When patients hear terms like “spondylosis” or “spondylolisthesis,” it can sound a bit intimidating, even for the most health-savvy among us! These words all relate to spine conditions, but each describes a distinct issue. Let’s unpack these terms and explore them from a physiotherapist’s perspective, including the symptoms you might experience.
Spondylosis: The “Wear and Tear” Condition
Spondylosis is essentially osteoarthritis of the spine. Think of it as the spine’s natural ageing process. Over time, the discs between your vertebrae may shrink, and bony growths called osteophytes can develop.
Symptoms:
- Stiffness and a reduced range of motion, particularly in the morning.
- Aching or discomfort in the neck or lower back.
- Pain that radiates into the arms or legs if nerves are compressed.
- In severe cases, numbness, tingling, or weakness in the limbs.
What does this mean for physiotherapy?
The goal is to improve mobility and strengthen the surrounding muscles. Stiffness in the spine can make everyday activities harder, so we focus on exercises to enhance flexibility, core stability, and posture alongside manual treatment such as dry needling, cupping or mobilisations. Small adjustments to the way you move can often bring big improvements in managing symptoms (1,2).
Spondylolysis: The Stress Fracture
Spondylolysis refers to a stress fracture in one of the vertebrae, commonly in the lower back. It’s frequently seen in young athletes involved in sports requiring repetitive back- bending, like gymnastics or cricket.
Symptoms:
- Localised lower back pain that worsens with activity, especially bending or twisting.
- Pain that improves with rest.
- In some cases, no symptoms at all, with the fracture found incidentally during imaging.
What does this mean for physiotherapy?
Rehabilitation starts with reducing activities that aggravate the injury (sorry, no cartwheels for a while). We focus on managing pain initially, followed by strengthening the core and hips to provide better support for the spine. Once the healing process is underway, we’ll guide athletes in safely returning to their sport (3).
Spondylolisthesis: The Slipping Vertebra
Spondylolisthesis occurs when one vertebra slips forward over the one below it. This can result from spondylolysis, degeneration, or even trauma.
Symptoms:
- Persistent lower back pain, often described as a deep ache.
- Pain that worsens with standing, walking, or leaning backward.
- Nerve-related symptoms such as numbness, tingling, or weakness in the legs if nerves are compressed.
- Tightness or stiffness in the lower back and hamstrings.
What does this mean for physiotherapy?
Stabilising the spine is the top priority. Core strengthening exercises are essential, along with work to improve the strength and flexibility of the back and lower limbs. Physiotherapy can also involve lifestyle modifications to prevent movements that exacerbate the slippage (4). For severe cases, we collaborate with surgeons to support post-operative recovery (5).
Spondylitis: The Inflammatory Condition
Spondylitis involves inflammation in the spine and is often linked to autoimmune conditions like ankylosing spondylitis.
Symptoms:
- Persistent pain and stiffness, especially in the lower back and hips.
- Symptoms that worsen after periods of inactivity (e.g., in the morning or after sitting for long periods).
- Improved pain and stiffness with activity and movement.
- In advanced cases, a hunched-forward posture or fused vertebrae.
- Fatigue and generalised discomfort in severe inflammatory cases.
What does this mean for physiotherapy?
In cases of spondylitis, keeping the spine moving is crucial. Gentle stretching and low- impact activities, such as swimming or Pilates, help maintain mobility and prevent stiffness. Strengthening the muscles around the spine can also help support better posture and reduce strain on affected areas (6,7).
Why See a Physiotherapist?
Regardless of the specific “spondy” condition, physiotherapy is about more than just addressing pain. It’s about empowering you to move better, feel stronger, and take control of your health. Whether it’s teaching better movement patterns, guiding you through a tailored exercise programme, or equipping you with tools to manage symptoms, physiotherapy is all about keeping you active and resilient.
The spine may be complex, but caring for it doesn’t have to feel overwhelming. If you’re dealing with any of these conditions, a physiotherapist can help you move towards better mobility, reduced discomfort, and a healthier back.
Our Barnet, Cockfosters & Enfield Physio’s have tons of experience and are specialists in dealing with spine-related issues. Have confidence that our specialist Physiotherapists will closely assess, diagnose & treat you in the correct & evidence-based way for all injuries. You can book an appointment here.
Blog By: Emre Oz (Musculoskeletal Physiotherapist at Crouch Physio).
References
- Roshni G. Kachhadiya, Priyaben A Jani, Shreya B Vaidya et.al. A review on advanced physiotherapy treatment for cervical spondylosis. Int J Health Sci Res. 2023; 13(3):126-139
- Middleton, Kimberley, and David E. Fish. “Lumbar spondylosis: clinical presentation and treatment approaches.” Current Reviews in Musculoskeletal Medicine 2 (2009): 94-104.
- Debnath, Ujjwal K. “Lumbar spondylolysis-Current concepts review.” Journal of Clinical Orthopaedics and Trauma 21 (2021): 101535.
- Rhajib, Mohammad Ainur Nishad, et al. “Evidence based Physiotherapy Intervention of Lumbar Spondylolisthesis: A Narrative Review.” Journal of Spine Research and Surgery 4.2 (2022): 72-79.
- Manni, Tiziana, et al. “Rehabilitation after lumbar spine surgery in adults: a systematic review with meta-analysis.” Archives of Physiotherapy 13.1 (2023): 21.
- Dagfinrud, Hanne, Kåre Birger Hagen, and Tore K. Kvien. “Physiotherapy interventions for ankylosing spondylitis.” Cochrane database of systematic reviews 1 (2008).
- Gravaldi, Luca Pontone, et al. “Effectiveness of physiotherapy in patients with ankylosing spondylitis: a systematic review and meta-analysis.” Healthcare. Vol. 10. No. 1. MDPI, 2022.
