Does Spondylosis Equal Back Pain?

The following articles clarify the relationship between spondylosis and back pain:

  • The MRI scan confirms disc degeneration disease (spondylosis) of the intervertebral discs. However-  Spondylosis is not in itself a cause for low back pain, but it can be described as a morphological consequence of stressors applied to the lumbar discs and zygapophyseal joints during life.  Spondylosis is irregularly associated with symptoms and disability.  The incidence of spondylosis is just as great in patients with pain as there are people with pain and no signs of spondylosis (Torgerson, W. R., Dotter, W. E. Comparative roentengraphic: a study of the asymptomatic and symptomatic lumbar spine. J Bone Joint Surg 1976; 58a; 850-853).
  • In a review article, examining 56 articles Andersson has concluded that degenerative changes of the spinal column have long been and continue to be confused with the presence of spinal distress and pain. All parts of the spine undergo degenerative changes as we age. (Andersson, G  B(1998). What are the age-related changes in the spine?. Baillieres Clinical Rheumatology. 12(1):161-73, 1998 Feb).
  • A comparative roentgenographic study was carried out on 217 asymptomatic patients between forty and seventy years old and 387 symptomatic patients in the same age range. Spondylosis (osteophyte formation) did not appear to have any direct relationship to low back pain.(Torgerson WR, Dotter WE. Comparative roentgenographic study of the asymptomatic and symptomatic lumbar spine. J Bone Joint Surg 1976;58A:850-853)
  • A systematic review of published observational studies was performed examining the relevance of radiographic findings in patients with back pain. 58 articles were reviewed and concluded that there is no firm evidence for the presence or absence of a causal relationship between radiographic findings and non-specific low back pain. (van Tulder, M W. Assendelft, W J. Koes, B W. Bouter, L M.(1997).  Spinal radiographic findings and nonspecific low back pain. A systematic review of observational studies. Spine. 22(4):427-34, 1997 Feb 15.)
  • A high quality article from the Framingham Study looking at the relationship between facet joint osteoarthritis and low back pain concluded that in the present study we failed to find an association between facet joint osteoarthritis, identified by multidetector CT scan, at any spinal level and low back pain in a community –based population (Kalichman et al Facet Joint Osteoarthritis & Lower Back Pain in the Community-Based Population. Spine2008 July 11)

It is really important that we understand that if you have underlying spondylosis you are not doomed to a life of chronic pain. The two are not in a direct relationship – spondylosis does not always cause back pain.