Spondylitis is a group of inflammatory conditions that affect the joints in your spine. Spondylosis isn’t due to inflammation but rather the wear and tear of your spine.

Spondylitis and spondylosis are two conditions that cause arthritis-related pain and stiffness. But they have different causes and tend to affect different populations.

This article will take a look at the similarities and differences.

Spondylitis, also known as spondyloarthritis, is a group of conditions in which you experience inflammation in your spine or joints. “Spondylo” means spine, and “arthro” means joints.

Spondyloarthritis also causes enthesitis, which is inflammation at the points where your tendons, ligaments, and joint capsules insert into your bone.

Doctors and healthcare professionals categorize spondyloarthritis as either axial or peripheral. Axial spondyloarthritis (axSpA) primarily affects your spine and sacroiliac joints, which connect your pelvis and spine. Peripheral spondyloarthritis affects joints outside your spine.

There are several subtypes of axial and peripheral spondyloarthritis.

Axial spondyloarthritisPeripheral spondyloarthritis
ankylosing spondylitis (AS)
nonradiographic axSpA
psoriatic spondylitis
enteropathic arthritis
reactive arthritis
• undifferentiated spondyloarthritis

The American College of Rheumatology notes that ankylosing spondylitis (AS) is the most common of the conditions.

Although anyone can develop spondylitis, it usually develops in younger adults. For example, symptoms of AS typically start between the ages of 20 and 40 years old. Though rare, children can also develop spondylitis.

Spondylosis, also known as spinal osteoarthritis, refers to age-related wear and tear of your spine. This can happen when your disks and joints degenerate, causing reduced spinal movement. It can also occur due to an injury, such as blunt force trauma to your spine.

Although it’s a type of arthritis, it’s not an inflammatory condition.

Based on which part of your spine it affects, doctors categorize spondylosis as:

Spondylosis mostly affects older adults. The American Academy of Orthopaedic Surgeons estimates that more than 85% of people older than 60 years of age have cervical spondylosis.

Which is more common — spondylitis or spondylosis?

About 3.2 million U.S. adults have spondylitis, according to the Spondylitis Association of America. A 2016 study found that about 1 in 1,000 people have AS, while a bit more than 2 in 1,000 have axSpA. But research from 2021 suggests that the numbers are likely higher, as the 2016 study only included people with a diagnosis.

Spondylosis is much more common. A 2018 study found that more than half of people ages 40 to 59 years old already showed signs of moderate to severe spinal osteoarthritis.

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It’s unclear what causes spondylitis, though it may be a combination of genetics and environment. For example, scientists have linked 113 different gene locations to the development of AS. Your risk may be higher if you carry the HLA-B27 gene, though not all people with the gene develop AS.

Some conditions may increase your risk of specific types of spondylitis. For example:

Degeneration of spinal disks (vertebra) and facet joints causes spondylosis. Over time, your disks may weaken and dry out, making them more likely to collapse and lose their cushioning characteristics.

Your facet joints experience increased pressure and start degenerating. You may also have cartilage wear, the part that protects your joints.

Other risk factors for spondylosis include:

  • obesity
  • being assigned female at birth
  • a family history

Who’s most likely to get spondylitis or spondylosis?

Spondylosis is more common in older adults, while spondylitis typically develops in younger adults.

Spondylitis can also run in families. You may be more likely to develop it if you carry the HLA-B27 gene. In the United States, both the gene and AS are most common in white people and are least common in Black people.

AS may be more common in people assigned male at birth. But assigned sex doesn’t seem to affect the prevalence of nonradiographic axSpA.

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Spondylitis and spondylosis often have similar symptoms. Common symptoms include:

  • pain
  • stiffness
  • fatigue

Spondylitis causes inflammation, which can result in swelling, a change in skin color, and warm joints.

Different types of spondylitis may affect your other body systems. Depending on the type, you may also experience:

  • swelling of your fingers and toes (dactylitis)
  • eye inflammation (uveitis)
  • enthesitis
  • stomach pain
  • diarrhea

Most people with cervical spondylosis don’t ever have symptoms. Still, some experience neck pain that may spread to their head or shoulders. They may also develop headaches, neck stiffness, and muscle spasms.

With thoracic or lumbar spondylosis, pain may radiate down to your legs.

According to the American Association of Neurological Surgeons, medical professionals may perform a physical exam and suggest undergoing an X-ray and MRI exam if you have symptoms of osteoarthritis. The imaging tests can determine the severity of your condition, as they can indicate the level of damage.

An X-ray can also show damage from AS. But you’ll need an MRI to see the damage from axSpA.

Spondylitis, spondylosis, spondylolisthesis, and spondylolysis

Conditions that affect your spine have similar names, which can be confusing. Here are two other conditions you may come across:

Spondylolisthesis is when one of your vertebrae slips forward. It can be painful, making it difficult to walk or run. People may also experience weakness or numbness.

Spondylolysis is a stress fracture to one of your vertebrae. It’s typically due to trauma or degeneration and can lead to spondylolisthesis.

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A doctor may prescribe medication to help relieve pain from spondylosis. Options include:

Other treatments include:

A doctor may also suggest using a soft collar or a cervical pillow to help relieve neck pain from cervical spondylosis.

Healthcare professionals may recommend similar treatments for people with spondylitis. These include:

Your outlook with spondylosis will depend on your symptoms and the severity of your condition. Some people may experience severe disability, while others don’t have any symptoms at all.

Reports suggest that people who require surgery for spondylosis have reduced pain after surgery, though it may not improve their walking ability.

As for spondylitis, home remedies may help you manage your symptoms and improve your quality of life. You may consider:

  • exercising regularly
  • maintaining a moderate weight
  • quitting smoking if you do

For people with severe spondylitis, surgery typically leads to a positive outcome. Still, there’s a high risk of complications.

Spondylitis and spondylosis both affect your spine but have different causes and tend to affect different populations.

Spondylitis is an umbrella term for a group of inflammatory conditions that affect your spine and joints. The most common is AS. Symptoms typically develop in early adulthood.

Spondylosis is osteoarthritis of your spine due to wear and tear. It’s more common for older adults to experience pain from spondylosis.

Medication, physical therapy, and exercise may help improve symptoms of either condition.

Consider the following table to help you distinguish between the two conditions:

Spondylitis Spondylosis
Causescombination of genetics and environmentdisk degeneration
Prevalencerare, affecting less than 1% of the populationcommon, affecting most older adults
Onsettypically develops in early adulthooddevelops throughout lifetime, but symptoms tend to appear in older adults
Unique symptomsdepends on the type, but can include swelling, gastrointestinal symptoms, or eye inflammationheadaches, leg pain