Both spondylitis and spondylosis often confuse people, as they have a similar prefix-spondy, which refers to the spine. Although they have many symptoms in common, spondylitis and spondylosis are two different diseases.
Age-related wear and tear of the joints result in spondylosis. On the other hand, spondylitis is an autoimmune condition affecting joints and surrounding tissues. The patients feel neck and back pain or stiffness in both diseases. Let’s understand more about these conditions so that patients can recognize the right medical conditions and take appropriate steps for suitable treatment.
What is spondylitis?
Spondylitis or spondyloarthritis is an inflammatory condition. It affects the joints of the spine and sacroiliac regions (pelvis and lower spine). Spondylitis is a collective term for numerous inflammatory arthritis conditions, including:
- Ankylosing spondylitis
- Psoriatic arthritis
- Juvenile spondyloarthritis
- Peripheral spondyloarthritis
- Reactive arthritis
- Enteropathic arthritis
In spondylitis, a patient’s immune system mistakenly attacks the joints and surrounding tissues, which leads to inflammation, pain, bone fusion, and excess bone formation. This inflammatory condition usually develops early in life, and patients start experiencing symptoms in their 20s and 30s.
What is spondylosis?
Spondylosis is age-related degenerative arthritis of the spine. Normal wear and tear of the spinal discs and spinal joints in the neck and back can decrease the spine’s movement and affect the nerves and other functions. After the age of 60 years, cervical spondylosis affects more than 85% of elders. According to the part involved, spondylosis can be of the following types:
- Cervical spondylosis affects the neck during aging. It is the most common type of age-related degenerative disorder.
- Thoracic spondylosis affects the chest area or middle part of the spine.
- Lumber spondylosis affects the lower part of the spine and is one of the most common causes of pain in the lower back during older age.
- Multilevel spondylosis happens when this degenerative disease affects more than one part of the spine.
Symptoms of spondylosis vs spondylitis
Both spondylitis and spondylosis have numerous similar symptoms, such as:
- Chronic and severe back and hip pain and stiffness
- Both limit the range of motion
- Difficulty in walking
- Bowel and bladder ailments
- Numbness or tingling sensation in the upper and lower limbs
Specific symptoms of spondylitis
- The inflammatory or ankylosing spondylitis can cause weaker bones and sometimes lead to osteoporosis.
- It can also lead to stiffness and soreness in back
- Spondylitis affects the lumber spine (lower back) and sacroiliac joints, but in peripheral spondylitis, the joints farther from the spine, such as hands and feet, are involved.
- Patient experiences worsening symptoms after resting.
- Back pain while sitting or lying down.
- The spondylitis inflammation can rarely affect other organs, such as the eyes (uveitis), the skin (psoriasis), or the digestive system (inflammatory bowel disease).
Specific spondylosis symptoms
With aging, the vertebral discs start shrinking and developing bone spurs and osteoporosis along the neck and back bones. Sometimes, this osteoporosis and osteoarthritis develop without displaying any symptoms. Some symptoms are:
- Neck pain, which may extend to arms or shoulders
- Neck stiffness
- Spondylosis can cause compression on the nerve roots and leads to neuropathy, which causes numbness or tingling sensations in the hands, arms, feet, and legs.
- Neuropathy sometimes may also cause poor balancing and difficulty in walking.
- Loss of bladder and bowel movements
Causes of spondylosis and spondylitis
The principal cause of spondylosis is age-related wear and tear in joints. Previous injuries can increase the degeneration in spondylosis.
Spondylitis is due to inflammation related to an overactive immune system. Genetics, environmental factors, and exposure to certain chemicals also play a role in spondylitis.
How to diagnose spondylitis vs spondylosis
Both spondylosis and spondylitis have similar symptoms, so diagnosis becomes difficult without imaging. The doctors suggest numerous imaging and lab tests that confirm the exact condition, such as:
- Blood test to detect inflammatory markers and genetic markers
- Magnetic resonance imaging (MRI)
- CT scan
Treatment of spondylitis and spondylosis
The exact cure for spondylitis and spondylosis is not yet available. The main goal of treatment modalities is to help alleviate pain, and stiffness, relieve compression of nerves and slow the progression of diseases. The doctors recommend the following treatment modalities:
- More active lifestyle
- Consumption of a balanced diet
- Medications: The doctors can prescribe Non-steroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants to relieve mild to moderate pain and inflammation in both conditions.
Sometimes, in severe inflammation and pain or to improve the range of motions, the doctors recommend oral steroids or epidural steroid injections.
- Transcutaneous electrical nerve stimulation (TENS) also reduces pain and stiffness in joints and surrounding tissues.
Whole-life disease management is crucial to prevent or delay the progression of these diseases. Therefore, harmony in diet, exercise, and proper medications is beneficial in spondylitis and spondylosis.
Dr. V. A. Senthil Kumar | HOD & Senior Consultant – Orthopaedics, Spine Surgery and Arthroscopy | Dharamshila Narayana Superspeciality Hospital, Delhi