Spondylosis vs. Spondylitis: Understanding the Difference and Key Causes

Kamlesh, a 35-year-old IT professional, is healthy, eats a balanced diet, and works out regularly. However, for the past few months, he has been experiencing acute pain in his lower back. His doctor attributed this condition to long working hours and  a sedentary lifestyle. He further said to him that he might be suffering from either of the two spinal conditions: spondylitis or spondylosis, and advised him to get a diagnosis.

Perplexed between the two complex terms, Kamlesh seeks expert guidance from an orthopaedic specialist.

However, for many others who want to clear the confusion, here’s a comprehensive guide telling the difference between spondylosis and spondylitis.

What is Spondylitis?

Spondylitis is an inflammatory condition of the spine, often autoimmune. The terms ‘Spondylo’ mean spine, and ‘arthro’ means joints. It involves inflammation of the following vertebral joints: 

• Vertebrae (spondylitis), 
• Sacroiliac joints (sacroiliitis) and 
• Entheses, i.e., the points where tendons/ligaments attach to bone.

Also known as Ankylosing Spondylitis (AS), this condition is caused by an overactive immune system attacking healthy tissues in the spine and other areas. The condition gradually worsens to cause fusion of vertebrae called ankylosis, leading to a rigid spine, also referred to as ‘bamboo spine’. This rigid spine can also affect the functioning of other organs.

AS has a strong genetic link. The significant reason for spondylitis is the  HLA-B27 gene, contributing to its heritability.

What is Spondylosis?

In common parlance, spondylosis is primarily degenerative, age-related wear and tear of the spine. Also known as spinal osteoporosis, it involves changes like bone spurs (osteophytes), disc degeneration, and facet joint arthritis. The primary reason behind spondylosis is age-related chronic degeneration, which causes wear and tear of the vertebral joints.

Know Your Problem: The Difference Between Spondylosis and Spondylitis

Mostly, people who suffer from chronic back pain are unaware of the type of complication they have. So, here is a comprehensive chart comparing spondylitis vs spondylosis:

An immune system disorder affecting healthy tissues in the spine and other areas. The most common form is AS, which has a strong genetic link (e.g., the HLA-B27 gene).

ProgressionIt develops gradually over many years due to wear and tear caused by ageing.Symptoms may fluctuate but generally progress with age.Progresses to cause fusion of vertebrae (ankylosis), leading to a rigid spine, also called ‘bamboo spine’. It can also affect other organs

The above chart can help you deeply understand the difference between spondylosis and spondylitis and know about the exact condition of your spine. Accordingly, you can take medical help to treat your condition.

However, age-related spondylosis can occur differently and affect various regions inside the vertebrae. 

Different Types of Spondylosis

There are several types of spondylosis, categorised by the specific region of the spine affected:

• Cervical Spondylosis: It impacts the neck area of the spine, involving the cervical vertebrae, and is common among older adults. It can cause neck pain, stiffness, headaches, and sometimes radiating pain, numbness, or weakness in the arms and hands due to nerve root compression.
• Thoracic Spondylosis: This impacts the middle section of the back (thoracic vertebrae). It is less frequently symptomatic compared to cervical or lumbar spondylosis, but it can lead to mid-back pain, stiffness, and occasionally pain that radiates around the chest or abdomen if nerves are involved.
• Lumbar Spondylosis: Impacting the lumbar vertebrae in the lower back, lumbar spondylosis is a common cause of back pain and stiffness, especially with age. Symptoms often include pain that intensifies with activity and decreased flexibility. Occasionally, sciatica may occur, which is radiating pain, numbness, or weakness down the leg, and compression of nerve roots may occur.
• Multi-level Spondylosis: This refers to spondylosis affecting multiple spine regions simultaneously. For instance, a person might have both cervical and lumbar spondylosis.

How are Spondylosis and Spondylitis Diagnosed?

Due to different factors contributing to their symptoms, there are various methods to diagnose both types of spine disorders.

Diagnosing Spondylosis

Spondylosis is typically identified through a combination of methods:

• Physical Examination: A doctor will assess your symptoms and physical condition.
• Imaging Tests:

1. X-rays: Used to detect bone spurs and narrowing of disc spaces.
2. MRI (Magnetic Resonance Imaging): Detailed disc degeneration and nerve compression images are provided.
3. CT Scans (Computed Tomography): Offers cross-sectional views of the affected areas.

Diagnosing Spondylitis:

Diagnosing spondylitis involves a more comprehensive approach, including:

• Physical Examination: As with spondylosis, a physical assessment is a first step.
• Imaging Tests

1. X-rays: The X-ray image can reveal sacroiliitis, i.e., inflammation of the sacroiliac joints and changes in the vertebrae.
2. MRI (Magnetic Resonance Imaging): Helps to identify active inflammation in the affected areas.

• Blood Tests

1. ESR (Erythrocyte Sedimentation Rate) and CRP (C-reactive protein): These markers indicate inflammation in the body.
2. HLA-B27 Genetic Marker: A genetic test that can indicate a predisposition to certain forms of spondylitis.

These are the conventional methods to diagnose the possibility of spondylitis and spondylosis.

• Clinical Criteria: Doctors also rely on specific clinical criteria based on your symptoms and medical history to confirm a diagnosis.

How to Treat Spondylosis?

The treatment for spondylosis primarily focuses on pain management. Since this is an age-related denegenration, it can’t be eliminated. Hence, different approaches are used to mitigate the pain, which includes 

• Regular physiotherapy sessions, 
• Prescribed exercises to manage pain, 
• Prescribed anti-inflammatory medications, and 
• Lifestyle modifications such as yoga. 

In some severe cases, injections or surgery may be considered to relieve nerve compression. However, you must avoid over-the-counter painkillers and must do only those exercises that your physician prescribes.

What is the Treatment for Spondylitis?

Since spondylitis is linked to genetic factors, treatment for spondylitis typically includes the following medications and approaches:

• Non-steroidal anti-inflammatory drugs (NSAIDs), 
• Physiotherapy 
• Prescribed exercise

Your physician may also prescribe disease-modifying antirheumatic drugs (DMARDs), such as biologic agents, to control inflammation and prevent further progression. However, you must avoid over-the-counter painkillers.

Besides proper treatment and lifestyle modifications to mitigate the symptoms of both conditions, it is crucial to prearrange your finances towards an affordable health insurance plan to cover treatment costs.

Mitigate the Financial Pain of Spondylosis with Health Insurance

The treatment for a musculoskeletal problem, such as spondylosis, often continues throughout life and involves high treatment expenses such as regular physiotherapy sessions, besides prescribed anti-inflammatory medications. It is therefore important to have an affordable health insurance plan to cover treatment expenses that may put undue burden on your savings. These days, many  competent health coverage plans offer certain benefits, such as waiting period modification for slow-growing diseases such as arthritis. You must carefully refer to the policy documents for such benefits while buying the plan.

Disclaimer: It is essential to verify the policy details and coverage with the official policy documents. Also, kindly consult a professional medical expert to verify the details of your health concerns.