Patients usually describe stiffness that’s worse first thing in the morning or after sitting still for a while, easing once they get moving. Aching that builds through the day, particularly after standing or activity, is common too, along with a general sense of reduced flexibility compared with years before. Unlike a disc problem or trapped nerve, it rarely produces sharp, shooting pain down a limb, though it can coexist with those issues, since the same degenerative process can affect the space nerves pass through as well.

How Chiropractic May Help You

A large body of imaging research shows that degenerative changes like disc bulges and facet joint wear are extremely common, even in people with no back pain at all. Symptoms may present in around a third of pain-free adults in their twenties and the large majority by their eighties.[2] This matters because it means a diagnosis of wear and tear doesn’t reliably predict how much pain you’ll have or whether chiropractic care can help you feel better regardless of what a scan shows.

NICE guidance on osteoarthritis is clear that exercise is the core and first-line treatment. This is advised ahead of medication for improving symptoms and maintaining function over the long term. Though it’s worth noting that much of this evidence comes from knee and hip osteoarthritis research rather than the spine specifically.[3] Manual therapy has its own, more modest evidence base. A systematic review looking specifically at older adults with chronic low back pain found moderate evidence that manual therapy reduced pain and disability, though the authors of the review were honest that only a small number of well-designed studies existed and were cautious about firm recommendations from them.[1]

In my chiropractic practice, care usually combines gentle manual therapy with a tailored exercise programme, since the research consistently points to staying active as doing more long-term good when combined with hands-on technique. What that looks like varies a great deal between patients, someone very stiff first thing in the morning needs a different approach to someone whose main issue is pain after standing for long periods. I build the plan around what’s actually limiting you, your care will be individual.

If arthritis in your spine is getting in the way of things you would rather be doing, come and talk it through. I offer a free 15-minute consultation, you can come in for a short no-obligation chat with no examination or treatment.

Book a free consultation

Or call for a chat on 01202 937568

Red Flags

Spinal osteoarthritis itself isn’t a medical emergency and the stiffness and aching it causes, while frustrating, isn’t a sign that something serious is happening. It’s worth seeing your GP promptly, though, if pain comes with unexplained weight loss, fever, a history of cancer, significant trauma or any new numbness, weakness or bladder and bowel changes, since these point to something other than straightforward wear and tear.

Book your chiropractic appointment online

If you’ve been told you have wear and tear or osteoarthritis in your spine or any associated back pain issues and want to understand what it actually means for you, I’m happy to talk it through.  If you come in with a wear and tear diagnosis, the first visit focuses on understanding how it’s actually affecting you day to day, through a detailed history and physical assessment, rather than treating the scan report on its own. From there we agree a plan together, usually combining hands-on care with specific exercises suited to your situation. My first visit page covers what to expect in more general detail and I also have a huge range of questions and answers on our FAQ’s page should be useful too.

Frequently Asked Questions

Chiropractic care may help manage the symptoms of spinal osteoarthritis, though it cannot reverse the underlying joint changes. NICE recommends manual therapy alongside exercise and self-management as part of osteoarthritis care.[3] My aim at Bournemouth Chiropractic is to ease stiffness and support movement, not to claim I can undo wear that has built up over years.

To a large extent, yes. Degenerative changes in the spine are extremely common with age and often show up on scans in people with no pain at all. This is why I treat the person and their symptoms rather than the X-ray report, since the two frequently do not match. However, X-rays have their role to play because as chiropractors, we are qualified to read spinal X-rays.

For practical purposes, yes. Spondylosis is the umbrella term radiologists use for age-related degenerative change in the spine, covering both the discs and the small facet joints. Spinal osteoarthritis refers specifically to wear in the facet joints and wear and tear is simply the everyday name for the same process. Whichever term appears on your report, it describes the same set of changes and is managed the same way.

Usually the opposite. For osteoarthritis, staying active is one of the most effective things you can do and appropriate exercise is a core NICE recommendation. [3] Gentle, regular movement tends to reduce stiffness and maintain function. I will guide you on what is suitable.

Not usually. Spinal osteoarthritis is generally diagnosed from your history and examination and routine imaging is not recommended for most back and neck pain because it rarely changes the plan. If I find anything during your assessment that warrants imaging or a GP referral, I will arrange that.

Whatever's behind your spinal osteoarthritis or wear and tear, come and find out

Spinal osteoarthritis, spondylosis and wear and tear can each cause pain in different ways and a good first step is almost always a proper assessment. Especially if it is getting in the way of your day-to-day life, I'd happily see you to find out whether chiropractic may help. During your consultation I'll take a full medical history, examine you carefully and answer your questions about what is going on. Alternatively, I offer a free chat to help you decide

Spinal osteoarthritis and wear-and-tear changes are a very common reason people book in to see me here in Bournemouth and Poole.

In many of the cases I see, chiropractic care is a very well-tolerated option worth considering and I'll explain clearly whether it's likely to help in your particular case. If I think you'd be better served by your GP, a specialist or another practitioner, I'll help point you in the right direction. Either way, you'll leave knowing more than when you arrived.

There's no pressure and no obligation, just come in, get assessed and let's find you a way forward.

The first step is just a conversation. Call, message or email, whatever's easiest and we'll take it from there.

References and Further Reading

References

[1] de Luca KE, Fang SH, Ong J, Shin KS, Woods S, Tuchin PJ. The effectiveness and safety of manual therapy on pain and disability in older persons with chronic low back pain: a systematic review. J Manipulative Physiol Ther. 2017;40(7):527-534. doi:10.1016/j.jmpt.2017.06.008

[2] Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811-816. doi:10.3174/ajnr.A4173

[3] National Institute for Health and Care Excellence. Osteoarthritis in over 16s: diagnosis and management. NICE guideline NG226. 2022.

Medical Disclaimer : The information on this website is provided for general informational purposes only and does not constitute medical advice. It is not a substitute for professional diagnosis, treatment, or guidance from a qualified healthcare practitioner. If you are experiencing pain or any other health concern, you should seek advice from your GP or another appropriately qualified clinician. Chiropractic treatment may not be suitable for everyone. Leslie Budzynski DC will assess your suitability for treatment at your initial consultation and will refer you to another healthcare professional where appropriate. Treatment outcomes vary between individuals. No guarantee of results is made or implied.

Practitioner: Leslie Budzynski D.C. | Doctor of Chiropractic | GCC registration: 00043 | BCA membership number: 0072

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