How Arthritis in the Back Is Treated

Arthritis in the back—known as spinal arthritis—is inflammation of the joints in the spinal column, ranging from the pelvis up to the neck. Spinal arthritis can be caused by autoimmune disorders, infection, and everyday wear and tear on the back. Back arthritis causes back pain and stiffness, and in some cases, limited range of motion. 

Spinal arthritis is not one disease. Different types of arthritis may cause back pain and stiffness. The more common types of arthritis that affect the back include: 

Osteoarthritis (OA): The most common form of back arthritis, osteoarthritis is a degenerative joint disease that causes the cartilage cushioning at the end of joints to gradually wear away, causing pain and stiffness in the back.

Individuals with OA often experience mechanical pain that worsens with activity and movement and improves with rest. The risk of osteoarthritis increases with age. 

Rheumatoid arthritis (RA): RA is an autoimmune disorder that affects the lining of the joints. This inflammatory arthritis often affects the cervical region of the spine (neck). It is more commonly diagnosed in women. 

Spondyloarthritis (SpA): This umbrella term for several types of arthritis that cause inflammation in the spine includes ankylosing spondylitis, psoriatic arthritis, reactive arthritis, undifferentiated spondyloarthritis, and inflammatory bowel disease-associated spondyloarthritis.

Though each of these spondyloarthritis conditions can bring on different symptoms, they all can cause inflammation and pain in the spine. 

The treatment for spinal arthritis varies depending on several factors, including type and severity of arthritis, level of pain, age, and overall health status. Because arthritis is a chronic disease (meaning there is no cure), the treatments typically focus on pain management and preventing further damage to the joints. 

Back pain

9nong / iStock / Getty Images

Over-the-Counter Therapies 

Over-the-counter (OTC) medications are generally the first-line treatment for arthritis in the back. Tylenol (acetaminophen) and NSAIDs like ibuprofen and naproxen can help temporarily relieve pain and inflammation in the joints. 

Topical pain relievers are medications that you can apply directly to the skin overlying the affected joints. Several over-the-counter topical treatments are available, including creams, gels, and sprays that help temporarily relieve arthritis pain.

The ingredients in topical pain relievers may include NSAIDs (which include the same active ingredients as oral NSAIDs) and capsaicin (an active component found in chili peppers) and help dull pain caused by arthritis. 

Over-the-counter therapies can be used along with other kinds of treatments to treat inflammation, pain, and swelling caused by spinal arthritis. 

Prescriptions

When OTC medications are not enough to reduce the pain caused by back arthritis, your doctor may prescribe stronger medications. Some NSAIDs, such as Zorvolex (diclofenac), are available by prescription only and help reduce pain and inflammation.

In addition to prescription NSAIDs, anti-inflammatory medications known as steroids may be prescribed if you have a type of inflammatory arthritis. These may be oral medications or given as injections. 

Injected corticosteroids are powerful anti-inflammatory hormones. These injections reduce inflammation in the joints and may be combined with an anesthetic to reduce pain further. Repeated cortisone injections may be harmful to the tissues surrounding joints and are generally only recommended a few times a year.

Mild narcotic painkillers may be prescribed for pain relief. Due to their potential for addiction, these are used on a short-term basis and are not often prescribed for prolonged use.

If back pain is from an inflammatory cause/autoimmune disease, immunosuppressive therapy would be needed, which could include disease-modifying antirheumatic drugs (DMARDs) or biologic agents.

Surgeries and Specialist-Driven Procedures

Radiofrequency ablation (RFA) is an outpatient procedure that uses heat (radiofrequency waves) to ablate (burn) the nerve fibers carrying pain signals to the brain, helping reduce or stop the pain. This is a simple procedure, and most patients can walk around immediately after the procedure.

Though it may take up to two weeks to feel relief after the procedure, many patients report experiencing long-term relief of up to one to two years. Recent research shows that RFA is a highly effective treatment for many arthritis patients.

Surgery is a last resort for treating spinal arthritis. It is most often recommended when other treatments don’t relieve back pain. The type of surgical procedure depends on the region of the back affected and the type of arthritis diagnosed.

Depending on the procedure performed, surgery may help decompress the spinal cord, helping relieve pressure on nerve roots caused by inflammation. It is also used to stabilize the spine (spinal fusion) to reduce pain and increase mobility. 

Complementary and Alternative Medicine

In addition to prescribing medications to manage arthritis pain, your doctor may also recommend complementary therapies to help reduce symptoms.

Acupuncture

Acupuncture is an ancient Chinese practice that uses small, thin needles to stimulate acupuncture points on the body to promote healing. Acupuncture for back pain involves the practitioner inserting needles into specific trigger points on the body (e.g., lower back, hip, back of the knee).

The needles touching these points are believed to stimulate the central nervous system and may release chemicals that could help alleviate symptoms and relieve pain. Research shows that acupuncture is associated with significant reductions in pain intensity, improved functional mobility, and better quality of life.

Massage Therapy

Massage therapy is a therapeutic approach to pain management. A licensed massage therapist will use techniques to massage and manipulate tissues and muscles to release deep tension. In addition, massage therapy boosts circulation, promoting repair and reducing inflammation in the muscles, tissues, and joints.

Research shows that massage therapy can improve range of motion and flexibility, alleviate pain, and improve emotional and mental well-being on a short-term basis. If you cannot see a massage therapist, you can use massage devices and self-massage at home. 

Meditation

Mindfulness-based practices such as meditation can help the body relax, reducing stress. When stress is reduced, inflammation levels and tension in the body also decrease, which can provide relief for those living with back pain.

Research shows that meditation can help reduce acute stress and pain response in the body. In addition to the physical benefits of meditation, many people living with chronic pain find it beneficial for improving emotional and mental health.

Meditation has been proven effective at reducing anxiety and depression and promoting deeper sleep. All of these offer benefits to people with arthritis, improving their overall quality of life. There are many different meditation methods. Explore available apps and online instructional videos to find the right meditation method for you.

Home Remedies and Lifestyle

There are a number of home remedies and lifestyle changes that can be added to your arthritis management techniques. These can be very helpful in reducing pain so you can live a full, active life.

Weight Loss

When you’re carrying extra weight, it puts extra pressure on the spine, leading to numerous conditions, including back pain and spinal arthritis. Maintaining a healthy weight can reduce pressure and stress on the joints and lessen back pain.

Aim to eat a healthy, balanced diet by consuming plenty of fruits, vegetables, whole grains, and protein. Avoid processed foods as well as foods high in sugar to help lose extra weight. 

Exercise

Exercise may be the last thing on your mind when your back is hurting, but it is a critical part of managing spinal arthritis. Gentle exercises, such as yoga and Pilates, can help increase mobility and reduce pain.

Regular strength training and flexibility exercises such as stretching can help strengthen back and core muscles, which support a healthy spine. Cardiovascular exercise such as swimming or walking promotes good circulation in the spine and helps maintain a healthy weight. Check with your doctor before beginning any exercise program. 

Physical Therapy

A physical therapist can show you how to modify exercises so they don’t worsen your pain. Physical therapy has been shown to help reduce most types of back pain, improve range of motion, and strengthen back and core muscles to improve spinal health.

When living with back pain, it is important to work with a physical therapist to learn how to do exercises correctly to prevent injury or increased pain. 

Quit Smoking

Smoking affects more than your lungs—it affects all tissues in the body and reduces the body’s ability to heal, making arthritis more resistant to treatment. Smoking is associated with lower back pain and intervertebral disc disease, and smokers report high levels of pain compared to nonsmokers.

There are many methods to help you quit smoking. Your doctor can direct you to the right smoking cessation program for you. 

A Word From Verywell

Although spinal arthritis is chronic, it can be managed through a combination of medication, lifestyle changes, and complementary therapies. With the right treatment plan, individuals with spinal arthritis can live healthy and active lifestyles. Speak with your doctor to determine the best course of treatment for you. 

Was this page helpful?
Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Johns Hopkins Medicine. Spinal arthritis (arthritis in the back or neck).

  2. Liu D, Ahmet A, Ward L, et al. A practical guide to the monitoring and management of the complications of systemic corticosteroid therapy. Allergy Asthma Clin Immunol. 2013;9(1):30. doi:10.1186/1710-1492-9-30

  3. Conger A, Burnham T, Salazar F, et al. The effectiveness of radiofrequency ablation of medial branch nerves for chronic lumbar facet joint syndrome in patients selected by guideline-concordant dual comparative medial rranch blocks. Pain Med. 2020;21(5):902-909. doi:10.1093/pm/pnz248

  4. Johns Hopkins Medicine. Acupuncture.

  5. Manyanga T, Froese M, Zarychanski R, et al. Pain management with acupuncture in osteoarthritis: a systematic review and meta-analysis. BMC Complement Altern Med. 2014;14:312. doi:10.1186/1472-6882-14-312

  6. Crawford C, Boyd C, Paat CF, et al. The impact of massage therapy on function in pain populations-a systematic review and meta-analysis of randomized controlled trials: Part I, patients experiencing pain in the general population. Pain Med. 2016;17(7):1353-1375. doi:10.1093/pm/pnw099

  7. Zeidan F, Vago DR. Mindfulness meditation-based pain relief: a mechanistic account. Ann N Y Acad Sci. 2016;1373(1):114-127. doi:10.1111/nyas.13153

  8.  Sharma H. Meditation: Process and effects. Ayu. 2015;36(3):233-237. doi:10.4103/0974-8520.182756

  9. Johns Hopkins Medicine. Spinal arthritis (arthritis in the back and neck).

  10. Centers for Disease Control and Prevention. Physical activity for arthritis. Updated November 18, 2018.

  11. Bachmann S, Oesch P. Physiotherapie und rehabilitation bei unspezifischen kreuzschmerzen [Physiotherapy and rehabilitation for low back pain]. Ther Umsch. 2013;70(9):543-548. doi:10.1024/0040-5930/a000444

  12. Behrend C, Prasarn M, Coyne E, Horodyski M, Wright J, Rechtine GR. Smoking cessation related to improved patient-reported pain scores following spinal care. J Bone Joint Surg Am. 2012;94(23):2161-2166. doi:10.2106/JBJS.K.01598