What is the difference between spondylitis and spondylosis?

If you’ve ever felt confused by the terms “spondylitis” and “spondylosis,” you’re not alone. Many people get tripped up by these technical-sounding — and similar-sounding — spine conditions. Spondylitis is inflammation of one or more vertebrae, while spondylosis is a general term that refers to the degenerative changes in the spine. If you’ve been diagnosed with one or the other, you probably have a lot of questions, and you’ll need accurate answers in order to find the most effective treatment plan for you.

The team at Laser Spine Institute — the nation’s leader in minimally invasive spine surgery^ — can help. We take a patient-centered approach to spine care, beginning with educating our patients so they are sufficiently prepared to make fully informed treatment decisions. Here’s a brief overview of spondylitis and spondylosis, which you may find helpful.

What is spondylitis?

Spondylitis is a type of inflammatory arthritis that primarily affects the spine, causing the spinal joints and nearby ligaments to become increasingly inflamed. Usually, spondylitis initially develops in the lower back or sacroiliac (SI) joints at the base of the spine. In some cases, the inflammation eventually progresses into the joints in the upper back and neck (cervical spondylitis) or the shoulders, hips or knees. As the condition advances over time, the spinal joints and vertebrae may gradually become fused together, leading to spinal rigidity and reduced mobility.

What are the symptoms of spondylitis?

The onset and course of spondylitis can vary significantly from person to person. In many cases, the condition is diagnosed in late adolescence or early adulthood, but it can also develop much earlier or later in life.

The most common early symptoms of spondylitis are dull pain and stiffness in the lower back and buttocks. Initially, the pain may be felt only on one side of the body, or it may alternate sides. Later, the pain may spread to both sides of the buttocks and into the hips, thighs and heels, or the upper back, ribs, shoulders and neck. Less frequently, spondylitis may develop in a peripheral joint, such as a hip, knee, ankle, heel, shoulder or elbow, producing inflammation at the point where a ligament or tendon attaches to bone.

Spondylitis pain may also be accompanied by:

  • Fever
  • Loss of appetite
  • Mild to moderate anemia
  • General fatigue (which can occur as the body fights off the inflammation)
  • Bowel inflammation related to ulcerative colitis or Crohn’s disease
  • Eye inflammation (iritis or uveitis)

The precise causes of spondylitis remain unclear, although scientists have established a genetic link in certain cases. While there is currently no known cure for spondylitis, there are several forms of treatment available that can potentially alleviate the associated pain and enhance spinal function.

How is spondylitis treated?

In general, spondylitis treatment focuses on relieving pain and improving function. Because conservative treatment can be very effective for addressing spondylitis symptoms, most physicians advise their patients to begin with a combined approach that includes several nonsurgical therapies. Some options include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs). Often recommended as the first-line treatment for spondylitis, over-the-counter NSAIDs such as ibuprofen and naproxen can help relieve the associated pain and stiffness.
  • Analgesics. An over-the-counter pain reliever such as acetaminophen can be taken as needed during painful flare-ups. If necessary, a physician may prescribe a stronger medication.
  • Disease-modifying anti-rheumatic drugs (DMARDs). For a patient who does not find sufficient relief with the use of NSAIDs and analgesics, a physician may prescribe a traditional DMARD, such as sulfasalazine, or a biologic response modifier, such as a tumor necrosis factor inhibitor (TNF).
  • Corticosteroid injections. A powerful anti-inflammatory medication can be injected directly into the space surrounding an inflamed joint or ligament.
  • Physical therapy. A physician or physical therapist can recommend a regimen of targeted stretching and strengthening exercises designed to improve posture, enhance spinal flexibility and strengthen the core, back and abdominal muscles that support the spine.
  • Weight maintenance. Inflammation, certain medications and anxiety associated with a chronic illness can lead to a loss of appetite or upset stomach, making it difficult to keep weight on. On the flip side, every pound of excess weight can intensify the stress that is continually exerted on inflamed joints and ligaments. For these reasons (and myriad others related to general health and wellness), people who are diagnosed with spondylitis are encouraged to maintain a healthy body weight.

While surgical treatment is sometimes considered to address spondylitis, surgery is typically recommended only in very severe cases. For instance, a joint replacement procedure may be appropriate for a patient who is experiencing significant mobility issues. Additionally, spondylitis can sometimes cause kyphosis, an excessive curvature of the upper spine that results in a permanently slouched forward (hunchback) posture. Surgery, such as a spinal fusion procedure, may be recommended as a last resort treatment if kyphosis results in spinal nerve compression, difficulty breathing, digestive issues, disabling pain or impaired mobility.

What is spondylosis?

A much broader term than spondylitis, “ spondylosis “ refers to a group of degenerative spine conditions that often develop as a consequence of the natural aging process. Over time, repetitive motion can create cumulative wear and tear on the spine. In fact, the vast majority of people show some evidence of spondylosis after age 40.

Some common types of spondylosis include:

  • Degenerative disc disease. The spinal discs, which cushion and separate the vertebrae, can gradually become drier and thinner over time. In this weakened state, the discs are more prone to damage. For instance, if a disc bulges or ruptures, it can potentially invade the spinal canal and compress the spinal cord and or a nerve root.
  • Facet syndrome. With continual use, the cartilage the lines the highly mobile facet joints, which connect adjacent vertebrae, can slowly wear away, sometimes leading to painful bone-on-bone contact. In response, the body may produce protective bony growths (bone spurs) that can potentially press on nearby spinal nerves.
  • Spinal stenosis. Due to the presence of displaced tissue, such as a bulging or herniated disc, inflamed facet joint, spinal bone spur or thickened ligament, the spinal canal can become narrower. Within this limited space, the spinal cord or a nerve root may become constricted.

What are the symptoms of spondylosis?

The symptoms of spondylosis can vary based on the nature, location and severity of the underlying spine condition, and whether there is any nerve involvement. For instance, spondylosis may cause:

  • Localized pain and stiffness that worsen with rest and improve with physical activity
  • Pain that intensifies with certain body positions and movements, such as prolonged sitting
  • Difficulty bending or twisting the neck or back
  • Pain, muscle weakness, numbness and tingling sensations that travel from the neck through a shoulder, arm and hand, or from the lower back through a buttock, leg and foot
  • Headaches
  • A grinding sensation with spinal movement (crepitus)
  • A loss of balance
  • Difficulty walking
  • Bladder or bowel incontinence (this could be a sign of a rare, but serious complication known as cauda equina syndrome, which warrants emergency medical attention)

How is spondylosis treated?

Most people with spondylosis are able to manage their discomfort with home remedies and other nonsurgical treatments. Some common options include:

  • Physical therapy. A physician or physical therapist can recommend specific exercises to strengthen the muscles surrounding the spine. As these muscles become stronger, they will be better able to hold the spine securely in place and shift some of the pressure away from compressed spinal nerves.
  • Restorative yoga. When practiced consistently, certain yoga poses can help strengthen the core, back and abdominal muscles that help keep the spine in proper alignment.
  • Weight loss. Losing excess body weight — even just a few pounds — can help relieve painful pressure on the spine.
  • NSAIDs. Many varieties of NSAIDs are readily available over the counter or by prescription. A physician can recommend the best option for relieving pain, inflammation and stiffness associated with spondylosis.

In sum, spondylitis and spondylosis are both potentially painful conditions that can affect the spine, but that’s essentially where their similarities end. If you have further questions, feel free to reach out to Laser Spine Institute. Our surgeons perform minimally invasive outpatient surgery to address spondylosis and related conditions. If you’ve been diagnosed with spondylosis and are considering surgical treatment, we can provide a free MRI review* to help you determine if you are a candidate for our minimally invasive surgery.

On the other hand, Laser Spine Institute does not specifically treat spondylitis. Nevertheless, if you’ve been diagnosed with spondylitis, our team can help you explore your treatment options — both conservative and surgical — to relieve some of the pain and stiffness that you may be experiencing as a result of this chronic inflammatory condition.