What Is Spondylosis & What Actually Helps?

This article provides an overview of spondylosis including what it is, the symptoms it can cause, and evidence-based management. It includes information as seen in the video What Is Spondylosis? (& What Actually Helps)

https://www.youtube.com/watch?v=3DkE0JFwDEk

What Is Spondylosis?

Spondylosis is a general term used to describe age-related changes in the spine. For example degeneration of the intervertebral discs, changes in the spinal joints, or adaptations in surrounding tissues such as ligaments and muscles.

Spondylosis can occur in different parts of the spine:

·      the cervical spine (neck)

·      the thoracic spine (mid-back)

·      the lumbar spine (lower back)

What do scans tell us?

Most commonly, spondylosis is identified in a scan such as an MRI or X-ray. These scans show the anatomy of the spine and surrounding tissue. In the case of spondylosis, the scans will show changes to the anatomy. For example, reduced intervetbral disc height, foraminal narrowing (narrowing around the nerves), or osteophytes (bone spurs).

What they don't show is the symptoms we will experience. This is because changes visible on scans can occur in people with symptoms and without symptoms, meaning a person with changes visible on a scan may or may not experience pain and symptoms.

Additionally, the degree of changes seen on imaging does not necessarily correlate with the severity of symptoms. This means it is not really possible to predict a person’s symptoms based on the changes seen on MRI.

This is good news, because it means that anatomical changes don’t necessarily dictate the symptoms experienced. This means, in most cases it is possible to improve symptoms despite the anatomical changes.

What symptoms can occur with spondylosis?

Pain is usually the most noticeable symptom and the main reason people seek help. For example, aching pain around the neck or back, sharp pain with certain movements, or radiating pain into the arm or leg.

Other common symptoms include

·      stiffness

·      reduced mobility

·      muscular tightness

·      or difficulty tolerating activities that were previously easy to manage

Symptoms often fluctuate over time with many people experiencing periods where symptoms are manageable, followed by flare-ups where pain or stiffness temporarily increase.

What Actually Helps?

In many cases symptoms can be managed effectively, and exercise is considered the main non-surgical treatment approach for spondylosis.

Some of the key goals of physiotherapy exercise are to:

·      Reduce or manage pain

·      Improve movement

·      Build strength and endurance

Typically, exercise programs include three broad categories.

1. Pain management exercises. These are gentle movements aimed at reducing pain and stiffness.

2. Range of motion exercises. These help maintain or improve movement through the spine and surrounding joints.

3. Strength exercises. These help build muscle mass, endurance, and overall physical capacity.

Importantly, exercise does not need to be extreme to be helpful like perfect posture, intense workouts, or hours in the gym. For most people, consistency and gradual progression matter far more than perfection.

Won’t Exercise Make Things Worse?

This is one of the most common concerns people have and it makes sense. As humans, our natural response to pain is to protect the area and reduce movement. Historically, this was helpful because pain was often linked to acute injuries like cuts, fractures, or sprains.

But with longer-term conditions like spondylosis, avoidance of movement can become part of the problem. Over time, inactivity can contribute to:

·      reduced strength

·      increased stiffness

·      reduced confidence

·      lower tolerance to activity

So while short periods of rest can help during a flare-up, prolonged inactivity often makes symptoms worse long term.

That does not mean ignoring pain or pushing through severe symptoms. Instead, the aim is usually gradual, tolerable, and consistent movement.

For example, during a flare-up it may help to:

·      temporarily reduce activity levels

·      prioritise sleep and recovery

·      take short rest breaks

·      continue gentle movement as tolerated

This approach is more effective than complete bed rest or stopping activity altogether.

When Should You Seek Professional Help?

While many people can successfully self-manage spondylosis, there are situations where professional assessment is important.

1. If you haven’t previously had a clinical assessment.  Assessment can help to confirm symptoms are consistent with spondylosis, rule out other conditions, and identify whether further investigation is needed.

2. To design an individualised exercise program. Exercise is also most effective when tailored to the individual. A physiotherapist can help design a progressive exercise program based on your symptoms, goals, fitness level, and current function.

Medical assessment should also be sought if symptoms develop such as:

·      numbness

·      muscle weakness

·      reduced grip strength

·      balance difficulties

·      unexplained falls

·      changes in bladder or bowel function

And prompt medical review is important if you experience:

·      severe or rapidly worsening pain

·      persistent night pain

·      fever or chills

·      unexplained weight loss

·      significant trauma such as a fall or accident

In summary spondylosis refers to common age-related changes in the spine.

·      Imaging findings do not always predict pain or function.

·      For most people, movement and exercise are part of the solution

·      Evidence-based physiotherapy management focuses on improving movement, building strength, managing flare-ups, and helping people stay active and confident over time.

If you’d like additional guidance, the accompanying A Practical Guide to Exercising with Spondylosis can be found on the age fit with tess website. It includes:

·      exercise planning,

·      flare-up management strategies,

·      and a comprehensive exercise library.

Tess Halbauer

Physiotherapist