Saturday, October 04, 2008


This is a common observation made by radiologists reading MRI reports of the cervical or lumbar spine. I usually ignore it, but I realized recently that I didn't really know what it meant. So now I do, and soon you will too.

Spondyl- refers to the joints and bone of the vertebral column and -osis means abnormal. Now there's a fancy diagnostic term that really is a non-diagnosis. Do I need a several thousand dollar imaging test to tell an aging someone with back pain that they have an abnormal spine?

More specifically, however, spondylosis is applied to those age-related changes in your backbone that leave you stiff and sore. This is a wear-and-tear sort of phenomenon, that which I used to call osteoarthritis or degenerative arthritis. But now I know that -itis means inflammation and, on average, if you're old and degenerating, your collagen and tendons are breaking down in an -osis not -itis sort of way. Therefore, arthrosis(1), tendonosis(2), ligamentosis(3), and degenerative discs(4) leave your vertebrae spurred and misaligned (see x-ray above) and your spinal nerves pinched and complaining.

Spondylosis city here. What a drag it is getting old.
(1) abnormal joints due to cartilage breakdown
(2) abnormal tendons due to collagen breakdown
(3) I'm not even sure that's a word, but if it is, can't you just feel those thickened and stretched old ligaments allowing one vertebra to slip slideways on the next one down?
(4) the spongy, springy collagenous shock absorbers that are no longer so spongy and springy


Ruth said...

People are sent to me with this condition but PT cannot fix it. We pay over time for our upright posture.

Anne Morley said...

If this is a consequence of "aging" and "upright posture" then everyone over a certain age has it, right? Certainly some to a higher degree than others, but why doesn't everyone have pain? Could there be something else going on? Perhaps even something emotional or psychological that contributes to the pain?

femail doc said...

Ruth: I'm always glad to get your perspective on my 'bones and joints' postings. If you check back in here, can you comment on Anne's musings about why not everyone feels pain?

Anne: I don't suppose we know how prevalent these changes are as we don't x-ray or image people without pain. I do agree that chances are good most everyone of a 'certain age' has some degree of spondylosis.

That said, who knows what goes into one person's perception of pain. I've often wished I could walk awhile on someone else's sore knee or sore foot to see what they're really experiencing.

Certainly emotions can affect pain perception for better or worse. I also think (I hope Ruth might chime in here) that secondary consequences of age-related -osis conditions, including misalignment of joints or myofascial adhesions, might contribute to pain. And if that is true, my experience is that deep tissue work, PT, chiropracty, braces, orthotics, etc. can improve the situation even if you can't reverse some of these degenerative changes.