Spondylosis and "Wear and Tear" on Your Scan: What It Really Means
Quick summary
- Spondylosis is a broad term for age-related changes in the spine's discs and joints. It is a description of what a scan shows, not a diagnosis of why you hurt.
- In people with no back pain, disc degeneration appears in about 37% at age 20 and 96% at age 80, and facet joint changes become common with age too (Brinjikji et al., 2015).
- Australia's care standard advises against routine imaging for low back pain because incidental findings can cause unnecessary worry (ACSQHC, 2022).
- Staying active, strengthening and graded exposure to the movements you've been avoiding are the foundations of care, whatever the scan says.
Words like "degenerative", "wear and tear", "spondylosis" and "arthritis of the spine" can make a back feel fragile overnight. It's common for people to stop gardening, lifting grandchildren or going to the gym after reading a scan report. Understanding what these words actually mean is one of the most useful steps you can take.
What Spondylosis Means
Spondylosis is an umbrella term for age-related changes in the spine. It covers discs that have lost some height and water content, small bony outgrowths at the joint edges (osteophytes), and thickening of the facet joints at the back of the spine. Cervical spondylosis refers to the neck and lumbar spondylosis to the lower back.
These changes are part of how the spine ages, in the same way that skin wrinkles and hair greys. They can contribute to stiffness and, in some people, to nerve narrowing (see lumbar spinal stenosis). Their presence on a scan does not mean they are the source of your current pain.
How Common Are These Changes in People Without Pain?
A systematic review pooled imaging findings from more than 3,000 people without back pain. With age, the prevalence of disc degeneration rose from 37% at 20 to 96% at 80, and disc bulges from 30% to 84%. Facet joint degeneration and disc height loss also became more common with each decade. The authors' conclusion was direct: many of these findings are likely part of normal ageing and not associated with pain, so they must be interpreted in the context of a person's symptoms (Brinjikji et al., 2015).
In other words, if you're over 50 and had a scan of your back or neck, it would be unusual for it to show no degenerative changes, whether or not you had pain.
Why Labels Matter
Australia's Low Back Pain Clinical Care Standard asks clinicians to explain the limited role of imaging, because routine scans don't improve outcomes and incidental findings can create unnecessary concern (ACSQHC, 2022). Words like "degeneration" can lead people to protect their back by moving less, but a stiffer, weaker, less active back usually feels worse, not better. A more accurate way to think about it is that your spine has age-related changes, and your current pain is a separate question to work through.
What Actually Helps
- Keep moving. Regular walking and general activity are among the most consistently helpful things for back and neck pain at any age.
- Strengthen. Progressive strength training for the legs, hips, trunk and upper back supports the spine and helps with everyday tasks such as lifting, carrying and getting up from low chairs.
- Gradually return to what you've been avoiding. If bending, lifting or gardening has become a worry, build back into it step by step rather than avoiding it indefinitely.
- Use hands-on care as a support, not a substitute. Manual therapy can help ease stiffness and pain in the short term, which can make it easier to stay active.
At Spirit Chiropractic in Kogarah, we'll go through your scan report with you in plain language. We'll examine how your back or neck actually moves and feels, and help you set realistic goals for getting back to the things that matter to you.
Not all back or neck pain is "just wear and tear." See a doctor promptly for pain with fever, unexplained weight loss, a history of cancer, pain that is severe and unrelenting at night, new weakness or numbness, problems with balance or hand coordination, or bladder or bowel changes.
Worried by the words on your scan report?
Bring it in. We'll explain what it does and doesn't mean, examine how your back or neck is actually working, and make a plan focused on getting you moving with confidence.
Spirit Chiropractic is at Shop 23/6 Belgrave Street, Kogarah. If your GP has put you on a chronic condition management plan, here's how Medicare works for chiropractic.
Request an appointment Call 0410 420 856Frequently Asked Questions
Is spondylosis the same as arthritis of the spine?
Broadly, yes. Spondylosis describes age-related changes in the spine's discs and joints, including the facet joints, which are sometimes described as spinal osteoarthritis. It is common and does not necessarily cause pain.
Does degenerative disc disease get worse over time?
Scan changes tend to increase with age, but pain doesn't follow the same path. Many people with significant changes on imaging have little or no pain, and symptoms often fluctuate or improve with activity and strengthening.
Should I avoid lifting if I have wear and tear in my back?
Not usually. Gradually building strength and confidence with lifting and bending is generally more helpful than avoiding them. An assessment can help tailor this to you.
Can chiropractic help spondylosis?
Chiropractic care can't reverse age-related changes on a scan. Manual therapy combined with exercise and advice may help reduce pain and stiffness and support you to stay active. Care should be tailored to your age, bone health and any other conditions.
Why does my scan show problems on both sides when my pain is only on one side?
Age-related changes are usually spread across the spine and don't map neatly onto where pain is felt. That's one reason scan findings need to be read alongside a clinical examination.
References
- Brinjikji, W., Luetmer, P.H., Comstock, B., et al. (2015). Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. American Journal of Neuroradiology, 36(4), 811–816. https://doi.org/10.3174/ajnr.A4173
- Australian Commission on Safety and Quality in Health Care. (2022). Low Back Pain Clinical Care Standard. Sydney: ACSQHC.
- Maher, C.G., Archambeau, A., Buchbinder, R., et al. (2023). Introducing Australia's clinical care standard for low back pain. Medical Journal of Australia, 218(8), 354.
This article is general information, not a diagnosis or a substitute for an individual assessment. If you have new or worsening symptoms, see a registered health practitioner.
