Spinal Osteoarthritis (Spondylosis)

Spinal osteoarthritis, also called spondylosis, is the wear-and-tear arthritis of the spine. It is extremely common with age and is a major cause of neck and lower back stiffness, although many people with imaging findings of arthritis have little or no pain.

What's happening in your spine

Each level of the spine has a disc in front and a pair of facet joints in back. With years of use, the discs gradually lose water, the facet joint cartilage wears down, and small bone spurs (osteophytes) can form. These changes can narrow the spaces nerves travel through and irritate the surrounding joints and soft tissues.

Common symptoms

• Neck or lower back pain and stiffness, worse in the morning or after inactivity
• Pain that flares with weather changes or heavy activity
• Reduced flexibility and a grinding or clicking sensation
• Headaches at the base of the skull (cervical arthritis)
• Arm or leg pain, numbness, or weakness if nearby nerves are pinched

Causes & risk factors

Age is the leading risk factor. Other contributors include prior spine injury, repetitive heavy work, obesity, family history of arthritis, and underlying scoliosis. Smoking accelerates disc degeneration and is associated with worse arthritis-related pain.

How it's diagnosed

Diagnosis is based on history and exam, supported by X-rays (which show alignment and bone spurs) and MRI when nerve pain, numbness, or weakness is present. Imaging is interpreted alongside symptoms because arthritis is so common that scans can show changes that don't match how you feel.

Treatment options

Most patients do well with simple, long-term self-care.

• Daily aerobic activity such as walking, swimming, or biking
• Physical therapy and a home exercise program targeting core and posture
• Weight management
• NSAIDs and topical pain relievers; short courses of stronger medication for flares
• Image-guided facet or epidural steroid injections for stubborn pain

Surgery is considered only when arthritis causes significant nerve compression — most often spinal stenosis, a pinched nerve, or spondylolisthesis — that has not responded to non-surgical care. The procedure is tailored to the specific problem and may involve decompression, fusion, or both.

When to see a specialist

See a spine specialist if neck or back pain has lasted more than 6–8 weeks, if it limits work or sleep, or if you develop arm or leg pain, numbness, weakness, or balance problems.