There are so many factors that can contribute to back pain that it can be hard to pinpoint the one that’s causing your discomfort (and it’s rarely just a single factor anyway). But, as you age, there’s a strong chance that arthritis might be a likely culprit. 

Arthritis can be a natural part of aging, but it doesn’t always cause pain. If you’re among the millions of people worldwide who struggle with back pain, however, it’s worth considering if arthritis — and the inflammation it causes in your joints — may play a role in the achiness you’re experiencing. 

Fortunately, there’s a lot you can do to ease pain caused by back arthritis so you can continue doing the activities you enjoy.

Read on to learn more about back arthritis, what causes it, and how to feel better with help from our Hinge Health physical therapists.

What Is Back Arthritis?

“The word ‘arthritis’ refers to inflammation in a joint,” says Samantha Stewart PT, DPT, a physical therapist at Hinge Health. Most of the time, arthritis in the back comes in the form of osteoarthritis, which refers to joint changes that occur gradually over time and are more prevalent as you get older. Osteoarthritis can lead to stiffness, swelling, and pain. 

Doctors often refer to osteoarthritis in the spine as spondylosis. While that might sound alarming, this condition doesn’t always cause symptoms. In fact, most people who have it don’t even know it. For those who do have symptoms, the discomfort is usually concentrated in the lower back (lumbar spine).

Back Arthritis: A Hinge Health Perspective

If you have back pain and think it’s related to arthritis — or maybe a doctor has already told you that it is — there’s no need to panic. “Pain is one of the many ways your body communicates with you,” says Dr. Stewart. “It doesn’t mean that you’re damaged.”

What’s more, you don’t need an official diagnosis or imaging before you can start getting better. “The way you treat arthritis in the back is the same way you’d treat generalized back pain,” says Dr. Stewart. And that starts with moving more. 

Although moving through back pain can be scary and uncomfortable, small changes to your habits can yield benefits. As our Hinge Health care team says, movement is medicine. Movement encourages blood and oxygen delivery to tissues for healing, keeps lower back muscles strong and limber, and helps reduce pain.

Physical therapy can aid in easing lower back pain that may be related to arthritis, especially if you prefer to exercise with some support. A physical therapist (PT) can create a personalized treatment plan that includes exercises to strengthen the muscles supporting the spine and improve flexibility and posture. “When you come to physical therapy, we focus on addressing the symptoms, and our main goal is to get you back to moving comfortably,” says Dr. Stewart.

You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

Types of Arthritis Affecting the Back

There are over 100 forms of arthritis, but a few are more likely to impact your back. They include:

• Osteoarthritis (OA). The overwhelming majority of people with back arthritis have osteoarthritis, which occurs when the protective cartilage that cushions the ends of bones changes over time. For some, it can cause symptoms such as pain and stiffness that tend to worsen after activity.

• Rheumatoid arthritis (RA). A systemic, autoimmune disease, rheumatoid arthritis occurs when your immune system mistakenly attacks the lining of your joints (synovium). It often impacts joints in the hands and feet, but your back might also be affected. RA may also be accompanied by unexplained fever and fatigue.

• Psoriatic arthritis (PsA). PsA is an autoimmune condition that’s more likely to affect your fingers or toes, though, in some people, it shows up as inflammation in the spine. PsA usually overlaps with psoriasis (skin lesions). 

• Ankylosing spondylitis. Another autoimmune condition, ankylosing spondylitis primarily causes inflammation in the spine. Over time it may progress and cause the vertebrae to fuse so that the spine loses flexibility. 

Symptoms of Back Arthritis

Not everyone with back arthritis has symptoms, but for those who do, they may include:

• Pain. This is the most common one, says Dr. Stewart. It can be a dull, achy back pain, as opposed to pain that’s sharp or radiating, which is typically caused by a different problem such as sciatica. 

• Stiffness, especially first thing in the morning and after sitting for long periods. 

• Reduced range of motion in the back. 

Back pain is rarely serious, says Dr. Stewart, but you should see your primary care provider first if the pain is accompanied by new bowel or bladder problems or fevers, or if it’s the result of a trauma (like a fall or a car accident). You should also talk to your doctor if you have already been diagnosed with an autoimmune form of arthritis, such as rheumatoid arthritis.

Causes of Back Arthritis

Many different factors can contribute to arthritic changes in the back. Still, there are things that may increase the likelihood you’ll develop back arthritis, including: 

• Age. As you get older, changes to cartilage that lead to arthritis become more common. About 95% of men and 70% of women over age 60 have some degree of spinal arthritis, though many don’t have symptoms.

• Genes. Genetics can contribute to the shape of your bones or the alignment of your joints, which impacts your risk of developing the condition, too. While you can't control your genes, lifestyle factors — especially movement — can play a big role in reducing arthritis risk and symptoms.

• Activities. Back osteoarthritis has been linked to certain jobs that require a lot of squatting and lifting. 

Pain related to back arthritis is rarely caused by one single factor, so even though there are some things that are out of your control, there’s a lot you can do to ease back pain caused by arthritis and improve mobility. 

Treatment Options for Back Arthritis

If you have back arthritis or suspect that you do, there are several conservative ways you can manage it, says Dr. Stewart. They include:

• Heat or ice. It’s a personal preference, but many people with arthritis prefer heat, says Dr. Stewart. Using a heating pad may relax the muscles in your back and help you ease into movement.

• Over-the-counter medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for pain related to back arthritis. It’s important to make sure that you are safely able to take these medications, based on your medical history.

• Lifestyle tweaks. Chances are there are things you do throughout the day that have the potential to make your back pain better — or worse, says Dr. Stewart. If you’re on your feet a lot, she advises changing positions frequently. If you sit often, a lumbar pillow or blanket rolled up behind your back might help. If you’re bending over often, like when you’re unloading and reloading the dishwasher, try to hinge at your hips instead of at your back. Standing in a long line at the grocery store? Lean your elbows on the cart and rest one foot on it. “Think about what causes you the most symptoms throughout the day and then make adjustments accordingly,” she says.

• Exercise. Long gone are the days when people with back pain were advised to stay in bed. Gentle movement helps lubricate the joints and alleviate stiffness. Any activity that you can tolerate is okay, says Dr. Stewart, but many people with a flare-up of back pain prefer to start slow. “If you’re in a lot of pain, start by just going for a walk around the block or even around the house while swinging your arms a bit,” she says. “Gentle, repetitive motion is what will be most helpful at this time, and you can work up from there.”

• Physical therapy. While any type of movement is beneficial, physical therapy for back pain takes it a step further by focusing on specific moves that will help you stretch and strengthen the area around painful joints. The goal is to relieve discomfort as well as take pressure off vulnerable areas, says Dr. Stewart.

Hinge Health physical therapists often recommend these moves to people with symptoms of back arthritis. They’re safe for most people, but check with your healthcare provider first if you’ve recently had a trauma or suspect something more serious might be contributing to your back pain.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

PT Tip: Don’t Fear Movement

Many people with back pain are afraid to move because they think it might be dangerous or make their pain worse, but that’s hardly the case, says Dr. Stewart. Instead, she urges people with back arthritis to take pain and stiffness as signs that they probably need to move more. “If one of the lights in your car comes on, you don’t park it in the driveway and hope it fixes itself,” she says. The same goes for back arthritis. Instead of just resting, focus on strengthening and stretching exercises that actively contribute to your recovery. 

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program. 

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Spinal Arthritis. (2023, October 11). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/spinal-arthritis 

2. Khormaee, S. (2023, April 17). Spondylosis: Causes, Symptoms, Diagnosis and Treatment | HSS. Hospital for Special Surgery. https://www.hss.edu/conditions_spondylosis-overview.asp 

3. Back pain. (2018, February 18). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906 

4. Spinal Arthritis (Arthritis in the Back or Neck). (n.d.). Johns Hopkins Medicine. Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/spinal-arthritis 

5. Rheumatoid arthritis. (2021, October 15). Arthritis Foundation. https://www.arthritis.org/diseases/rheumatoid-arthritis 

6. Psoriatic arthritis - Symptoms and causes. (2018). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/psoriatic-arthritis/symptoms-causes/syc-20354076 

7. Ankylosing Spondylitis. (2017, April 5). National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov/health-topics/ankylosing-spondylitis 

8. Cuthbertson, J. (n.d.). Osteoarthritis of the Back/Spine. Arthritis Foundation. https://www.arthritis.org/health-wellness/about-arthritis/understanding-arthritis/back-oa