Lumbar Spondylosis

Overview

Lumbar spondylosis refers to age-related “wear and tear” changes in the lower back (lumbar spine). Over time, the discs, joints, and ligaments in the spine naturally undergo changes. This may lead to stiffness, back pain, or sometimes nerve irritation causing leg pain.

It is a very common condition, especially in adults over 40, and is considered a part of the normal ageing process. The good news is that most people manage their symptoms well with simple lifestyle changes and non-surgical care. Only a small percentage ever require surgery.

Causes

Lumbar spondylosis develops gradually and can be influenced by:

• Ageing – Discs lose water and flexibility, joints wear down.
• Bone spurs (osteophytes) – The body forms small bony outgrowths to stabilize the spine.
• Disc degeneration – Flattening or bulging of the spinal discs.
• Ligament thickening – Making the spine stiffer.
• Lifestyle factors – Prolonged sitting, poor posture, obesity, heavy lifting, or previous injuries.

Studies show that more than 60% of adults over 50 have radiological evidence of lumbar spondylosis, though many never develop significant symptoms.

Signs and Symptoms

Not everyone with lumbar spondylosis has symptoms. When present, they may include:

• Low back pain – Aching or stiffness, often worse after prolonged sitting or standing.
• Morning stiffness – Improving with movement.
• Pain radiating to the legs (sciatica) – If nerves are irritated.
• Numbness, tingling, or weakness in legs (in advanced cases).
• Reduced flexibility – Difficulty bending or twisting.

Treatment Options

Conservative (Non-surgical) Care – First Choice

Most patients improve with simple, evidence-based treatments such as:

• Medications – Pain relievers (acetaminophen, NSAIDs), short courses of muscle relaxants.
• Physical therapy – Stretching, strengthening, and core stability exercises.
• Lifestyle changes – Maintaining healthy weight, posture correction, ergonomic adjustments.
• Heat/ice therapy – For flare-ups of pain.
• Epidural steroid injections – In selected cases for nerve-related pain.

Research shows that 80–90% of people with lumbar spondylosis improve with conservative care and never require surgery .

Surgical Options – When Needed

Surgery is considered only if:

• Symptoms are severe and persistent despite several weeks/months of non-surgical treatment.
• There is progressive leg weakness, numbness, or difficulty walking.
• Rarely, if there are signs of cauda equina syndrome (bladder/bowel problems, severe nerve compression).

Common surgical procedures include:

• Decompression surgery (laminectomy/laminotomy) – Relieves pressure on spinal nerves.
• Spinal fusion – Stabilizes the spine if instability is present.

Surgical success rates are high, with 70–85% of patients reporting significant pain relief and functional improvement.