Clinical Education


  • In spondylosis, degenerative changes start in the intervertebral discs with osteophyte formation and involvement of adjacent soft tissue structures.
  • When mechanical factors are prominent, the condition is often referred to as “spondylosis,” although the term is often applied to all non-specific spinal pain.
  • Mechanical and degenerative factors are more likely to be present in chronic spinal pain.
  • Severe degenerative changes are often asymptomatic, but can lead to spinal pain, stiffness, or neurological complications.

Cervical spondylosis – degenerative changes noted at C2,3 and C3,4

Subjective Examination:

The most common symptoms of spondylosis are pain and stiffness in the spine
Spondylosis can be asymptomatic
Pain can be variable, with flare-ups followed by symptom-free periods.
Around 1 in 10 people develop long-lasting (chronic) pain.
Objective Examination:

Cervical Spondylosis
Poorly localised tenderness
Limited range of movement which can be in all directions.
Lumbar Spondylosis
Presents with pain, restricted range of motion, paraspinal muscle spasm and loss of lumbar spine lordosis
Pain is usually reported as mild to moderate, and is initially a dull ache that gradually increases in intensity
Pain is commonly localized to the paraspinal region, gluteals and posterior aspect of the thighs

Image from OpenI – Licensed by CC
Image from OpenI – Licensed by CC

Symptoms will normally respond to conservative measures including analgesia, activity modification and Physiotherapy intervention which may include exercise therapy to increase active range and localised and global strength.
Stress management and postural advice on daily activities, work, and hobbies may be useful in some patients to encourage self-management of their symptoms.
Manual therapy may be useful in some patient groups

Image from OpenI – Licensed by CC
Image from OpenI – Licensed by CC