Spondylitis vs Spondylosis: Key Differences & Treatment

The Naming Confusion

Both words contain "spondyl" (Greek for vertebra) and "-itis/osis" — but that's where the similarity ends. Confusing the two can lead to seriously wrong treatment decisions.

Spondylosis — Wear and Tear

Spondylosis is a degenerative condition — the age-related "rusting" of the spine. It involves:

• Disc dehydration and loss of disc height
• Formation of bony spurs (osteophytes)
• Facet joint arthritis
• Ligament thickening

Age of onset: Typically 40s onwards, though symptoms often begin earlier with poor posture or heavy lifting.

Key feature: Worse with prolonged activity or prolonged rest; relieved by gentle movement.

Cause: Mechanical — cumulative loading, poor posture, genetics.

Spondylitis — Inflammation

Spondylitis is an inflammatory arthritis of the spine — an autoimmune condition. The most important form is Ankylosing Spondylitis (AS), now called Axial Spondyloarthritis (axSpA).

• Inflammation at the sacroiliac joints and vertebrae
• Can fuse the spine (ankylosis) over time
• Systemic features: fatigue, uveitis (eye inflammation), enthesitis (tendon attachment inflammation)

Age of onset: Typically 15–35 years — younger than spondylosis.

Key feature: Morning stiffness lasting MORE than 45 minutes; IMPROVES with exercise (unlike mechanical pain).

Cause: Autoimmune — strongly linked to HLA-B27 gene (90% of AS patients positive).

Treatment Differences