Lumbar spondylosis Arthritis of the lower back: symptoms, causes and treatment

Many people first see the words “lumbar spondylosis” on an X-ray or MRI report and worry that their spine is crumbling. It is not. Spondylosis describes normal age-related wear, much like gray hair, and the findings on a scan do not always match how much it hurts. This post explains what the term means, which symptoms it can cause and how lower back arthritis is treated. For the full range of lower back pain treatment we offer, see lower back pain.

What lumbar spondylosis is

• Disc degeneration: the cushions between the vertebrae lose water and height, so the spine moves less smoothly
• Facet joint arthritis: the small paired joints at the back of each level wear and stiffen, like arthritis in any other joint; see facet joint pain
• Bone spurs: small bony ridges form at the edges of the vertebrae as the spine tries to stabilize itself
• Narrowing: in some people, discs, spurs and thickened ligaments narrow the spaces where the nerves run

The chart in the first video shows these changes. Age is the main cause, with past injuries, heavy manual work, smoking, extra weight and family history adding to it.

Symptoms of lumbar spondylosis

• An ache and stiffness across the lower back, often worse first thing in the morning or after sitting (see back pain in the morning and back pain from sitting)
• Pain that eases once you get moving, then returns after a long day on your feet
• Pain when leaning back or twisting
• Buttock or thigh ache that does not go below the knee
• If a nerve is narrowed: pain, numbness or tingling into the leg, or legs that tire when you walk and ease when you sit or lean forward

Spondylosis, stenosis and spondylolisthesis: not the same

These terms often appear together on a report. Spondylosis is the general wear. Spinal stenosis means the wear has narrowed the space for the nerves; see spinal stenosis. Spondylolisthesis means one vertebra has slipped forward on the one below. Ankylosing spondylitis is a different, inflammatory condition that usually starts in younger adults. A physician explains which ones apply to you and which actually explain your pain.

How it is diagnosed

The diagnosis is based on your history and a physical exam. X-rays show disc height and bone spurs; an MRI is used when there are leg symptoms, weakness or red flags, or when a procedure is being planned. If leg numbness or weakness is part of the picture, EMG and nerve conduction testing can show whether a nerve is affected. When the facet joints are suspected, a numbing test block confirms the source.

Lumbar spondylosis treatment

Exercise and physical therapy first

For most people, the most helpful treatment is regular movement. Core and hip strengthening, gentle stretching, walking and cycling keep the spine supple and the muscles supporting it strong. Hands-on manual therapy and lumbar traction can help some people. Physical therapy is offered at our Brooklyn and Staten Island offices; for a home routine, see our lower back pain exercises.

X-ray-guided injections

When pain persists despite exercise, a physician may suggest a targeted injection, placed with live X-ray, as the videos show. An epidural steroid injection puts anti-inflammatory medicine near an irritated nerve root, the option for leg pain from narrowing. The second and third videos show this type of injection. Read more in our post on epidural injections for back pain.

Medial branch blocks and radiofrequency ablation

When the facet joints are the main source, a test block of the small nerves that carry their pain comes first. If it brings clear relief, radiofrequency ablation for back pain from the facet joints can quiet those nerves for many months. Pain procedures are performed at all three offices, and your physician explains where and when yours will be scheduled.

Surgery

Surgery is considered only for a small number of people, usually those with severe nerve compression, weakness, or pain that still limits daily life after a good trial of other treatment.

Living with lower back arthritis

• Stay active every day; long rest makes stiffness worse
• Use heat in the morning to ease stiffness
• Change position every 30 to 45 minutes when sitting
• Keep a healthy weight and do not smoke, which speeds disc wear

Go to an emergency room or call 911 for back pain with loss of bladder or bowel control, numbness in the groin, or sudden leg weakness.

Related care at Precision Care Medical & Sports Performance

Lower back arthritis care near you

Looking for a back pain doctor near me who treats lower back arthritis? For back pain treatment in Brooklyn, Ashley Marcus, MD sees patients at our Brooklyn pain management office on Shell Rd, close to Gravesend, Coney Island and Midwood. For a back pain doctor on Staten Island, Jake Stephen, DO sees patients at our Staten Island pain management office, convenient to New Dorp, Oakwood and Great Kills. Both offices also have physical therapy on site.

For a back pain doctor in Midtown East, Yuri Gordin, MD sees patients at the Precision Care Spine & Pain Center in Midtown Manhattan, 150 E 55th St, reached easily from Washington Heights, Spanish Harlem and the Financial District. Physical therapy is not offered at the Manhattan office. Bring your X-ray or MRI report. Request an appointment or call the office closest to you.

Questions patients ask

Educational only, not medical advice. These videos and this article explain common problems and treatments in general terms. They are not a diagnosis or a treatment plan for you. Results vary from person to person. See a qualified clinician about your own symptoms, and call 911 or go to an emergency room for an emergency.

← More videos and articles on the Precision Care Medical & Sports Performance blog