Understanding Spondylosis Vs Spondylitis: What’s the Difference?

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If you’re experiencing back pain, you may be wondering—do I have spondylosis or spondylitis? These two conditions affect the spine but have key differences in their underlying causes and symptoms. Read on for a comprehensive overview of spondylosis vs. spondylitis.

What is Spondylosis?

Spondylosis refers to general wear-and-tear changes in the spine that occur as part of the natural aging process. It involves:

  • Bone spurs – additional bits of bone that grow along the spine
  • Degenerative disc disease – breakdown of the intervertebral discs between vertebrae
  • Spinal stenosis – narrowing of the spinal canal

In essence, spondylosis stems from chronic, gradual degeneration of tissues in the spine.


The most common spondylosis symptoms include:

Because spondylosis develops slowly over time, symptoms tend to come on gradually as well. Pain often starts mild initially but grows more severe.


While aging itself directly contributes to spondylosis, other factors can accelerate it, such as:

  • Repetitive strain from occupation – e.g. heavy lifting
  • Injury – fractures and disc injuries
  • Obesity
  • Genetics

Overall, age-related wear and tear combined with one or more risk factors speeds up spondylosis progression.


Typical spondylosis treatment aims to alleviate pain and improve function. Options include:

  • NSAIDs – non-steroidal anti-inflammatory drugs like ibuprofen
  • Physical therapy – stretches and exercises to improve flexibility
  • Chiropractic manipulation
  • Epidural steroid injections
  • Surgery – for cases unresponsive to conservative treatment

What is Spondylitis?

Spondylitis refers to inflammation affecting the joints between vertebrae in the spine. Several subtypes exist, with ankylosing spondylitis being most common.

With spondylitis, the body’s immune system attacks the spine, triggering inflammation. This can eventually cause vertebrae to fuse.


Symptoms of spondylitis include:

  • Low back pain/stiffness – typically worse in the morning
  • Fatigue
  • Pain at sites other than the spine – eyes, bowel, joints
  • Limited range of motion

Spondylitis pain and stiffness tend to be more severe at rest. Symptoms start earlier in life than spondylosis as well—often between ages 20-40.


The exact cause of spondylitis is unknown, but some combination of genetic and environmental factors contribute, such as:

  • Genetics – presence of HLA-B27 gene
  • Stimulation of the immune system – from infection or gut bacteria

Essentially, those with a genetic predisposition might develop spondylitis after exposure to inflammatory triggers.


Treatment focuses on reducing inflammation to limit spinal damage. Options consist of:

  • NSAIDs
  • TNF-alpha inhibitors – powerful biologics/DMARDs to block inflammation
  • Physical therapy
  • Surgery – in cases of severe joint damage

Early, aggressive treatment is best to help prevent permanent spinal fusion.

Spondylosis vs Spondylitis Chart

Gradual wear and tearImmune-mediated inflammation
Develops over time with agingOnsets earlier – ages 20 to 40
Stiffness after rest or sleepMorning stiffness over 1+ hours
Mild to moderate chronic painSevere or episodic acute pain
Numbness/tingling into limbsFatigue and eye/bowel involvement
Degeneration seen on X-rayFusion visible on X-ray in late disease

Frequently Asked Questions

Can You Have Both Spondylosis and Spondylitis?

Yes, it’s possible to have overlapping features of both spondylosis and spondylitis. Many with chronic spondylitis also develop age-related spondylosis over time.

Is Spondylitis Worse Than Spondylosis?

Spondylitis pain tends to be more severe with higher risk of spinal fusion if not treated promptly. However, both cause significant pain and loss of function.

Can Spondylosis Turn Into Spondylitis?

No, spondylosis cannot turn into spondylitis since the underlying mechanisms differ. Spondylosis stems from aging/injury while spondylitis is an immune-mediated inflammatory disease.

Final Thoughts

Embark on the path to a healthier spine by understanding the nuances of spondylosis versus spondylitis. At Innovative Healthcare Centers, our expert team is dedicated to providing comprehensive assessments and personalized treatment plans to address these conditions. Don’t let spinal discomfort disrupt your life. Whether you’re grappling with spondylosis or spondylitis, we are here to guide you towards relief and improved mobility.

Schedule a consultation with us today and let our skilled physical therapists tailor a program that suits your unique needs.