Spinal Arthritis: Symptoms, Causes and the Best Exercises

Living with spinal arthritis doesn't mean giving up the activities you enjoy.

Being told you have arthritis in your spine can feel worrying. Many people immediately assume that their back:

• Will continue wearing out
• Will only get worse with age
• Is crumbling

Thankfully, that isn't usually the case.

One of the most reassuring things I tell my patients is that arthritis is a normal part of ageing, not necessarily a sign of ongoing damage. Plenty of people have arthritic changes on an X-ray or MRI and no pain whatsoever.

The good news is that, for many people, the right combination of education, movement, strengthening and simple lifestyle changes can significantly reduce pain and improve confidence.

This guide explains what spinal arthritis is, why it develops and, most importantly, what you can do to help yourself.

What is spinal arthritis?

Many of my patients get confused about what spinal arthritis actually is. It's not surprising when there are several different terms all referring to much the same thing. These include:

• Wear and tear of the spine
• Degenerative joint disease
• Facet joint arthritis
• Osteoarthritis of the spine, or spondylosis

When we refer to spinal arthritis, it describes age-related changes affecting the small joints of your spine, known as the facet joints.

These joints sit at the back of each vertebra and help guide movement, allowing your spine to bend, twist and extend smoothly.

Like every other joint in the body, the facet joints are covered in smooth cartilage. Over time, this cartilage gradually becomes thinner, the joints become slightly rougher and small bony growths called osteophytes (bone spurs) may develop.

These changes sound alarming, but they are incredibly common, and they matter far less than most people expect.

This isn't just my opinion. NICE guidance on osteoarthritis advises against routinely using imaging to diagnose or guide treatment, precisely because what shows up on a scan often has very little to do with how much pain someone is in.

That's why it's important to remember that your scan doesn't tell the whole story.

When I see people with spinal arthritis pain in clinic, it's commonly down to:

1. Joint irritation
2. Muscle weakness
3. Stiffness
4. Reduced movement, and sometimes changes affecting nearby discs or nerves

Here's the part worth holding onto: not one of those four is fixed. That's the whole reason this page exists.

If you've also been diagnosed with degenerative disc disease, don't be surprised. The two often occur together as part of the same ageing process. I've written a separate guide on what degenerative disc disease is and how it differs from spinal arthritis.

Why does spinal arthritis develop?

"Why me?" is probably the question I'm asked most. Honestly, there's rarely one single answer. It's usually several things quietly stacking up over a lifetime.

• Age. This is the big one. Joint surfaces change as the decades go by, in much the same way skin and hair do.
• Previous injury. A joint that has taken a significant strain, such as after a whiplash injury, can show age-related changes sooner than its neighbours.
• Sustained postural load. Years of long days at a desk won't cause arthritis on their own, but they do load the same segments over and over. Tech neck is the pattern I see most often in the neck.
• Altered mechanics. Where the spine is shaped a little differently, such as with scoliosis or an increased mid-back curve, load is shared unevenly and some segments end up working harder than others.
• Family history. Osteoarthritis does tend to run in families, although no single gene has been shown to explain it.
• Body weight. Extra load carried through weight-bearing joints day after day adds up over the years.

Notice how much of that list above you still have some influence over. That's where I'd spend your energy, rather than on the parts you can't change.

What are the symptoms of spinal arthritis?

Symptoms vary depending on whether the arthritis affects your neck, middle back or lower back, but common symptoms include:

• Morning stiffness that gradually eases with movement.
• Pain after sitting for prolonged periods.
• Localised aching in the neck or back.
• Reduced flexibility when bending or turning.
• Pain that increases after standing or walking for long periods.
• Muscle tightness around the spine.
• Flare-ups that come and go.

One detail worth knowing about that first symptom. With osteoarthritis, morning stiffness is usually short-lived and tends to ease within about half an hour of getting moving. The NHS uses that 30-minute mark as one of the ways of telling it apart from inflammatory arthritis such as rheumatoid arthritis, where stiffness typically lasts considerably longer. If yours drags on all morning, or you're getting joint swelling, fevers or unexplained weight loss alongside it, please mention that to your GP rather than assuming it's simple wear and tear.

If your arthritis is affecting your neck, you'll also find my neck pain guide useful, along with the page on mechanical neck pain, which overlaps a good deal with this one.

Arthritic necks and broken sleep tend to travel together. If you're waking up stiffer than you went to bed, I'd sort the pillow before spending money on anything else. I've written about the pillow I most often recommend to patients with neck pain, including who it doesn't suit.

If your arthritis is affecting your lower back, start with my lower back pain guide, then read mechanical low back pain, which covers many of the factors that commonly contribute to persistent back pain.

Pain that sits low and to one side, around the dimple at the base of your back, is often the sacroiliac joint rather than the facet joints. It's a distinction worth making, because the exercises differ.

If your pain sits between the shoulder blades or wraps around towards the ribs, my mid back and shoulder blade pain guide covers that region. It's also worth ruling out rib joint pain, which can feel remarkably similar.

Sometimes people also notice pain travelling into an arm or leg.

Although arthritis can contribute to this, symptoms such as numbness, tingling or weakness are more often associated with conditions like spinal stenosis, sciatica or a bulging disc in the lower back rather than arthritis alone.

In the neck, a pinched nerve or a cervical disc bulge can produce the same pattern down the arm. Any of these is worth getting properly assessed rather than self-diagnosing from a website, including this one.

Common mistakes I see

One of the advantages of working with people with back and neck pain every day is that you start to notice the same misconceptions appearing again and again.

Mistake 1 – Believing your scan predicts your future

Many people assume arthritis means their spine will inevitably continue to deteriorate. Thankfully, that's rarely how it works. Plenty of people with arthritis stay active for decades with very manageable symptoms.

Mistake 2 – Resting too much

During a painful flare-up it's sensible to modify activities, but prolonged rest often leads to stiffer joints and weaker muscles. Gentle movement is usually one of the best medicines for spinal arthritis.

Mistake 3 – Only stretching

Stretching often feels good in the moment, but the relief rarely lasts. Lasting improvement usually comes from pairing mobility work with exercises that build stability and strength, so the joints are better supported between sessions. The three-stage plan further down this page is built to fix exactly that.

What actually helps spinal arthritis

Having treated a great many patients with arthritis over the years, I can tell you from experience that no single treatment works for everyone.

What I see in clinic does line up closely with the guidance, though. NICE recommends therapeutic exercise and weight management as core treatments for osteoarthritis, with medication in a supporting role rather than a leading one. Put plainly: the things that work are mostly things you do, not things done to you.

• Staying physically active. Walking, swimming, cycling, gardening, whatever you'll actually keep doing. Joints tolerate regular moderate load far better than long spells of nothing.
• Doing specific exercises regularly. Little and often beats one heroic session a week. The staged plan below is how I'd start you off.
• Building strength as well as flexibility. Strong muscles share the load with the joint. This is the part most people skip, and it's the part that makes the difference last.
• Keeping your weight in a healthy range. Every extra kilo is load your spine carries all day. Small sustainable changes count for far more than crash diets.
• Hands-on treatment where appropriate. Manual therapy can settle an irritable joint and make movement more comfortable, which buys you the window you need to get the exercises done. I'd see it as a way of helping you move, not as a treatment in its own right.
• Heat during periods of stiffness. Heat won't change the joint itself, but it makes those first few movements of the day considerably easier, which is often all you need to get started. A reusable hot and cold pack is one of the cheapest things you can own that genuinely earns its keep.
• Sorting out how you sit. If sitting is reliably your worst position, that's where to intervene, because it's where most people spend the bulk of their day. I've written honest reviews of whether ergonomic chairs actually help back pain and whether standing desks are worth it, including where both of them fall short.
• Managing flare-ups sensibly. Reduce the load, don't stop moving altogether, and expect it to settle. Flare-ups are part of the pattern rather than evidence that something has been damaged.

A quick word on those product links. Some are affiliate links, which means I may earn a small commission if you buy through them, at no extra cost to you. I only mention things I'd suggest to someone sitting in my treatment room, and I'll say it plainly: not one of them will do as much for you as the exercises below. They remove friction. They don't do the work.

The best exercises for spinal arthritis: the three stages I use in clinic

Here's where most people go wrong. They read that strength matters, go straight to planks and bridges on a stiff, irritable spine, ache for two days afterwards, and conclude that exercise isn't for them.

In clinic I stage it instead. You earn the right to progress rather than starting at the end. The timings below are a guide, not a rule. Some people move through stage one in a few days, others need a few weeks, and neither is a problem.

Stage 1 – Calm it down and get it moving (roughly weeks 1 to 2)

Gentle range of movement, little and often. Aim for comfortable movement rather than a deep stretch, and stop well short of pain. Most people do best with a short session morning and evening.

• Cat/Cow Stretch – the one I start almost everyone on. It wakes up the whole spine without loading it.
• Child's Pose – a resting position that tends to settle an irritable lower back.
• Supine Leg Rotations – gentle rotation through the lower back with the floor taking your weight.
• Gluteal Stretch – tight glutes make a stiff lower back feel considerably worse than it is.
• Neck Mobilisation Exercises for Stiffness – start here if the neck is your problem area.
• Upper Trapezius Stretch – for that band of tightness across the top of the shoulders that so often comes with a stiff neck.

Stage 2 – Teach your spine to hold a better position (roughly weeks 2 to 4)

Once things have settled, the job changes. Now we're building the endurance to hold a decent position without having to think about it. These are low-load holds, so they shouldn't flare you up, but you should feel the muscles working.

• Brügger's Relief (Postural Reset) – a 30-second reset you can do at your desk, several times a day.
• Chin Tuck Exercise – the foundation for the neck. Unglamorous, and it works.
• Floor Angels – opens the mid back and gets the shoulder blades moving properly again.
• Bird Dog – teaches the lower back to stay still while the arms and legs move.
• Dead Bug – the same idea lying on your back, which is kinder on sore joints.

Stage 3 – Build the strength that keeps it settled (week 4 onwards)

This is the stage that makes the improvement stick. Strong muscles take load off the joint and keep taking it off. Build gradually, and expect some muscle soreness, which feels quite different from joint pain.

• Glute Bridge – builds the hips and glutes, which are the lower back's best allies.
• The Plank – start from the knees if you need to. Quality of position beats time on the clock.
• Prone Dorsal Raises – strengthens the muscles along the back of the spine.
• Supine Chin Tuck Head Lift – the strength progression for the deep neck muscles.

The flare-up rule I give patients: a mild ache that settles within about 24 hours is usually fine. If it's still noticeably worse the next day, you did too much. Drop back a stage, don't stop.

If you'd rather not assemble stage one yourself, I've put the key movements together into a single short routine. It takes seven minutes, and it's close to what I'd hand a patient with arthritic stiffness on their first visit.

Once you're moving comfortably through stage three, building long-term strength and the habits that keep you pain free are where I'd point you next.

Final thoughts

In my experience, the people who achieve the best long-term results are those who commit to small, consistent improvements rather than searching for a quick fix.

Arthritis on a report is not a sentence. The NHS is clear that osteoarthritis doesn't necessarily get worse over time and that symptoms can sometimes gradually improve. What I'd have you focus on isn't how your spine looks on a scan. It's how well it moves and how much it can comfortably handle. Both of those are things you can change, and you can start this week.

Related guides

• Disc Degeneration: Causes, Symptoms & Treatment – the condition that most often sits alongside spinal arthritis.
• Spinal Stenosis: Causes, Symptoms & Exercises – read this if walking brings on leg pain or heaviness.
• Sciatica: Causes, Symptoms & Exercises – for pain that travels down the leg.
• Mechanical Low Back Pain: Causes, Symptoms & Exercises – the everyday back pain that often coexists with arthritic change.
• Mechanical Neck Pain: Causes, Symptoms & Exercises – the neck equivalent.
• Kyphosis: Causes, Symptoms & Exercises – if an increased mid-back curve is part of your picture.