What Osteoarthritis Actually Looks Like
An Osteopath’s Perspective on Living Well with Arthritic Back Pain
As an Osteopath at The Waterside Practice, Warboys. One of the most common conditions I support patients with is osteoarthritis in the lower back. Many people hear the word “arthritis” and immediately assume it means severe disability or that their spine is “wearing out” and there is nothing that can be done to help them beyond painkilling medication.
In reality, osteoarthritis is incredibly common, particularly as we move through adulthood, and many people continue to live active and fulfilling lives with the right management and understanding.
This article is designed to help you better understand what osteoarthritis is, what happens within the lumbar spine, the symptoms people commonly experience, and how Osteopathy can help patients manage and maintain their mobility long term.
What Is Osteoarthritis?
Osteoarthritis is a degenerative joint condition affecting the smooth cartilage surfaces within joints. Cartilage acts as a protective cushioning layer that allows joints to move smoothly and comfortably.
Over time, these joint surfaces can begin to change. The cartilage may thin, roughen, or become less effective at absorbing load. The body can also respond by creating extra bony growths called osteophytes, commonly referred to as “bone spurs”.
In the spine, osteoarthritis most commonly affects the facet joints. These are the small joints located at the back of each spinal segment that guide and control movement.
The lumbar spine, or lower back, is particularly vulnerable because it carries much of the body’s weight and absorbs significant forces through everyday life.
What Happens in the Lumbar Facet Joints?
The lumbar facet joints are designed to glide smoothly during movement. In osteoarthritis, several changes can occur:
Cartilage within the joints begins to wear down
Joint spaces may narrow
The surrounding tissues can become inflamed
Muscles around the spine often tighten protectively
Stiffness develops through reduced movement
The body may produce osteophytes around the joints due to joint surface wear
Importantly, pain is rarely coming from one structure alone. In clinic, we frequently see a combination of joint irritation, muscular tension, reduced spinal mobility, and surrounding tissue sensitivity all contributing together.
This is why lower back osteoarthritis can feel very different from person to person.
Common Symptoms of Lumbar Osteoarthritis
Patients with lumbar osteoarthritis commonly describe:
Aching pain across the lower back
Morning stiffness
Pain after periods of inactivity
Difficulty standing upright after sitting
Reduced flexibility
Pain when twisting or bending backwards
Tightness through the hips and buttocks
Fatigue from persistent discomfort
Symptoms often fluctuate. Many people experience “flare ups” where pain temporarily increases, followed by periods where symptoms settle again.
Interestingly, scans and symptoms do not always match. Some people with significant arthritic changes on imaging have very little pain, while others with mild degeneration may experience considerable discomfort. This is why clinical assessment and understanding the whole patient remains important.
Causes of Osteoarthritis?
Age is one factor, but it is not the only one. Other contributing factors can include:
Previous injuries
Repetitive strain
Sedentary lifestyles
Reduced muscular support
Occupational loading
Genetics
Carrying excess body weight
Poor movement patterns over time
However, it is important not to view osteoarthritis as simply “damage”. The body is adaptable, and movement remains one of the most important tools we have for maintaining spinal health.
Can Osteopathy Help?
As an Osteopath, my role is not simply to chase pain temporarily, but to help patients maintain function, mobility, and confidence in movement.
Treatment often focuses on:
Improving movement through stiff spinal joints
Reducing muscular tension
Supporting posture and biomechanics
Improving mobility through surrounding tissues
Helping patients remain active safely
Managing flare ups effectively
Providing rehabilitation exercises
Educating patients about pacing and long term management
Many patients with lumbar osteoarthritis become what we call maintenance or relapse-prevention patients. This means they attend periodically throughout the year to help keep symptoms manageable and mobility maintained.
For many people, this allows them to continue doing the things they enjoy:
Walking
Gardening
Travelling
Playing with grandchildren
Exercising
Continuing work comfortably
Treatment goals are to improve and maintain mobility through the spine, and help keep pain levels under control.
The Importance of Movement
One of the biggest misconceptions surrounding osteoarthritis is that movement should be avoided. And as I said on a recent talk about back pain quite plainly: “if you’re not moving you’re not going to maintain health for very long”. Our bodies thrive on motion, so my aim as an Osteopath is to encourage and maintain it.
In reality, appropriate movement is often one of the best things for arthritic joints. Motion helps nourish cartilage, maintain flexibility, support circulation, and reduce stiffness.
This does not mean pushing aggressively through severe pain. It means finding sustainable, manageable movement that keeps the body functioning.
For some patients this may be walking. For others:
Pilates
Swimming
Strength work
Mobility exercises
Gentle stretching
Consistency tends to matter more than intensity.
Exercises for Lumbar Osteoarthritis at Home
When managing osteoarthritis in the lower back, gentle and consistent movement is often more beneficial than complete rest. The aim is not to force the spine, but to keep the joints moving, reduce stiffness, and maintain confidence in movement.
Here are a few simple exercises commonly recommended for lower back mobility and comfort.
Pelvic Tilts
Lie on your back with your knees bent and feet flat on the floor. Gently rock your pelvis backwards to flatten your lower back into the floor, then release.
Repeat slowly for 10 to 15 repetitions.
This exercise helps improve awareness and mobility through the lower lumbar spine.
Knee Rolls
Lie on your back with knees bent together. Slowly allow both knees to move side to side within a comfortable range.
Repeat for 30 to 60 seconds.
This encourages gentle rotational movement through the lumbar joints and can help reduce stiffness.
Cat Stretch
Position yourself on hands and knees. Slowly arch the back upwards, then gently lower and lift the chest slightly.
Move slowly and comfortably for 10 repetitions.
This helps improve spinal mobility and reduce muscular guarding.
Gentle Walking
Walking remains one of the best forms of movement for many people with lumbar osteoarthritis.
Short, regular walks are often more beneficial than long periods of inactivity followed by overdoing activity during “good days”.
Important Advice
Exercises should feel manageable and should not significantly increase symptoms afterwards. Mild stretching discomfort can be normal, but sharp, severe, or worsening pain should be assessed professionally.
Consistency is usually far more important than intensity. Small amounts of regular movement performed daily often provide better long term results than occasional strenuous exercise.
A Last Note
Being diagnosed with osteoarthritis in the lower back does not automatically mean your spine is failing or that your future must involve increasing disability.
For many people, osteoarthritis becomes a condition that is managed rather than feared.
Through education, movement, manual therapy, and long term support, many patients are able to continue leading active and meaningful lives despite ongoing arthritic changes.
At The Waterside Practice, our practitioners regularly support patients living with lumbar osteoarthritis and chronic back pain with a realistic, practical, and supportive approach focused on helping people stay moving and doing what they love. Why not have a quick chat with one of our osteopaths to see if we could help you? Book a free call here: https://thewatersidepractice.janeapp.co.uk/#/discipline/1/treatment/96