How to Manage Chronic Arthritic Back Pain

Living with chronic arthritic back pain isn’t easy. However, there are things you can do to manage your pain. You should visit a doctor before doing anything else. Your doctor can help you develop a treatment plan and put together a team of specialists to manage your pain. Everyday solutions you can do yourself include using hot or cold packs and doing some moderate physical activity. Working in a place free of strenuous physical labor or an overly-sedentary environment and maximizing your comfort at work is also important.

Method 1

Method 1 of 4:

Seeking Medical Help

1
See a doctor.^{[1]XTrustworthy SourceArthritis FoundationMain organization devoted to arthritis support and educationGo to source} There are multiple kinds of medical specialists who might be able to give you further advice and prescribe necessary treatments. If you are in the US, you may contact the National Institute of Arthritis and Musculoskeletal and Skin Diseases for advice about where to find a doctor near you.^{[2]XResearch source}
- Rheumatologists are specialists in arthritic diseases.
- Chiropractors, osteopaths, and nutritionists are alternative specialists who treat diseases or injuries to the muscles and skeleton and help patients make lifestyle changes for better overall health and well-being.
- You might choose to see one or many types of specialists when developing your treatment plan. Many types of specialists can help you manage your pain and give you advice relevant to your specific situation.
- A physical therapist can teach you some daily stretching exercises that may help alleviate some of your back pain symptoms.^{[3]XExpert SourceStuart Rammell, DO
  Board Certified Interventional Pain SpecialistExpert Interview. 1 September 2021.}
2
Get examined. Your doctor might request a number of tests to determine the extent and exact location of your chronic back pain. The doctor can use this information to better provide treatment and help you manage your pain. You might get:^{[4]XTrustworthy SourceMedlinePlusCollection of medical information sourced from the US National Library of MedicineGo to source}
- A number of diagnostic tests, many involving a blood test, biopsy, joint fluid test, or skin sample, may be used to confirm diagnosis of more common types of arthritis.^{[5]XTrustworthy SourceArthritis FoundationMain organization devoted to arthritis support and educationGo to source}
- A magnetic resonance image (MRI), a painless procedure involving magnetic fields and radio waves to form a 3D image of the inside of the muscles and bones of your back.
- An x-ray. X-rays are painless imaging procedures involving electromagnetic radiation to produce a black-and-white visualization of your skeletal system.
- A computed tomography (CT) scan. CT scans use x-rays to create a layered image of your spine.
3
Use medication.^{[6]XTrustworthy SourceArthritis FoundationMain organization devoted to arthritis support and educationGo to source} Talk to your doctor about what medication choices are available to you, including over the counter medications and supplements.^{[7]XExpert SourceStuart Rammell, DO
Board Certified Interventional Pain SpecialistExpert Interview. 1 September 2021.} Your doctor may also suggest a prescription, but prescriptions are made on a case-by-case basis depending upon the severity of the condition.
- Disease-modifying antirheumatic drugs (DMARDs), methotrexate, and hydroxychloroquine (marketed under the brand name Plaquenil) are some of the most common prescription drugs.
- Over-the-counter medications like ibuprofen, as well as some supplements natural remedies, may be effective at reducing pain and inflammation as well.^{[8]XTrustworthy SourceArthritis FoundationMain organization devoted to arthritis support and educationGo to source}
- If you have trouble paying for your medications, contact the Patient Access Network Foundation or the Medicare Rights Center. Both organizations are involved in helping people pay for the medicine they need.
- Always use medications as directed.
^{[9]XTrustworthy SourceMedlinePlusCollection of medical information sourced from the US National Library of MedicineGo to source} Old injuries and fractures might be irritated by surgery. Unless your surgery is absolutely necessary, you should manage your back pain in less invasive ways.
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Method 2

Method 2 of 4:

Managing Daily Pain

1
Get a hot or cold pack.^{[10]XTrustworthy SourceMedlinePlusCollection of medical information sourced from the US National Library of MedicineGo to source} Hot packs and cold packs are small bags filled with a special gel-like substance that can be frozen or heated, then applied to the skin at the point where it hurts for pain relief. Wrap the hot or cold pack in a paper towel or washcloth and place it on your back where you’re experiencing pain.
- Whether you use a hot or cold pack depends on how your body responds to each type. Some people find one works better than the other. Others find both work equally well.
- Alternately, you could use a hot-water bottle or heat blanket to provide warmth and pain relief on your back. Hot bath or a washcloth soaked in warm water may also help. If you do not have a cold pack, wrap ice in a washcloth to make a cold compress.
- Apply cold packs for no more than 15-20 minutes. Longer than that and you risk damaging your skin.^{[11]XTrustworthy SourceArthritis FoundationMain organization devoted to arthritis support and educationGo to source}
2
Ask your boss for a workplace accommodation.^{[12]XResearch source} A workplace accommodation is any kind of adjustment to your workspace or responsibilities that will help you manage your chronic back pain. An accommodation might be as simple as providing you a different chair with better padding to sit on at your desk. You might also request a transfer to a less physically rigorous job at the same company. Be prepared to provide verification from your doctor if management requests such.
- If things are really bad for you, you could request a reduction in your work hours.
- If your back pain is so serious that you feel you cannot work at all, you might be able to file a disability claim. Usually, only the most serious cases can receive disability pensions through Social Security. If you believe your case is severe enough to warrant a disability claim, contact a lawyer to help walk you through the filing process.^{[13]XResearch source}
3
Use transcutaneous electrical nerve stimulation (TENS). TENS is a technique in which electricity is sent to your nerves in order to block the pain signals to your brain. A TENS device is about the size of a tape cassette, and has two or more electrodes coming out of it. When you feel pain, apply the electrodes to the skin of the affected area, or as directed by your doctor. Once turned on, the device sends a low-level electrical impulse to your brain, reducing or eliminating the pain signal.
- Ask your doctor what the best power settings for the device is.^{[14]XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source}
4
Stay active.^{[15]XTrustworthy SourceArthritis FoundationMain organization devoted to arthritis support and educationGo to source} Engaging in physical activity that gently stretches and strengthens your back is a good way to reduce your back pain. Dance, yoga, and other whole-body activities might help reduce your back pain.
- Don’t strain yourself. Sports and strenuous physical activity -- especially anything that involves bending or lifting -- can exacerbate your back pain. Consider using an activity tracker to monitor your steps so that you don't over-extend yourself.^{[16]XTrustworthy SourceMedlinePlusCollection of medical information sourced from the US National Library of MedicineGo to source}
- While physical activity is important, try to avoid contact sports like hockey, rugby, and football.
- Instead, go for a run or ride your bike to meet your daily activity requirements.
- Losing weight (even if you are only modestly overweight) can help reduce your pain.^{[17]XExpert SourceStuart Rammell, DO
  Board Certified Interventional Pain SpecialistExpert Interview. 1 September 2021.} A large belly pulls the spine into an unnatural position and causes hunching.
5
Visit a massage therapist. Massage therapy can help relieve pain in your back. By gently massaging your back in sensitive and painful areas, the massage therapist can reduce your pain. Many forms of massage therapy are acceptable for back pain relief, including:^{[18]XTrustworthy SourceArthritis FoundationMain organization devoted to arthritis support and educationGo to source}
- Swedish massage
- Neuromuscular massage
- Deep tissue massage
- Myofascial massage
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Method 3

Method 3 of 4:

Coping With Secondary Symptoms

1
Keep your energy levels up.^{[19]XResearch source} Chronic arthritic back pain often leads to feelings of fatigue. There are several things you can do to combat fatigue.
- Get enough sleep. Most people need six to eight hours of sleep each night. You may even consider a sleep-monitoring application to help you determine if your treatments are working.
- Take short naps of no more than 30 minutes. If you feel too tired during the day, take a quick nap. However, naps longer than 30 minutes can actually sap your energy and leave you feeling more fatigued.
- Engage in physical activity. Moving around is a great way to boost your energy levels. Don’t do anything that could negatively impact your back. Stick to biking, walking, and running. Steer clear of contact sports like hockey and football. You may also consider strength exercises using weighted wristbands or resistance bands.^{[20]XResearch source}
- Avoid sugary foods. Sweet snacks, candy, and soda cause your blood sugar levels to spike. While this will give you a short-term energy boost, it will leave you feeling exhausted after an hour or so.
2
Deal with your anxiety. Anxiety – persistent and overwhelming feelings of stress or fear – is often a byproduct of chronic arthritic pain.^{[21]XResearch source} Anxiety might manifest as social anxiety disorder, generalized anxiety disorder, or separation anxiety disorder.
- Don’t use recreational drugs and alcohol. These can both increase anxious feelings.
- Avoid caffeinated beverages. Caffeine can make you feel more anxious. Stay away from coffee and soda.^{[22]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source}
- Eat a healthy diet. A diet based primarily on whole grains, vegetables, and fruits, with a small amount of lean protein might help you reduce your risk for anxiety.
- Consider adding daily meditation to your routine, as it has shown some promise in both pain control and anxiety control.^{[23]XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source}
3
Adopt a positive attitude.^{[24]XTrustworthy SourceArthritis FoundationMain organization devoted to arthritis support and educationGo to source} Depression is often a result of chronic arthritic pain. Even though it’s hard to feel hopeful about your situation, being positive will help relieve some of the burden. Staying positive will increase your resilience to chronic back pain and help you forge ahead when things get tough.
- Start a gratitude journal. Each day before you go to bed, write down five things you’re thankful for, and continue writing things down that have made you happy throughout the day. They could be things that don’t have a direct connection to you, but made you happy anyway.
- Use positive self-talk.^{[25]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source} Positive self-talk involves recognizing negative thoughts and pushing them aside. For instance, when you notice yourself thinking, “My situation is hopeless,” or “I will never live without pain,” use a more hopeful thought to push the negative one away. For instance, you might counter a negative thought about your chronic pain with a thought like, “Someday, I will live without this pain.”^{[26]XResearch source}
- Surround yourself with supportive people. Getting support from your family and friends can help you feel happier and more positive. Avoid negative people who minimize your pain and hurt your feelings.
- Encourage yourself. Think about how your pain has gotten better over time, and look forward to a better tomorrow.
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Method 4

Method 4 of 4:

Recognizing Symptoms

1
Monitor unusual sounds and feelings in your back. The most obvious feeling is pain radiating from your back, even when you don’t move it. Additionally, when you stretch or bend your back, you might hear a grinding or crunching sound. This is common in the neck, especially. You might also feel a pinch or tingling feeling along your spine caused by the spinal cord irritating the nerves in your back.^{[27]XResearch source}
- Chronic arthritic low back pain can cause sciatica, which is when you feel a shooting pain down your leg.^{[28]XExpert SourceStuart Rammell, DO
  Board Certified Interventional Pain SpecialistExpert Interview. 1 September 2021.}
^{[29]XResearch source} A hunched-over neck or a crooked spine could mean you have arthritis in your back. Swelling might be visible along your spine or certain back muscles.
3
Recognize a long-term problem. The “chronic” part of chronic arthritic back pain means that the problem has been ongoing (and possibly getting worse) over time. If you feel that you’re dealing with back pain every day or nearly every day for any extended period of time, consult a physician.^{[30]XResearch source}
- Don’t ignore chronic pain. Take proactive steps to deal with it sooner rather than later. It will likely not go away on its own.
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Question
What is the best exercise for arthritis of the spine?
Stuart Rammell, DO
Board Certified Interventional Pain Specialist
Dr. Stuart Rammell is a board certified Interventional Pain Specialist. He specializes in helping patients reduce pain and improve bodily function through spine and peripheral injections, radiofrequency ablation, and spinal cord stimulation. Dr. Rammell holds a BS in Exercise Science from Brigham Young University and a DO from Midwestern University. He completed his fellowship and residency in interventional pain medicine and anesthesiology at Loma Linda University.
Stuart Rammell, DO
Board Certified Interventional Pain Specialist
Expert Answer
You should use conservative measures, such as daily stretching exercises. To avoid problems, discuss this with your physical therapist so that they can teach you the proper form. Remember to exercise consistently to improve!
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Question
What is the best treatment for arthritis in lower back?
Stuart Rammell, DO
Board Certified Interventional Pain Specialist
Dr. Stuart Rammell is a board certified Interventional Pain Specialist. He specializes in helping patients reduce pain and improve bodily function through spine and peripheral injections, radiofrequency ablation, and spinal cord stimulation. Dr. Rammell holds a BS in Exercise Science from Brigham Young University and a DO from Midwestern University. He completed his fellowship and residency in interventional pain medicine and anesthesiology at Loma Linda University.
Stuart Rammell, DO
Board Certified Interventional Pain Specialist
Expert Answer
An interventional procedure that can be very helpful in this situation is a radiofrequency ablation of the small sensory nerves that bring sensation back from the lumbar facet joint.
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What is best painkiller for arthritis?
Stuart Rammell, DO
Board Certified Interventional Pain Specialist
Dr. Stuart Rammell is a board certified Interventional Pain Specialist. He specializes in helping patients reduce pain and improve bodily function through spine and peripheral injections, radiofrequency ablation, and spinal cord stimulation. Dr. Rammell holds a BS in Exercise Science from Brigham Young University and a DO from Midwestern University. He completed his fellowship and residency in interventional pain medicine and anesthesiology at Loma Linda University.
Stuart Rammell, DO
Board Certified Interventional Pain Specialist
Expert Answer
You can use over-the-counter medications, such as acetaminophen or ibuprofen, although these aren't necessarily good to be on long-term.
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Tips

Get recommendations from your doctor for exercises that could help your pain.
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Move around in the bed in the morning while you are still warm to loosen your joints up. Lie on your stomach and push yourself up with your arms.
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Have other family members do chores that could cause back pain.
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