Clinically reviewed by What is lumbar spondylosis
Lumbar spondylosis is the age related wear of the lower back. The discs lose height and water, the small joints at the back of the spine thicken, and bony spurs form at the edges of the vertebrae. On a report it is often written as degenerative changes.
In Urdu it is explained as kamar ki haddi ka ghisna, the wearing of the back bone.
Now the part that matters most, the same point our cervical spondylosis page makes about the neck. These changes are a normal part of ageing. They show up in large numbers of people with no back pain at all, and in nearly everyone by old age. So an X-ray saying spondylosis does not tell you where your pain is coming from. The examination does.
Symptoms you might have
- Lower back ache and stiffness, worst in the morning and easing after 15 to 30 minutes of moving
- Worse with standing for a long time, walking on hard ground, and bending backwards
- Often easier when sitting, which is the opposite of disc related pain
- Pain across the lower back and into the buttocks, but not below the knee
- Grinding or clicking with movement, which is common and not a sign of damage
- Good spells and bad spells over years rather than a steady decline
Why it happens
- Age, which is the main factor. The changes begin in most people from the thirties onwards
- Heavy manual work, loading, carrying and shifting weight over years
- Repeated lifting with a bent and twisted back
- Long hours on a motorbike, which combines vibration with a held posture
- Smoking, which is associated with faster disc degeneration
- Family history, which has more influence on disc wear than most people realise
- Weak trunk and hip muscles, so the worn joints take the load
When you should see a physiotherapist
Come in with the pain and the stiffness, and bring the X-ray by all means, but understand that the film is not what is being treated. Movement, strength and load tolerance all improve at any age, and none of that depends on changing the report.
Go to a hospital the same day with numbness around the groin or back passage, loss of bladder or bowel control, or weakness in both legs.
See a doctor rather than a physiotherapist for back pain with fever, unexplained weight loss, night pain that does not change with position, a history of cancer, or a significant fall.
Also see a doctor if your walking distance is shrinking because of leg heaviness, since worn joints can narrow the nerve tunnel. Our spinal stenosis page covers that.
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How it is treated
The aim is a lower back that moves and muscles strong enough to take load off the worn joints. Both are achievable at any age.
- Exercise therapy, the most useful thing by far. Movement for the stiff segments, then strengthening for the trunk, hips and legs so ordinary loads stop provoking it
- Manual therapy to the stiff lumbar segments and hips, which usually improves movement within the first few sessions and makes the exercises easier
- Dry needling for the muscles beside the spine that go into protective spasm during a flare
- Hijama (cupping therapy) where tightness is spread across the lower back rather than at one point
- Electrotherapy and TENS for pain relief early on, so you can move enough to exercise
- Advice on lifting, standing, riding and work, which is what lengthens the good spells
Surgery has no role in ordinary spondylosis. It is considered only when the wear has caused something specific, such as nerve compression with worsening weakness, and that is a spine surgeon's decision.
Exercises, and what to avoid
What helps
- Walking daily, starting with ten minutes a few times a day and building up
- Gentle movement both ways: knee rolling, pelvic tilts and knee hugs, done often rather than hard
- Glute bridges, bird dog and side planks, two or three times a week
- Hip and hamstring flexibility, because stiff hips push extra load into the lower back
What to avoid
- Bed rest beyond a day. It reliably slows recovery and leaves the back stiffer
- Repeated hard arching backwards if that is the direction that hurts
- Giving up movement because a report looked frightening. The wear on the film is not a reason to stop using your back
- Lifting with a rounded twisted back, and carrying loads away from your body
What you can do at home
Heat is the right choice here, especially in the morning and in winter. Fifteen to twenty minutes of a hot pack loosens the stiffness. Ice is only for a fresh sharp flare in the first day or two.
Build a five minute morning routine before you start the day: rolling, bending the knees and gentle tilts. Worn joints are stiffest on waking and they loosen with movement, not with waiting.
Wear shoes with some cushioning on hard floors. Thin chappals on concrete all day add up.
Keep the strengthening going through the good spells. That is what makes the flares shorter and further apart.
How long it takes
A flare of lumbar spondylosis usually settles over two to six weeks with treatment, and movement often improves within the first two or three sessions because much of the stiffness is joint and muscle rather than bone.
Back pain that has been present for more than three months takes longer, usually three to six months of consistent work. It tends to become less reactive before it becomes less frequent.
This is a long term condition with good and bad spells, so the honest answer is that it is managed rather than cured.
People who keep two short strengthening sessions a week have fewer and shorter flares.
Urdu / Roman Urdu
Choose your reading script / اپنی پسند کا رسم الخط منتخب کریں
اردوUrdu script
لمبر اسپونڈیلوسس کمر کی ہڈی اور ڈسک کا عمر کے ساتھ گھس جانا ہے۔ ایکس-رے پر اسے تنزلی کی تبدیلیاں لکھا جاتا ہے۔
لیکن یہ تبدیلیاں عمر کے ساتھ ہر انسان میں آتی ہیں، اور بہت سے لوگوں کو درد بالکل نہیں ہوتا۔ صرف ایکس-رے سے طے نہیں ہوتا کے درد کہاں سے آ رہا ہے۔ چیک اپ سے طے ہوتا ہے۔
علاج میں ورزش سب سے زیادہ فائدہ دیتی ہے، ساتھ مینول تھراپی، ڈرائی نیڈلنگ، حجامہ، ٹینس اور گرم سیک۔ رپورٹ دیکھ کر حرکت چھوڑنا نقصان دیتا ہے۔
فوراً ہسپتال جائیں اگر: شرمگاہ یا پاخانے کے گرد سن ہونا ہو، پیشاب پاخانے پر کنٹرول ختم ہو جائے، یا دونوں ٹانگیں کمزور ہوں۔
Roman Urdu
Lumbar spondylosis kamar ki haddi aur disc ka umar ke sath ghis jana hai. X-ray par ise degenerative changes likha jata hai.
Lekin ye tabdeeliyan umar ke sath har insan mein aati hain, aur bohat se logon ko dard bilkul nahi hota. Sirf X-ray se tay nahi hota ke dard kahan se aa raha hai. Check up se tay hota hai.
Ilaj mein warzish sab se zyada faida deti hai, sath manual therapy, dry needling, hijama, TENS aur garam sek. Report dekh kar harkat chhorna nuqsan deta hai.
Foran hospital jayen agar: sharamgah ya pakhane ke gird sun hona ho, peshab pakhane par control khatam ho jaye, ya dono taangein kamzor hon.
Treatment at the clinic, and online
INFORMATION → INDIVIDUAL CARE
A plan built around you.
Talk with Dr. Zahra Fatima, DPT. Understand your next steps, with guidance for your own symptoms and daily routine.
Talk it through
Discuss your symptoms, what you find difficult and what you want to get back to.
Understand your next steps
Use the consultation to discuss which care and exercises fit your situation.
Take your plan with you
Your online consultation includes a written plan you can refer to afterwards.
Questions people ask
My X-ray shows lumbar spondylosis, is that why my back hurts?
Can lumbar spondylosis be cured?
Is walking good or bad for lumbar spondylosis?
Will it turn into something worse?
Should I wear a back belt?
Related conditions
- Lower back pain treatment
- Slip disc treatment
- Upper back pain treatment
- Middle back pain treatment
- Scoliosis physiotherapy