Orthopaedic Health Series

Ageing Spine Understanding Lumbar Spondylosis Effects

by Dr Fong Poh Ling

Part of the Muscle, Bone & Mobility Health Series

Older adult experiencing lower back pain, highlighting spinal strain and mobility challenges with age.

Man holding his lower back in pain.

Ageing in Singapore: Why It Matters

Growing older is a natural part of life. In Singapore, the population is ageing quickly. As of 2023, 17.3% of people are over 65, and fewer younger people are available to provide support.

This makes it even more important to stay healthy and age well.

How Ageing Affects the Body

As we age, our bodies go through many physical changes. Years of stress and strain affect our joints, ligaments, and muscles.

Joint cartilage wears down
Ligaments lose flexibility
Muscles lose strength and size

These changes can lead to:

Stiffness and joint clicking
Reduced flexibility
Lower endurance
Fatigue and pain

Many people also find it harder to stay active for long periods.

What Is Lumbar Spondylosis?

Lower back pain is common in older adults. One major cause is lumbar spondylosis, which refers to age-related wear and tear of the lower spine.

Other causes of back pain include poor posture or spinal alignment.

Warning Signs That Need Attention

Some symptoms may point to more serious problems:

Persistent or worsening pain
Pain that affects sleep
Weight loss, fever, or loss of appetite
Numbness, weakness, or tingling
Bladder or bowel problems
Pain after an injury

If you notice these signs, seek medical advice early.

What Happens in the Ageing Spine?

Lumbar spondylosis affects different parts of the spine, including:

Vertebrae (bones)
Intervertebral discs
Ligaments
Muscles

Disc Degeneration

Disc changes can begin early in life. Over time:

Discs lose nutrients due to reduced blood supply
The disc structure weakens
Cushioning between bones decreases

This shifts pressure to other parts of the spine and increases stress on joints.

Joint and Bone Changes

As stress increases:

Joints wear down
Bone spurs may form
The spine becomes less stable

This can create a cycle of ongoing damage and pain. In some cases, discs may tear or slip (prolapse).

Ligament and Spinal Canal Changes

Ligaments become thicker and less flexible. This can:

Reduce spinal stability
Narrow the spinal canal
Lead to nerve compression

Facet joints may also become inflamed, unstable, and enlarged.

Muscle and Bone Loss

From the 40s onward:

Bone density decreases
Muscle mass declines

In severe cases, this leads to osteoporosis or sarcopenia.

Osteoporosis: Weakening of the Bones

Osteoporosis causes bones to lose density and strength, increasing fracture risk.

Common signs include:

Back pain
Stooped posture
Fractures from minor falls

Causes

Age-related bone loss
Menopause
Medical conditions or long-term steroid use

Management

Treatment helps reduce fracture risk and may include:

Calcium and vitamin D
Weight-bearing exercise
Medication when needed

Sarcopenia: Loss of Muscle Strength

Sarcopenia refers to the loss of muscle mass and function with age.

This condition is becoming more common worldwide.

Why It Matters

Sarcopenia can lead to:

Higher risk of falls
Disability
Poor recovery after surgery

In Singapore, studies show that many adults already have low muscle mass—even before old age.

How to Manage Sarcopenia

Early action makes a big difference.

Focus on:

Nutrition

Adequate protein intake
Vitamin D support

Exercise

Resistance training
At least 2 sessions per week

Conclusion: Age Well with Early Action

Ageing affects the spine, but you can manage its impact.

Recognising early signs of conditions like lumbar spondylosis, osteoporosis, and sarcopenia allows for timely treatment.

Stay active, eat well, and seek medical advice when needed. These steps can help you maintain mobility and quality of life as you age. PRIME

Author

Dr. Fong Poh Ling

Senior Consultant Orthopaedic Surgeon

Alpha Joints & Orthopaedic MBBS (Spore), MMed (Ortho), FRCS (Ortho)(Edin)

Dr Fong Poh Ling is currently the Senior Consultant Orthopaedic Surgeon at Alpha Joints & Orthopaedic. Her primary interest lies in the treatment of ageing and degenerative spine conditions, with a special focus on sagittal balance and deformity. In the Singapore Spine Community, she is notable as the first female spine orthopaedic surgeon and serves on the diversity committee of the Singapore Spine Society. In this role, she engages with female residents and encourages greater female participation, in collaboration with the AOSpine global platform. She aims to inspire, inform and enable her patients to enhance their health and well-being.

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