These two terms can be confusing. In many ways they are similar and are both used to describe ‘wear and tear’, degeneration or ageing of the spine. I will forgive you if you consider them the same. Many clients may use either term and mean simply ‘something’s wrong’ or ‘wear and tear’. There are, however, some clear medical differences between the two terms.
It is useful to start with the definition of the words, for clarification:
‘Spondyl’ refers to the spine or vertebral column
‘-itis’ means disease or inflammation
‘-osis’ simply means something’s wrong, abnormal; a disease or pathology in a medical term
Similarities of Spondylitis and Spondylosis
They can both cause some similar symptoms:
- Chronic degenerative back and hip pain
- Stiffness and reduced range of motion
- Difficulty walking
- Bowel or bladder problems
- Neuropathy in the arms or legs, such as weakness, numbness, pins and needles or tingling sensation
This can be another term for osteoarthritis, spinal arthritis, degeneration or normal ageing wear and tear. It becomes worse as we age; 85% of us 60 and over experience some discomfort, stiffness or joint pain, which can be worse with previous injuries or trauma.
It can affect any region of the spine, but is most common in the neck and lower back.
With age as well as cellular changes, the muscles, tendons and ligaments in the spine slowly deteriorate. Spondylosis can affect younger people with injuries, or those participating in extreme sports. There is no specific inflammation with spondylosis.
Ageing vs Degenerative Process
There is a consideration that ageing is a more general degeneration throughout the spine, at many levels perhaps. Degenerative changes are considered more localised or focal in one area, affecting the disc then bone, possibly due to a trauma or injury at one specific spot.
Diagnosing and Treating Spondylosis with Chiropractic
X-rays, MRI or bone scan can help with the diagnosis of this pathology.
Treating spondylosis with Chiropractic is mainly about maintaining good joint function in the areas of increased stress, above and below the affected levels, maintaining joint mobility and keeping the surrounding muscles relaxed, mobile and responsive.
This can also come under the name spondyloarthritis or spondyloarthropathy. As the name implies, there is inflammation in the joints, which can come and go but at times gives hot, swollen, red and tender joints. There is an overactive immune system.
- Rheumatoid arthritis is the most common type
- Psoriatic arthritis with those who suffer from skin psoriasis
- Reactive arthritis, to certain bacteria like Chlamydia
- Ankylosing spondylitis may cause the vertebrae to fuse together
Blood tests can often help to diagnose the spondylitis more accurately and in later stages X-ray changes can show the reactive nature of the bone changes compared with osteoarthritic changes.
- Usually occurs in young adults between 17 and 35 years old
- Ongoing chronic pain
- Lower back stiffness especially late at night or after waking in the morning.
- Worse pain after rest or immobility
- Stiffness and pain can extend to the upper spine or rib cage.
- Inflammation can occur in the skin, eyes or digestive system.
Axial Spondyloarthritis (axSpA)
A rare inflammatory rheumatic disease (affecting about 1% of the population) where the immune system attacks the spine, joints and other tissues. It causes severe pain, stiffness and fatigue of the spine. It usually starts in late teens, or early adulthood (20s-30s); before the age of 45. It can have a huge impact on the patients’ mobility, physical function and their quality of life.
Symptoms of Axial Spondyloarthritis
- Inflammatory back pain
- Severe stiffness and immobility
- Tiredness, fatigue and poor sleep
- Less able to work and function at home
- Decreased quality of life and social activity
- Enthesitis – inflammation of tendon and ligament insertion points into bone
- Peripheral arthritis
- Dactylitis – inflammation of the fingers or toes
- Uveitis – Eye Inflammation
- Psoriasis skin disease
- Inflammatory bowel disease
Diagnosis of Axial Spondyloarthritis
X-rays may show visible structural damage to the sacroiliac joints subtype radiographic or r-axSpA, also historically like ankylosing spondylitis (AS). These can develop in the spine or create fusion, known as spinal ankylosis.
X-rays may show no visible damage subtype non-radiographic or nr-axSpA, or show changes later as the disease progresses.
The gene HLA B27 (as with Ankylosing spondylitis) is more common.
Some research suggests an infection can trigger this condition.
More information can be found here about Axial Spondyloarthritis.
This term applies to a slippage of one vertebra on another, at a specific spinal level, rather than more generally in the spine. Please read more here about Spondylolisthesis.