Spondylosis refers to degenerative changes in the spine, including arthritis, disc changes, bone spurs, and stiffness. It may contribute to neck pain, back pain, nerve symptoms, or sciatica-like pain, but imaging findings must be matched carefully with the full clinical picture.
Facet-mediated pain is a common cause of neck and back pain that originates from the small joints connecting the vertebrae. Dr. Siefferman explains the different causes of facet pain, including arthritis and joint hypermobility, and how treatment is tailored to the underlying source using options such as regenerative medicine, radiofrequency ablation, or other targeted therapies.
Our team organizes conditions and treatments into related zones of expertise to make it easier to explore the care paths most relevant to your symptoms and goals.
Use the zone tags above to browse dedicated pages for each focus area, including services, providers, and what to expect during treatment.
Hi, I’m Dr. Jason Siefferman, interventional pain specialist and medical director at Manhattan Pain Medicine. Facet mediated pain is a very common source of pain. It affects the joints in the spine where the vertebrae connect one to the next. So, anytime there’s bending, there’s motion.
Anytime there’s rotation, there’s motion. Now, facet mediated pain can occur in a couple of situations. One is with tincture of time. With time, there’s wear and tear to the joints. Osteoarthritis develops in these joints. That’s a standard common development with age. Steroid can be helpful temporarily. Radio frequency ablation is the treatment we use for more long-term relief.
For younger patients who are having facet mediated pain, it’s often due to hypermobility of these joints. We will confirm that with both physical exam and imaging where we’ll see with flexion and extension, there may be excessive motion. So when there’s excessive motion across that facet, yes, there’s more wear and tear, we’ll develop pain.
This is a situation that we don’t treat with steroid or radio frequency ablation because it can actually make things worse. This is a situation where instead we use regenerative medicine. Something like prolotherapy or platelet-rich plasma will actually strengthen the ligaments and the stabilizing structures so that these joints are more stable so that there’s less excessive motion and there’s less pain for that reason.
If you are having facet mediated pain know that we will strive to understand why and offer the treatment approach that is best suited for that specific reason for the pain.
Spondylosis is a broad term used to describe age-related or degenerative changes in the spine. These changes may involve the discs, facet joints, ligaments, bones, and surrounding soft tissues. Some patients have spondylosis on imaging with little or no pain, while others develop neck pain, back pain, stiffness, headaches, arm pain, leg pain, numbness, tingling, weakness, or walking limitation.
At Manhattan Pain Medicine (MPM), the goal is not simply to treat the imaging finding. MPM evaluates whether symptoms are coming from facet joints, discs, nerves, spinal stenosis, muscle guarding, SI joint dysfunction, inflammatory disease, hypermobility-related mechanics, or chronic pain sensitization. This diagnosis-first approach helps determine which treatment options are appropriate.
At MPM, evaluation begins with a careful review of symptoms, imaging, movement patterns, nerve findings, prior treatments, functional limitations, and patient goals.
For patients looking for spondylosis treatment in NYC, MPM considers whether pain is driven by spine arthritis, facet arthropathy, disc degeneration, nerve irritation, spinal stenosis, spondylolisthesis, SI joint dysfunction, inflammatory spine pain, hypermobility, EDS, or overlapping chronic pain mechanisms. Treatment may include conservative care coordination, medication management when appropriate, image-guided spine procedures, epidural injections, steroid injections in selected cases, regenerative options only when clinically appropriate, advanced pain options for persistent nerve pain, and referral to spine surgery when needed.
Many patients are told they have spondylosis after an MRI, CT scan, or X-ray. This can sound concerning, but degenerative spine changes are common and do not always mean they are the true source of pain. Some people have significant imaging findings with mild symptoms, while others have severe pain with only modest degenerative changes.
MPM evaluates imaging in context. The exam looks at pain location, movement triggers, stiffness, nerve symptoms, strength, sensation, walking tolerance, inflammatory features, SI joint involvement, and prior response to treatment. This helps determine whether spondylosis is the main pain generator, one contributor, or an incidental finding.
Spondylosis fits within MPM’s Musculoskeletal issues Zone of Expertise because degenerative spine changes can affect joints, discs, ligaments, muscles, nerves, and movement patterns. In some patients, the pain is primarily mechanical. In others, symptoms may involve nerve irritation, inflammatory overlap, SI joint dysfunction, hypermobility, or complex chronic pain.
MPM’s approach is to identify what is actually driving the patient’s symptoms. The goal is not to assume that every degenerative finding is painful, but to understand how the spine, joints, nerves, muscles, and functional demands are interacting.
These guys are the best. I've been going here for over 6 years and their familiarity with my Schwannomatosis (most ppl have never even heard of it - its rather rare) and their ability to diagnose my CRPS quickly and accurately and then treat it like I was merely getting a flu shot is just incredible...
Highly recommended for those who need Pain Management. Everyone at Manhattan Pain Medicine is extremely nice and helpful. I have had very good interactions with both Dr. Siefferman and Dr. Louis. All of the staff is very responsive. 5 stars.
The providers at Manhattan Pain Medicine are exceptional. I wish I had found them 30 years ago!
I genuinely can’t say enough good things about the team at Manhattan Pain Medicine. I have MCAS, EDS, and an inflammatory autoimmune disease, and I’ve basically been searching for answers since I was a kid. I had years of unexplained inflammation markers, chronic pain, and allergic reactions despite...
I have a complex medical history and have seen a lot of doctors over the years. Dr. Mikaberidze and Dr. Siefferman each took the time to really listen and understand everything I had been dealing with. I also appreciated how they work together and communicated about my care. I left with a plan that...
Sharing my gratitude for the pleasant experience last week during my visit, the medical team provided great care and also treated my session as a learning experience, I left my session with a wealth of knowledge. A big thank you to the kind, and professional staff who welcomed me to the office as a...
I cannot say enough good things about Manhattan Pain Medicine. From the moment I walked in, I felt truly cared for and taken seriously. Dr. Nino Mikaberidze, Director of Rheumatology, is exceptional — knowledgeable, compassionate, and incredibly thorough. She takes the time to listen, explains every...
Dr Siefferman is the most thorough, patient doctor I have even been to. Currently I travel from miami to nyc to see him because his bed side manner and desire to help is incomparable.
ZocDoc
This practice is wonderful. I have been a patient of Dr. Siefferman’s since 2019 and he’s extremely helpful and kind. He has brought in a Rheumatologist who is also great. They handle very complex pain issues and always try to find new ways to help me.
Dr. Siefferman is an incredible doctor! He is extremely diligent and knowledgeable. It feels like you are his only patient. He invests a lot of time and effort into your injuries and concerns. I did not find these wonderful qualities with other pain specialists before, who were always rushed and som...
ZocDoc
Dr. Siefferman is a doctor who combines the old world bedside manner of doctors from my childhood (60 years ago) with a sta te of the art embrace of modern technology. It is always a pleasure to have an appointment with him...always has options and solutions to my medical issues. He is truly the doc...
ZocDoc
Dr. Siefferman is a genius. He is very informed and listens attentively.
ZocDoc
Dr. Siefferman and his entire team continue to be efficient, dedicated, and driven by precision and a genuine desire to give fantastic care. Will always recommend.
ZocDoc
Doctor Siefferman is fantastic. Have been seeing him for 5 years. Couldn’t recommend more.
ZocDoc
Dr. Siefferman is the ONLY doctor who has ever been able to diagnose my pain and treat it. He is hands down the best
ZocDoc
Spondylosis is a general term for degenerative changes in the spine. It may involve disc degeneration, arthritis in the facet joints, bone spurs, ligament thickening, or stiffness in the spine. Spondylosis can occur in the neck, mid-back, or lower back. Some people have no symptoms, while others develop pain, stiffness, nerve irritation, or functional limitation.
Spondylosis often includes arthritis-like changes in the spine, especially in the facet joints. It may also include disc degeneration, bone spurs, and other age-related structural changes. While many people use the terms spine arthritis and spondylosis interchangeably, MPM evaluates which specific structures are involved and whether they are actually contributing to pain.
Spondylosis is commonly related to age-related wear, disc dehydration, facet joint degeneration, bone spur formation, ligament changes, posture, repetitive stress, prior injury, and spine mechanics. In some patients, inflammatory disease, hypermobility, EDS, or prior spine conditions may make symptoms more complex. The cause and pain generator should be evaluated before treatment is selected.
Cervical spondylosis affects the neck. It may cause neck pain, stiffness, pain with turning or extension, headaches, shoulder discomfort, or pain that travels into the arm if nerves are irritated. Some patients may have numbness, tingling, weakness, or coordination changes, which should be evaluated carefully.
Lumbar spondylosis affects the lower back. It may cause lower back pain, stiffness, pain with standing or walking, buttock or hip-region pain, or sciatica-like symptoms if nearby nerves are irritated. Symptoms may overlap with herniated discs, spinal stenosis, spondylolisthesis, SI joint dysfunction, hip conditions, or inflammatory back pain.
Yes. Spondylosis can contribute to nerve symptoms when degenerative changes narrow the space around the spinal cord or nerve roots. This may cause radiating pain, numbness, tingling, burning, weakness, or heaviness in the arms or legs. However, similar symptoms can also come from herniated discs, peripheral neuropathy, nerve entrapment, spinal stenosis, or other neurologic conditions.
Yes. Lumbar spondylosis may contribute to sciatica-like symptoms if degeneration leads to nerve irritation or spinal stenosis. Patients may feel pain, burning, numbness, or tingling traveling from the lower back or buttock into the leg. MPM evaluates whether symptoms are truly nerve-related and whether the source is spondylosis, disc disease, stenosis, SI joint dysfunction, hip pathology, or another condition.
Spondylosis describes degenerative spine changes. Spinal stenosis describes narrowing of the spinal canal or nerve openings. Spondylosis can contribute to stenosis when bone spurs, disc changes, or ligament thickening reduce space around nerves. The two conditions can overlap, but they are not the same.
Spondylosis refers to degenerative changes in the spine. Spondylolisthesis refers to one vertebra slipping out of alignment with the bone below it. A patient can have both conditions. MPM evaluates whether symptoms are coming from degeneration, instability, nerve compression, facet joints, discs, SI joint dysfunction, or another pain generator.
Yes. Degenerative spine changes are common and can appear on imaging even when they are not the main source of symptoms. This is why MPM does not treat imaging alone. The evaluation compares MRI or X-ray findings with pain location, exam findings, movement triggers, nerve symptoms, and functional limitations.
Treatment depends on the pain generator. Options may include physical therapy coordination, activity modification, medication management when appropriate, acupuncture, Feldenkrais, image-guided spine procedures, epidural injections, steroid injections in selected cases, and advanced pain options for persistent nerve pain. The right plan depends on whether symptoms are driven by joints, discs, nerves, stenosis, SI joint dysfunction, inflammation, or chronic pain mechanisms.
Epidural injections may be considered when spondylosis contributes to nerve irritation, radicular pain, spinal stenosis symptoms, or sciatica-like pain. They are not automatic treatment for all degenerative spine changes. MPM considers them when the symptom pattern, exam, imaging, prior care, and treatment goals support a nerve-targeted approach.
Spondylosis-related symptoms should be evaluated urgently if there is new or worsening weakness, trouble walking, loss of coordination, bowel or bladder dysfunction, saddle anesthesia, progressive numbness, fever, unexplained weight loss, history of cancer, major trauma, severe night pain, chest pain, shortness of breath, or rapidly worsening symptoms.
Before care begins, our team helps patients understand the practical side of treatment, including insurance verification, out-of-network benefits, cost-share estimates, self-pay options, and billing questions. We believe patients should have as much clarity as possible before moving forward.
If neck pain, back pain, stiffness, nerve symptoms, or sciatica-like pain is affecting your life, MPM can help determine whether spondylosis is contributing to your symptoms. Our diagnosis-first approach evaluates discs, facet joints, nerves, spinal stenosis, SI joint dysfunction, inflammation, hypermobility, and complex pain patterns before recommending care. Request an appointment to discuss your symptoms and treatment options.
Spondylosis is a broad term used to describe degenerative changes in the spine. These changes may involve the discs, facet joints, ligaments, vertebrae, bone spurs, and surrounding muscles. It can occur in the neck, mid-back, or lower back.
Many patients first hear the word spondylosis after an MRI, CT scan, or X-ray. The term can sound alarming, but it does not automatically mean something dangerous is happening. Degenerative spine changes are common, especially with age. The important question is whether those changes match the patient’s symptoms.
At MPM, the evaluation focuses on identifying the true pain generator. Spondylosis may contribute to pain, but it may also coexist with herniated discs, spinal stenosis, spondylolisthesis, facet arthropathy, SI joint dysfunction, inflammatory spine disease, hypermobility, nerve irritation, muscle guarding, or chronic pain sensitization.
Cervical spondylosis affects the neck. It may cause neck pain, stiffness, limited range of motion, headaches, shoulder discomfort, or arm symptoms if nerves are irritated. Some patients notice pain when turning the head, looking up, working at a computer, driving, or holding the neck in one position for long periods.
Thoracic spondylosis affects the mid-back. It may contribute to stiffness, rib-region pain, pain between the shoulder blades, or discomfort with posture and rotation. Thoracic pain can overlap with slipping rib syndrome, scapular dyskinesia, thoracic outlet-type symptoms, inflammatory spine pain, and muscle pain.
Lumbar spondylosis affects the lower back. It may cause low back pain, stiffness, pain with standing or walking, buttock pain, hip-region pain, or leg symptoms when nerves are involved. Lumbar spondylosis can overlap with spinal stenosis, sciatica, herniated discs, spondylolisthesis, SI joint dysfunction, and hip or pelvic conditions.
Spondylosis often includes arthritis-like changes in the facet joints. Facet joints are small joints in the back of the spine that help guide movement. When these joints become irritated or arthritic, patients may feel pain with extension, twisting, standing, or certain positions.
Spondylosis may also include disc degeneration. Discs can lose hydration or height over time, which may change how force moves through the spine. In some cases, disc changes may irritate nearby nerves or contribute to stenosis. In other cases, disc degeneration is visible on imaging but not the main source of pain.
Bone spurs may also form as part of degenerative change. Bone spurs do not always cause symptoms, but they can contribute to nerve compression if they narrow the space around spinal nerves.
Spondylosis describes broader degenerative spine changes. A herniated disc is a more specific condition in which disc material pushes outward and may irritate a nearby nerve. A patient can have both conditions at the same time.
The distinction matters because treatment depends on the pain generator. A herniated disc may cause acute radiating nerve pain, while spondylosis may contribute to chronic stiffness, facet pain, stenosis, or mechanical spine pain. MPM reviews imaging, symptoms, and exam findings together to determine which finding is clinically important.
Spinal stenosis refers to narrowing of the spinal canal or nerve openings. Spondylosis can contribute to stenosis through disc changes, bone spurs, facet enlargement, or ligament thickening.
When stenosis affects nerves, patients may experience pain, heaviness, numbness, tingling, or weakness in the legs or arms. Lumbar stenosis may worsen with standing or walking and improve with sitting or leaning forward. Cervical stenosis can be more concerning if it affects the spinal cord, especially when symptoms include hand clumsiness, balance changes, weakness, or coordination problems.
Spondylolisthesis occurs when one vertebra slips out of alignment with the vertebra below it. Spondylosis refers to degenerative changes. These conditions may overlap because degeneration can contribute to instability, and instability can increase stress on discs and joints.
MPM evaluates whether symptoms are coming from the vertebral slip, degenerative joints, stenosis, disc disease, SI joint dysfunction, hypermobility, or another pain source.
Many people have degenerative spine findings on imaging without significant symptoms. This is why pain should not be explained by the MRI alone. A patient’s scan may show spondylosis, but the true pain generator may be the SI joint, a nerve root, a muscle pattern, inflammatory disease, hip pathology, or chronic pain sensitization.
MPM uses a diagnosis-first process to avoid treating the wrong structure. The evaluation includes pain pattern analysis, movement testing, neurologic screening, imaging review, prior treatment history, and assessment for overlapping musculoskeletal or inflammatory contributors.
Spondylosis may cause nerve symptoms when degenerative changes narrow the space around a nerve root or spinal cord. Patients may describe burning, tingling, numbness, weakness, heaviness, or pain traveling into the arm or leg.
In the neck, nerve irritation may cause symptoms into the shoulder, arm, hand, or fingers. In the lower back, nerve irritation may cause symptoms into the buttock, thigh, leg, or foot. These patterns may resemble cervical radiculopathy, lumbar radiculopathy, sciatica, peripheral neuropathy, or nerve entrapment.
Because nerve symptoms can come from many sources, MPM evaluates the full pathway before recommending treatment.
In patients with hypermobility spectrum disorder or Ehlers-Danlos syndrome, spine pain can be more complex. Joint laxity, muscle guarding, altered proprioception, recurrent injuries, and instability may change how the spine absorbs load.
Spondylosis can still occur in hypermobile patients, but the symptoms may not behave like typical degenerative spine pain. Some patients experience recurrent flares, shifting pain, muscle tightness, headaches, SI joint pain, or nerve sensitivity. MPM evaluates hypermobility as one part of the clinical picture, not as an automatic explanation for every symptom.
Degenerative spine pain and inflammatory spine pain can overlap. Conditions such as seronegative spondyloarthropathy, autoimmune-related pain, rheumatoid arthritis, Sjogren’s, or enthesitis may contribute to stiffness, joint pain, tendon pain, or spine symptoms.
Inflammatory back pain may be more noticeable in the morning, improve with movement, worsen with rest, or occur with other inflammatory symptoms. MPM considers these patterns and may coordinate with rheumatology when autoimmune or inflammatory disease may be contributing.
MPM begins with a detailed history and physical exam. The evaluation reviews where pain occurs, how long it has been present, what movements worsen it, whether symptoms travel into the arms or legs, whether there is numbness or weakness, and how symptoms affect work, sleep, exercise, walking, or daily function.
The exam may include spine movement testing, neurologic screening, strength and sensation testing, gait assessment, SI joint and hip screening, and evaluation for muscle guarding or hypermobility when relevant. Imaging is reviewed in context rather than treated as the diagnosis by itself.
When symptoms suggest progressive neurologic involvement, inflammatory disease, vascular concerns, infection, fracture, or surgical pathology, MPM coordinates referral to the appropriate specialist.
Treatment depends on the main pain generator and the patient’s goals. Many patients begin with conservative care, especially when there are no urgent neurologic findings.
Conservative care may include physical therapy coordination, movement retraining, activity modification, posture and ergonomic changes, weight management when relevant, acupuncture, Feldenkrais, biofeedback, pain psychology, and medication management when appropriate.
When a specific pain generator is identified, image-guided procedures may be considered. These may include epidural injections for nerve irritation, steroid injections in selected cases, or other spine-related procedures depending on the diagnosis. For persistent neuropathic or complex spine pain, advanced options such as spinal cord stimulation or dorsal root ganglion stimulation may be discussed in carefully selected patients.
These treatments are not routine for every case of spondylosis. They require diagnosis-specific evaluation, risk discussion, and clinician supervision.
Image-guided spine procedures may help when symptoms are linked to a specific structure, such as a nerve root, facet joint, SI joint, or area of inflammation. In some cases, these procedures may have both diagnostic and therapeutic value. A response to an injection can help clarify whether the targeted structure is contributing to pain.
Advanced pain options may be considered when pain is persistent, nerve-related, and functionally limiting despite appropriate conservative and interventional care. These options require careful selection and are not appropriate for every patient.
Spondylosis is not automatically a surgical condition. Many patients can manage symptoms without surgery. However, surgical evaluation may be appropriate when there is progressive weakness, spinal cord compression, severe stenosis, disabling nerve symptoms, structural instability, or pain that remains severe despite appropriate nonsurgical care.
MPM helps patients understand when pain medicine care is appropriate and when spine surgery or neurosurgery input is needed.
Spondylosis often occurs alongside other pain generators. A patient may have facet arthropathy, disc degeneration, spinal stenosis, SI joint dysfunction, inflammatory pain, hypermobility, muscle guarding, peripheral neuropathy, or chronic pain sensitization at the same time. Treating only one imaging finding may not address the full problem.
MPM’s role is to identify the most relevant pain generators, create a stepwise care plan, coordinate with other specialists when needed, and help patients move toward better function with careful treatment selection.
Patients should seek urgent evaluation for new or worsening weakness, trouble walking, loss of coordination, bowel or bladder dysfunction, saddle anesthesia, progressive numbness, fever, unexplained weight loss, history of cancer, major trauma, severe night pain, chest pain, shortness of breath, or rapidly worsening symptoms.
Spondylosis-like symptoms can overlap with herniated disc, spinal stenosis, spondylolisthesis, facet arthropathy, SI joint dysfunction, hip disease, inflammatory spine disease, peripheral neuropathy, vascular disease, infection, fracture, malignancy, and central pain syndromes. Red flags should not be ignored.
MPM approaches spondylosis through a diagnosis-first model. The goal is not simply to treat degeneration. The goal is to understand whether degenerative spine changes are causing pain, whether another structure is more important, or whether multiple pain generators are interacting.
For patients looking for spondylosis treatment in Manhattan or NYC, MPM provides careful evaluation of neck pain, back pain, stiffness, nerve symptoms, spinal stenosis overlap, hypermobility-related complexity, inflammatory pain patterns, and chronic spine pain. Treatment is individualized and may include conservative care, medication management, image-guided procedures, advanced pain options for selected patients, and referral for surgical evaluation when appropriate.
