If you have spinal arthritis in your low back, I probably don’t have to tell you how painful and limiting it can be.
Osteoarthritis (anywhere in the body) starts with erosion of the cartilage in joints. (Cartilage is a softer-than-bone substance that provides lining and cushioning in the joint space; the joint space is the area between the two bones that comprise the joint.)
When osteoarthritis progresses, your cartilage may erode entirely so that bone moves on bone as you go about your usual routine. And I know I don’t have to tell you how excruciating that can be.
But that’s not all.
Spinal Changes and Spinal Arthritis
Breakdown and erosion of cartilage quite often leads to the joint changing its shape. This is due to a process known as bone remodeling, says Hagit Rajter, clinical physical therapist at the Joint Mobility Center, Hospital for Special Surgery, New York City. Bone remodeling may cause bone spurs and cysts to form at the edges of bones.
The low back is particularly affected when there is osteoarthritis in the spine. This is because the low back takes the day-to-day mechanical stresses of most of your body weight, says Rajter. "The excess pressure on the low back that results in strain and irritated spinal joints already damaged by arthritis can greatly amplify the pain," she says, adding that generally the facet joints and spinal discs are most affected. (The disc loses height.)
Rajter also notes that research supports the premise that osteoarthritis in your low back may affect your balance, along with your hip functioning and core strength. These ability-decreases will most likely make it more difficult to perform your usual activities at the level at which you may be accustomed. They also make it harder to exercise. "These are the indirect consequences of spinal arthritis," Rajter says. "They are not the disease, but they sure have an impact on it."
What Can You Do for Spinal Arthritis Pain in Your Low Back?
There’s no real cure for osteoarthritis. Treatment is generally focused on pain relief, slowing the progression of the condition, controlling inflammation in the joints and improving your ability to do what you like to do.
Treatment can be individually tailored to your needs, and often a multi-pronged treatment approach is taken. While different types of modalities are usually included in a treatment plan for spinal arthritis (such as taking medication, going for physical therapy and using joint protection aids), you must not ignore the importance of exercise in your daily life.
Motivation to Exercise When You're in Pain
I know. I know. It’s hard to get yourself up and motivated to exercise, especially when your pain is acting up, but hear me out. Exercise has too many benefits to ignore as part of your regular routine. Exercise can help reduce your stiffness, improve your overall mood, relieve your pain and may even slow down the progression of changes that occur in your spine as a result of the arthritis. Plus, it may protect against such diseases as heart disease, cancer and more.
Fitness and exercise programs generally consist of cardio, strength training and activities to increase your joint range of motion. Of these, the joint range-of-motion work may deserve much of your focus. Rajter says that range-of-motion exercises may interrupt the vicious cycle of stiffness, immobility, joint changes and pain often associated with arthritis.
For a basic low-back, range-of-motion program that’s safe, but not particularly aggressive, Rajter recommends three exercises, described below. She says that if you also have other medical conditions, or you have fitness goals you’d like to address without worsening your symptoms, you should make an appointment with a physical therapist for an evaluation and home exercise program.
For the following exercises, it's best not to do them in bed. Use a mat or blanket on the floor. I provide a very general write-up for each exercise below; if you're interested in detailed instructions with pictures, click the link to the left of each description.
Telephone Interview. Rajter, Hagit, PT, MSPT, Schroth Scoliosis Therapist, Cert. McKenzie Therapist, Advanced Clinician Physical Therapist, Joint Mobility Center, Hospital for Special Surgery, New York City. September 2011.