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Spondylosis Symptoms and Signs
Many people with spondylosis on X-ray do not have any symptoms. In fact, lumbar spondylosis (spondylosis in the low back) is present in 27%-37% of people without symptoms. In some people, spondylosis causes back pain and neck pain due to nerve compression (pinched nerves). Nerve compression is caused by bulging discs and bone spurs on the facet joints, causing narrowing of the holes where the nerve roots exit the spinal canal (foraminal stenosis). Even if they are not large enough to directly pinch a nerve, bulging discs can cause local inflammation and cause the nerves in the spine to become more sensitive, increasing pain. Also, disc herniations can push on the ligaments in the spine and cause pain. If new nerves or blood vessels are stimulated to grow from the pressure, chronic pain can result. Because of the pain, the local area of the spine may attempt to splint itself, resulting in regional tenderness, muscle spasm, and trigger points.
Characteristic findings of spondylosis can be visualized with X-ray tests. This findings include decrease in the disc space, bony spur formation at the upper or lower portions of the vertebrae, and calcium deposition where the vertebrae have been affected by degenerative inflammation.
However, it is controversial if more mild spondylosis, such as small bone spurs and bulging discs that do not compress nerves, cause back pain, because most middle-aged and elderly people have findings on X-ray of spondylosis, even if they are completely pain free. Therefore, other factors are likely major contributors to back pain.
Symptoms of spondylosis include localized pain in the area of spondylosis, usually in the back or neck. If a herniated disc causes a pinched nerve, pain may shoot into a limb. For example, a large disc herniation in the lumbar spine can cause nerve compression and cause pain that originates in the low back and then travels down one leg into the foot. This is called sciatica. Back pain due to a bulging disc is typically worse with prolonged standing, sitting, and forward bending and is often better with changing positions frequently and walking. Back pain due to osteoarthritis of the facet joints is typically worse with walking and standing, and relieved with forward bending. Symptoms of numbness and tingling may be felt if a nerve is pinched. If a nerve is severely pinched, weakness of an affected extremity may occur. If a herniated disc pushes on the spinal cord, this can cause injury to the spinal cord (myelopathy). Symptoms of myelopathy include numbness, tingling, and weakness. For example, a large herniated disc in the cervical spine could cause cervical myelopathy if it is large enough to push on the spinal cord with resulting symptoms of numbness, tingling, and weakness in the arms and possibly the legs.
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