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Osteoarthritis of the spine
Last reviewed: 08.07.2025
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Osteoarthritis of the spine (osteoarthritis of the apophyseal joints, spondyloarthrosis) and degeneration of the intervertebral discs (osteochondrosis) are different diseases.
By definition, osteoarthritis is a disease of the synovial joints or diarthroses, and osteochondrosis is a degenerative lesion of the cartilaginous joints or amphiarthroses. According to the ICD-10 classification, osteochondrosis and osteoarthritis of the spine are classified as different classes of diseases - M42 and M47, respectively. However, there is a relationship between osteoarthritis of the joints and osteochondrosis: they can contribute to each other's occurrence and usually coexist in the same area of the spinal column.
[ How does osteoarthritis of the spine manifest itself?
Most often, osteoarthritis of the spine affects the cervical (especially C5) and lumbar (especially L3-5) parts of the spinal column.
Osteoarthritis of the spine is characterized by a "mechanical" nature of pain in the lumbar region: pain appears/increases with movement, prolonged sitting, standing. It can radiate to the buttocks and thighs. Increased pain with back extension is more characteristic of osteoarthritis, increased pain with back bending - for degeneration of intervertebral discs.
Osteoarthritis of the spine is most often complicated by compression of the nerve roots by osteophytes or by subluxation of the apophyseal joints, which may be accompanied by sensory and motor disorders. Such complications may arise with damage to any part of the spinal column; they are especially pronounced in osteoarthritis of the cervical spine. Severe neurological disorders are observed with compression of the spinal cord by large osteophytes. Compression of the vertebral arteries may disrupt blood supply to the brain. However, it should be noted that osteoarthritis of the spine has such complications much less often than osteochondrosis.
How is osteoarthritis of the spine recognized?
Morphological and radiographic changes in the apophyseal joints of the vertebral column are similar to those in osteoarthrosis of other locations. Degeneration of the intervertebral discs is often accompanied by marginal osteophytosis. Probably, the clinical relationship between osteoarthrosis of the apophyseal joints and degeneration of the intervertebral discs reflects their biomechanical relationship: any changes in one of these joints inevitably entail abnormal loading on the other. The location of osteophytes on the vertebrae probably demonstrates the application of maximum load.
Radiographic signs of osteoarthrosis of the spine are so often detected at the age of about 40 years that the question is debated: is osteoarthrosis of the spine a natural process of aging? This hypothesis is supported by the fact that no connection has been found between the degree of radiographic changes in the joints of the spine and the severity of symptoms - even significant progression of morphological changes in the apophyseal joints of the spinal column with the formation of large osteophytes often does not manifest clinically. This also distinguishes osteoarthrosis of the spine from osteochondrosis, which is characterized by a clear relationship between the degree of expression of degenerative changes in the discs and clinical manifestation.