This category of treatment focuses on general physical fitness as well as specific activities to strengthen muscles around arthritic joints, and to increase joint mobility while adequately supporting affected joints to prevent injury. Helpful techniques include physical therapy and exercise (both land- and water-based).

Exercise and Physical Therapy for Spinal Arthritis

Many people with arthritis have found substantial relief from their symptoms through physical therapy and exercise.

Read more: Osteoarthritis Exercises

In fact, exercise is thought to be the most effective non-drug treatment for reducing pain and improving movement for people with osteoarthritis. For those with osteoarthritis, the exercises need to be done correctly to avoid causing joint pain. Specific exercises help strengthen the muscles around the joints (removing some stress from the joints), improve joint mobility and reduce joint stiffness and pain.

It has been demonstrated that back and/or neck pain inhibits extensor muscle function, and thus exercises should be focused on those particular muscles. Regular exercise also has a wide range of side benefits, as it typically improves attitude, promotes a healthy level of blood circulation, helps individuals maintain an appropriate weight, promotes endurance, provides more energy, improves sleep, and can even decrease depression.

See What to Consider Before Starting Exercises for Neck Pain

The patient may be referred to a physical therapist or exercise trainer by his/her doctor in order to determine the appropriate amount and types of exercise. For most, it is very important to work with an appropriately trained physical therapist in order to learn how to do the exercises correctly.

See How a Physical Therapist Can Help with Exercise


Types of Exercise for Osteoarthritis

In general, a person with painful osteoarthritis of the spine will benefit from all or some combination of the following categories of exercise:

See Symptoms of Arthritis of the Spine

Neck and back exercises to build strength

These exercises can help keep the spine strong and limber. Increased muscle strength better supports arthritic joints and keeps undue stress off of them. Inexpensive devices that add resistance, such as exercise bands, can be used, in addition to resistance and weight machines.

See Back Strengthening Exercises and Neck Strengthening Exercises

Low impact aerobic activities

These activities keep the lungs and circulation systems in shape, as well as helping control weight. Popular activities that do not place undue stress on the spine include walking, stationary cycling and exercising in the water (e.g. water therapy or pool therapy).

See Low-Impact Aerobic Exercise

Range of motion exercises

These exercises are focused on keeping the back joints limber, relieving stiffness and maintaining normal joint motion in the back. These may include bending sideways, forward, and backward.

Patients should be sure to ask for guidelines on exercising when the motion segment is sore. When patients are in pain, it may be necessary to use specific pain relieving techniques to help them tolerate exercises.

For example, pain-relieving drugs (such as analgesics or anti-inflammatories) taken an hour before exercising may help, or applying local heat before exercise and cold packs after exercise can help make exercising easier and help relieve pain and inflammation.

See Benefits of Heat Therapy for Lower Back Pain


Specific Osteoarthritis Exercise Routines

There is a wide range of exercises and activities that many people with spinal arthritis find appropriate and enjoyable.

Swimming and water therapy

Swimming is very well suited for patients with osteoarthritis because it allows patients to exercise with minimal impact stress to the joints and often with reduced pain. In addition to swimming, exercise routines performed in the water (e.g. a pool) can be beneficial since the water's buoyancy reduces weight placed on the spine, reducing irritation to the joints in the back and risk of possible injury that can occur with unintended movements during exercise.

See Water Therapy Exercise Program

Resistance exercise

To strengthen muscles and thus resist fatigue, it is necessary to undertake resistance exercise. What this means is that the patient's muscles have to work harder (not faster or longer) than they usually do with normal daily activity.


Many people with osteoarthritis find that an exercise program can even include a round of golf.

See Golf and Back Pain


Others find the gentle stretching and meditation associated with yoga may is quite helpful and gently alleviates the pain and helps maintain flexibility in the joints without placing undue stress or strain on the back.

See How Yoga Helps the Back

Patients should consult with their doctors before starting a water therapy, yoga, or any other exercise program and participate in programs conducted by appropriately trained professionals.

For more in-depth information, see Arthritis Exercises on

Dr. Vert Mooney (1931 - 2009) was an orthopedic surgeon, medical director for U.S. Spine and Sport, and a Clinical Professor of Orthopaedics at the University of California at San Diego. He received his Doctor of Medicine degree at Columbia University College of Physicians and Surgeons and completed his residency at University of Pittsburgh Hospitals.

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