Lumbar spondylosis: lower back pain from age-related changes, and how it's treated

What is lumbar spondylosis?

"Spondylosis" means age-related wear in the spine. "Lumbar" refers to the lower back. Lumbar spondylosis can include:

• disc changes: discs losing water and height (degenerative disc disease), sometimes with a disc bulge
• facet joint changes: wear in the small joints at the back of the spine that guide its movement
• bone spurs (osteophytes): small bony growths that form at the edges of the vertebrae

Sometimes these changes narrow the space for the nerves, which is called lumbar spinal stenosis.

Spondylosis can also affect the neck, where it's called cervical spondylosis.

How common is it?

Very common. A large 2015 review of scans in people with no back pain found disc degeneration in about 37% of 20-year-olds, rising to about 96% of 80-year-olds. The authors concluded that many of these changes are part of normal ageing.

That's why a spondylosis report on its own doesn't explain your pain. Your assessment looks at how your back moves and how you feel, not just the scan.

Symptoms

Many people with lumbar spondylosis have no symptoms. When it does cause problems, you may notice:

• aching or stiffness in your lower back, often worse in the morning or after rest
• pain after standing or sitting for a long time
• reduced flexibility, such as difficulty bending
• pain spreading into your buttocks or legs, with numbness or tingling, if a nerve is irritated
• leg pain or heaviness when walking that eases when you sit or bend forward (a sign of spinal stenosis)

What causes it?

• Age: gradual changes in the discs and joints of the spine
• Physical load: years of heavy lifting, bending or long hours of sitting
• Other factors that may contribute, such as previous back injury, excess body weight, smoking and genetics

When back pain is an emergency

How it's diagnosed

At your Maana Spine assessment, your physiotherapist asks about your symptoms and daily life, checks how your lower back moves, tests the strength, sensation and reflexes in your legs, and reviews any MRI, X-ray or lab reports you bring. You'll get a physiotherapy diagnosis and a personalised plan.

You don't need a scan to book. If one would help, your physiotherapist will recommend an MRI or X-ray.

→ What happens at your spine assessment

What the research says

Exercise. A 2021 Cochrane review found moderate-certainty evidence that exercise probably reduces pain in long-lasting low back pain, by an amount that makes a real difference to patients.

Decompression and traction. A 2013 trial of 148 people with age-related lower back disease found that traction-decompression in three planes gave faster and longer-lasting relief over 12 to 15 weeks than single-plane traction or no traction. The trial had limitations, including short follow-up and no description of blinding. Overall, in the small trials so far, pain relief has been similar between decompression and traditional traction, with some trials finding added benefits from decompression for function and patient satisfaction. Either works better combined with structured physiotherapy than physiotherapy alone.

PST (pulsed signal therapy). PST is a type of pulsed electromagnetic field (PEMF) therapy. A 2022 review found PEMF reduced long-lasting low back pain more than placebo or other treatments alone, though it didn't improve physical function. These studies used a range of PEMF devices, not necessarily PST.

→ Read our full review of the decompression evidence

Will I need surgery?

Most people with lumbar spondylosis don't need surgery. Non-surgical care is a reasonable first step for most people, and surgery stays available if you need it. If spondylosis has narrowed the space for your nerves and your symptoms are severe or getting worse, we'll tell you honestly if you should see a surgeon.

→ Do I need surgery for a disc problem?

Living with lumbar spondylosis: practical tips

• Start the day gently. A few easy movements before getting up can ease morning stiffness.
• Stay active. Walking and the exercises from your programme help keep your spine moving.
• Vary your position. Avoid long stretches of sitting or standing.
• Lift with care. Keep loads close to your body and avoid twisting.

These are general tips, not a substitute for an assessment.

When to book a spine assessment

Book an assessment if lower back pain or stiffness has lasted more than a few weeks, keeps coming back, spreads into your legs, or limits your work or daily life. Spine assessments are available at all five Maana Spine clinics in Kochi, Kozhikode, Thiruvananthapuram, Aluva and Perinthalmanna. The consultation fee is ₹250, and no doctor's referral is needed.

Book a Spine Assessment · or call or WhatsApp +91 99950 09403