What it is
Spondylosis is the umbrella term for degenerative change in the spine: disc height loss, bone spurs, facet joint enlargement and ligament thickening. It can affect the neck, the mid-back or the lower back, and it is usually present at several levels at once.
It is a description of what the imaging shows. On its own it does not explain symptoms, and it is not a reason to operate.
Symptoms
- Aching and stiffness, typically worse in the morning and after inactivity
- Pain that varies week to week rather than progressing steadily
- Reduced range of movement
- Where spurs narrow a nerve exit: pain, numbness or weakness into an arm or leg
- Where the canal is narrowed: the walking-limited pattern of stenosis
How it is diagnosed
X-rays show the changes clearly and are usually sufficient. MRI is added when the examination points to nerve or cord involvement. The important step is not the imaging but matching it to the examination: spondylosis is so common that a scan alone will almost always find something to blame.
Non-surgical treatment
Physical therapy, conditioning, weight management, activity modification, anti-inflammatory medication, and targeted injections where a specific joint or nerve has been identified. The great majority of spondylosis is managed this way indefinitely.
When surgery is considered
Only where the wear has produced a specific, identifiable problem — a compressed nerve with matching symptoms, instability, or deformity affecting balance. Surgery for spondylosis in general, without a specific target, does not have a good track record and Dr. Long will say so.