- Osteoarthritis Complete Treatment Guide
- Osteoarthritis of the Spine and Disc Degeneration
- Managing Pain and Stiffness from Osteoarthritis
- 5 Yoga Poses to Ease Arthritis
- Benefits of Yoga for Arthritis
- How to Choose A Yoga Style
- Yoga Poses for Arthritis
- Tips and Contraindications
- Yoga Benefits for Arthritis
- Make a Donation
- Become a Member
- Make a Honor or Memorial Gift
- Gift Planning
- Other Ways to Give
- More About Partnerships
- Yoga Poses for Arthritis Patients from Johns Hopkins • Johns Hopkins Arthritis Center
- FORWARD FOLD
- SIDE ANGLE POSE
- EXTENDED LEG BALANCE
- SEATED SPINAL TWIST
- Tips for Improving Your Flexibility When You Have Spinal Arthritis
- Back Pain Caused by Arthritis: Yoga Can Help!
- Arthritis-Friendly Yoga Poses
Osteoarthritis Complete Treatment Guide
Osteoarthritis and Treatment Options Video
While there is currently no proven treatment to stop or slow the progression of osteoarthritis in the spine, there are treatments to alleviate the pain and other associated symptoms, and for most people the condition will not become debilitating. Some patients with osteoarthritis have minimal or no pain, and may not need treatment.
See Symptoms of Arthritis of the Spine
Most people who require treatment will benefit from a combination of lifestyle changes such as exercise, weight reduction, and smoking cessation.
See Ways to Quit Smoking
Most treatment plans for osteoarthritis focus on controlling the pain and improving the patient's ability to function. Medication is typically used to reduce the inflammation, which in turn reduces the pain and stiffness. In only the most severe cases will surgery be necessary to treat pain and disability from osteoarthritis.
See Surgery for Osteoarthritis
Osteoarthritis of the Spine and Disc Degeneration
Medical practitioners often refer to osteoarthritis in the spine as spinal arthritis, degenerative joint disease, or arthritis of the facet joints.
Spinal arthritis is relatively common and is most ly to occur in people over age fifty. It represents an ongoing, degenerative process in the spine, and may be associated with a number of other degenerative spinal conditions.
In particular, osteoarthritis is associated with degenerative discs in the spine.
See What Is Degenerative Disc Disease?
Degenerative discs and osteoarthritis often occur hand in hand because the disc and facet joints (the joints in the back affected by osteoarthritis) are both part of the same three-joint complex.
It is thought that degenerating discs can place undue stress on the facet joints, thus over time leading to degeneration and formation of osteoarthritis in the facet joints (also called zygapophyseal joints).
This may be why the two degenerative conditions are so often seen together.
See Facet Joint Disorders and Back Pain
If the disc as well as the facet joints become painful as a result of degenerative changes in the spine, the condition is often called spondylosis. However, degenerative disc disease and osteoarthritis are different conditions and can occur separately: one can have degenerative discs without any facet osteoarthritis; or one can have facet osteoarthritis without degenerative discs.
See Spondylosis: What It Actually Means
Other anatomical markers of disc degeneration that often occur in conjunction with osteoarthritis and may or may not cause pain or other symptoms include:
Over time, degeneration of the facet joints in the lower back can result in formation of a fluid-filled sac called a synovial cyst. These cysts are benign in and of themselves, but if they put pressure on the spinal canal they can cause symptoms of spinal stenosis.
Lumbar Osteophytes (Bone Spurs) Video
Bone spurs (osteophytes)
It is thought (though not proven) that over time the combination of disc degeneration and small amounts of instability can cause bone spurs to form.
If the bone spurs impinge on the spinal canal, this can cause pain and symptoms from spinal stenosis. It should be noted that bone spurs are simply radiographic markers of degeneration, and are not in and of themselves painful (unless they pinch a nerve root).
Managing Pain and Stiffness from Osteoarthritis
Osteoarthritis of the spine is un arthritis of the hip, knee and other joints, as the pain, aches, tiredness and stiffness does not come from just the facet joints but often also from the degenerated discs and inhibition of the spinal extensor muscles.
No actual swelling of the facet joint has been demonstrated, but degeneration of the facet joint impacts the many anatomical structures surrounding it in the spine and it is thought that there is an inflammatory component to the condition.
The keys to managing pain and stiffness from osteoarthritis (the degenerating motion segments) are to get an accurate diagnosis of what is the underlying cause of the pain and proactively start treatment.
Lumbar Osteoarthritis Video
Most people over the age of 40 will have signs of degeneration in the spine; however, not all of these people will have pain or other symptoms. To correctly treat the patient's pain, it is critical to first identify the actual underlying cause of the patient's pain.
For example, the patient may have a degenerative disc and bone spurs, but it is the osteoarthritis in the facet joints that is causing the patient's pain on motion. In this case, it would not be necessary to treat the degenerative disc or bone spurs, but rather just to focus on alleviating the pain originating from the arthritic facet joints.
The best proactive treatment to help manage symptoms from osteoarthritis is an active exercise program that emphasizes stretching.
See Stretching for Back Pain Relief
Stretching the hip muscles, back joints, and hamstrings on a daily basis helps maintain the motion of the spine. Many patients will feel better in an active yoga or pilates program, or other gentle exercise program. Keeping the joints mobile will help them stay healthy.
See Yoga, Pilates, and Tai Chi
Spinal arthritis can occur in any part of the spine. This article focuses in particular on osteoarthritis in the low back (lumbar spine), rather than cervical osteoarthritis (arthritis in the neck) or other areas of osteoarthritis.
For more in-depth information, see Osteoarthritis Treatments on Arthritis-health.com
5 Yoga Poses to Ease Arthritis
Arthritis is a condition causing joint disease or joint pain, leading to inflammation, stiffness, and loss of mobility in the joints.
If you are suffering from arthritis or have a student who is, you'll know how much this can affect one's life. So it's useful to know what yoga could do, and how you could modify your yoga practice.
Benefits of Yoga for Arthritis
Arthritis generates swelling, pain, and stiffness in the joints. This decreases the range of motion in the body, and can seriously limit the daily activities. To ease the symptoms of arthritis, yoga can definitely contribute.
Regular yoga practice can help with many of the symptoms of arthritis, such as improve the joint mobility, reduce pain, and help with managing stress and anxiety. But as with any new practice, it is good to consult with your doctor first before starting.
How to Choose A Yoga Style
For people with arthritis, it may not be beneficial to jump into a Vinyasa or Ashtanga class, but choose an asana class which is more calm in nature, and which allows space for modification and the use of props.
The slow pace of Yin yoga brings the stretch into the connective tissues and the joints, which can bring great relief. Iyengar yoga uses various props which can be easily modified to match special needs. Otherwise, you can try a gentle Hatha yoga class or a restorative yoga class, and don't be afraid to ask for help from the teacher.
Yoga Poses for Arthritis
The key in yoga poses for arthritis is to bring more fluidity and flexibility into the joints, to stretch and relieve the joints, and to strengthen the muscles around the joints to give more overall stability. Slow and controlled movements are the way to go, and try to keep on moving the body to avoid further stiffness from inactivity.
1. Cat and Cow Pose
Image/Yogini Credit: Anna Coventry
The cat and cow sequence is beneficial for the spine, but also gives the wrist a little bit of pressure. You can come to your hands and knees, and move your spine from cat to cow pose slowly. Finish off with some wrists circles to release and move the wrist joint. If you cannot place any pressure on your wrists, take two blocks and rest your elbows on the blocks to free the hands.
For relieving back pain and calming the mind, spend some time in Child's pose. Keep your hands straight on the mat, or folded under your forehead. For more ease on the legs and knees, you can bring a pillow or a bolster between your buttocks and calves. This will allow you to rest even more in the pose.
3. Tree Pose
When we place all weight on one leg at a time, this tones and strengthens the muscles and joints in the standing leg. It will also strengthen the knees and hip joints, and improve your balance.
Keep your toes on the ground for better balance, and only lean the heal on the standing leg. Or you can place your foot on the shin of the standing leg. You can keep your arms in Anjali Mudra close to your chest, or lift them up either palms touching, or arms wider apart.
4. Cow Face Pose
This pose is good for stretching the arms and shoulders, as well as the spine and hip joints. If the legs can be included in the full pose, it can also help with blood circulation to the knees and ankles. This helps to lubricate your joints, relieving pain and swellings.
If your knees are hurting, you can sit cross-legged, and additionally sit on a block to elevate the hips. If you cannot make your arms touch behind your back, you can use a belt to hold on to with both hands. Remember not to use force!
5. Bridge Pose
The Bridge pose is great for opening the hips and spine and relieving any stiffness in this area. If you have injuries or pain in the neck, it's best to avoid this pose.
Lie on the floor with your feet flat, knees pointing up, arms next to you. While exhaling, lift up the hips while keeping the shoulders and head on the floor. You can walk your hands under your body and interlace your fingers, if this feels possible.
Tips and Contraindications
If your joints feel particularly painful, it's best to avoid stretching or exercising them until the pain resides. If you feel pain in any of the yoga movements, you should modify the pose or come it altogether.
Trying to fit a yoga practice in our daily life brings not only physical benefits, but also mental benefits. Yoga can help with the ways we deal with pain, and show us a new way to finding our calm.
Has yoga been therapeutic for your aches and pains? Share your story in the comment section!
Yoga Benefits for Arthritis
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Yoga Poses for Arthritis Patients from Johns Hopkins • Johns Hopkins Arthritis Center
Steffany Moonaz, PhD, RYT500
These are a few yoga poses that you may want to try at home. Before beginning any new activity, be sure to consult your doctor. It is important to listen to your body.
If you feel any sharp pain, instability or lightheadedness, stop and rest or adjust to a more comfortable position.
A well-trained and experienced yoga instructor will be able to offer more individual guidance to adapt the poses for your needs and limitations.
Slowly roll down the spine to hang forward, with weight in the middle of the feet, not the toes or heels. Be sure not to lock the knees or rolling in/out with the feet. Upper body should just hang without tension, including relaxed head. You can take hold of opposite elbows or interlace fingers behind your back.
Lay face down with tops of the feet resting on the floor. Palms are flat on the floor alongside the chest, elbows in close to the body. For those unable to place their palms on the floor, you can use fists or elbows.
Head, neck and chest are lifted off the floor, gaze forward, keeping the feet and legs down. Upper back muscles should be engaged and arms should not be used to execute the movement. You can test this by trying to lift hands from the floor and maintain the pose.
For more of a challenge, interlace fingers behind back to draw shoulder blades together (or hold opposite wrist).
SIDE ANGLE POSE
With feet about 4 ft. apart, turn the right foot out 90 degrees and angle the left foot in 45 degrees. Bend the right knee, keeping the knee directly over the toes. Bring your right elbow to the bent right knee and the left arm extends alongside the left ear. The goal is one continuous diagonal line from the back left foot to that extended left arm.
The arm should not be pointed straight up toward the ceiling. Gaze is past the extended fingers. Try not to tense or sink in the lower shoulder, but lift the supporting elbow. The hips and shoulders should be in one plane, as though laying against a wall. (You could even try it against a wall to check.) Release any tension in the hand and fingers of the extended arm.
Repeat on the other side.
EXTENDED LEG BALANCE
Stand up straight and slowly shift your weight into one leg (using a chair or wall for support if necessary). When you feel comfortable, lift one leg and hold the outside of the knee. The other hand can be placed on the hip, or extended overhead.
From this position, the leg can be brought out to one side, ensuring that the hip does not lift. It is also important to keep the other hip aligned with knee and ankle, without leaning to the outside of the supporting foot.
If feeling stable, you can take the other arm out to the side and/or turn the head to look the other way.
SEATED SPINAL TWIST
Start sitting with legs extended. You can sit up on a cushion or folded blanket if you feel any rounding in the lower back. Pull one knee in, lift the foot and cross it over to the outside of the extended leg.
If possible, plant foot on the floor as if making a footprint on the floor. Foot is pulled in as close to the opposite hip as possible. Wrap the opposite arm around the bent knee, hugging it into the body. This can happen by wrapping the elbow around the knee, or just the hand.
It is most important to sit up tall, lengthening the spine.
Tips for Improving Your Flexibility When You Have Spinal Arthritis
Jose Luis Pelaez Inc./Getty Images
If you have spinal arthritis in your low back, you probably don’t have to be told how painful and limiting it can be.
Osteoarthritis (anywhere in the body) starts with the erosion of the cartilage in joints. (Cartilage is a softer-than-bone substance that provides lining and cushioning in the joint space; the joint space is the area between the two bones that comprise the joint.)
When osteoarthritis progresses, your cartilage may erode entirely so that bone moves on the bone as you go about your usual routine. And you how excruciating that can be.
But that’s not all.
The breakdown and erosion of cartilage quite often lead to the joint changing its shape. This is due to a process known as bone remodeling, says Hagit Rajter, a clinical physical therapist at the Joint Mobility Center, Hospital for Special Surgery, New York City.
“Bone remodeling may cause bone spurs and cysts to form at the edges of bones.”
The low back is particularly affected when the osteoarthritis is in the spine. This is because the low back takes the day-to-day mechanical stresses of most of your body weight, Rajter comments.
“The excess pressure on the low back that results in strain and irritated joints already damaged by arthritis can greatly amplify the pain,” she says, adding that generally the facet joints and spinal discs are most affected.
(The disc loses height.)
Rajter also notes that research supports the premise that osteoarthritis in your low back may affect your balance, along with your hip functioning and core strength. These ability decreases can make it more difficult to perform your usual activities at the level to which you may be accustomed.
They also make it harder to exercise. “These are the indirect consequences of spinal arthritis,” Rajter says. “They are not the disease, but they sure have an impact on it.”
There’s no real cure for osteoarthritis. Treatment is generally focused on pain relief, slowing the progression of the condition, controlling inflammation in the joints and improving your ability to do what you to do.
Treatment can be individually tailored to your needs, and often a multi-pronged treatment approach is taken. While different types of modalities are usually included in a treatment plan for spinal arthritis (such as taking medication, going for physical therapy and using joint protection aids), it is wise to acknowledge the importance of exercise in your daily life.
It’s hard to get yourself up and motivated to exercise, especially when your pain is acting up, but hear me out. Exercise has too many benefits to ignore as part of your regular routine.
Exercise can help reduce your stiffness, improve your overall mood, relieve your pain and may even slow down the progression of changes that occur in your spine as a result of arthritis.
Plus, it may protect against such diseases as heart disease, cancer, and more.
Fitness and exercise programs generally consist of cardio, strength training and activities to increase your joint range of motion. Of these, the joint range-of-motion work may deserve much of your focus. Rajter says that range-of-motion exercises may interrupt the vicious cycle of stiffness, immobility, joint changes and pain often associated with arthritis.
For a basic low-back, range-of-motion program that’s safe, but not particularly aggressive, Rajter recommends three exercises, described below. She says that if you also have other medical conditions, or you have fitness goals you’d to address without worsening your symptoms, you should make an appointment with a physical therapist for an evaluation and home exercise program.
The following exercises will increase both the strength and flexibility of your back. It's best not to do them in bed. It is recommended to use a mat or blanket on the floor.
- Knees-to-Chest Stretch: Lie on your back and pull one knee toward your chest, using your hands. Be gentle, there’s no need to force this action. Hold it there for 15 seconds and then return your foot to the floor. Do about 10 to 15 lifts and then repeat with the other leg. Knees-to-chest should be done once or twice each day, says Rajter. She also recommends doing it first thing in the morning and at the end of the day, to relieve compression on your spine. If you can do a one-legged knees-to-chest without pain, try lifting both legs.
- Gentle Spine Twist: Lie on your back with your knees bent and your feet flat on the floor. Keep your shoulders nice and firm on the floor, too. Gently roll both bent knees to one side and stay there for 10 to 15 seconds. Breathe! Return to the start position and repeat the gentle spine twist on the opposite side. As with the knees-to-chest stretch, do 10 to 15 of these once or twice per day.
- Cat-Cow Stretch: Position yourself on your hands and knees. First, arch your back gently then slowly move to a position where you allow your abdomen to sag. Go to each position sub-maximally only. The cat cow makes a great warm-up for the bird dog exercise, and it helps mobilize your facet joints at the back of your spine.
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Telephone Interview. Rajter, Hagit, PT, MSPT, Schroth Scoliosis Therapist, Cert. McKenzie Therapist, Advanced Clinician Physical Therapist, Joint Mobility Center, Hospital for Special Surgery, New York City. September 2011.
Back Pain Caused by Arthritis: Yoga Can Help!
Have you been given a generic diagnosis of “arthritis” as a cause of your low back pain? Many clients I see tell me they have arthritis, but very few have a good understanding of not only the pathology, but also any type of treatment.
Often times at a doctor's office there is not enough time or a welcoming vibe to ask more questions.
What does that mean exactly? What can I do to address it (besides pop pills)? Can it improve? So first, a brief explanation on what that means:
Osteoarthritis (osteo=bone, arth=joint, itis=inflammation) in the spine is also known as Degenerative Joint (or Disc) Disease.
This is when the cushioning cartilage between each vertebrae wears down, causing compression in the facet joints, or the posterior (back)portion of the vertebrae. This can cause a chain reaction of inflammation and pain.
One common condition this can lead to is known as Spinal Stenosis, which is a narrowing of the spinal canal, and can cause compression on the spinal nerves. This can result in pain in the buttock(s) or down the leg(s).
The description above is extremely concise, and is not meant to be absolute. I frame it in that way in order to introduce the purpose of this post: how yoga can help.
The process described above, whether it is diagnosed as OA, DJD, or stenosis, has a typical presentation in terms of movement. Pain is usually increased with standing/walking, backward bending, or lying prone (on stomach).
Pain is usually decreased with sitting, bending forward, or lying on the side or supine (on back) with legs elevated.
Remember earlier when you read that compression occurs in the posterior (back) portion of the vertebrae? Well, when one stands, bends backwards, or lies flat on their stomach, it puts the lumbar spine in relative extension.
Extension further closes down the posterior portion of the vertebrae, where there is already compression. See how that would cause increased pain? Conversely, when one bends forward, or sits, or lies down with their legs elevated, this puts the spine into relative flexion.
Flexion tends to create more space in the posterior of the vertebrae. See how that would relieve symptoms?
In Hatha yoga, postures are broken down into a few different categories: forward folds, backbends, twists, hip openers, and so on.
For any arthritic process of the lumbar spine, I would say the most important category to focus on is forward folds. A close second is hip openers, which I will expand upon in a follow-up post.
For now, we'll explore basic, safe, and efficient ways to forward fold, and create more space in the posterior portion of the spinal joints.
1. Standing Forward Fold (Uttanasana)
DON'T: keep the legs straight and round the upper back, dangling in space. This does not produce the lumbar/hip flexion desired for the therapeutic purpose that forward bending has on arthritis. See how my lumbar area is flattened here and I am getting most of the flexion throughout the thoracic (mid-back) area?
DO: Use blocks or something to rest hands on, in order to bring the floor closer to you. Bend your knees and keep relative extension in the upper back, while allowing the lower back and hips to bend.
2. Seated Forward Fold (Paschimottanasana)
DON'T: sit flat on the floor with the legs straight, letting the upper back round. This just adds extra strain on the low back.
DO: sit up on a pillow or rolled up towel or blanket. Let the knees bend and fold from the hips, keeping the upper back in relative extension.
3. Legs Up The Wall (Viparita Karani)
Lay on your side in the fetal position with your butt against the wall, and your torso perpendicular to the wall. This starting position is important in setting up the end pose correctly. As you roll onto your back, slide the legs up the wall. Once you arrive, your butt should be touching the wall, and your torso still perpendicular to it.
If it didn't quite work out this way the first time, you might come down and try again. Again, if the set up isn't correct, it wont have the therapeutic benefit you are looking for. Once your positioning is aligned, bend your knees slightly, lift your hips up just enough to slide a pillow or folded blanket under the buttocks.
There are many things people can do to address an arthritic process anywhere in the body. Yoga is one that addresses the physical and emotional symptoms of the process.
But there are things that can actually affect the internal process itself, such as weight management, nutrition, and supplements, which I hope to have a guest writer (my extremely knowledgeable and well-read husband) expand upon in another follow up post.
Please feel free to comment below, ask questions, or harass Brian to write about what he has to say about nutrition and supplements!
FYI, I recorded a video on nOMad's online studio entirely focused on relieving back pain with a legs up the wall sequence. Check it out!You can also view my Studio Schedule to see when you can join me in one of my studio classes, or make an appointment with me for a private session. Namaste!
Arthritis-Friendly Yoga Poses
Every gift to the Arthritis Foundation will help people with arthritis across the U.S. live their best life.
Join us and become a Champion of Yes. There are many volunteer opportunities available.
Take part to be among those changing lives today and changing the future of arthritis.
Proud Partners of the Arthritis Foundation make an annual commitment to directly support the Foundation’s mission.
Every gift to the Arthritis Foundation will help people with arthritis across the U.S. live their best life. Whether it is supporting cutting-edge research, 24/7 access to one-on-one support, resources and tools for daily living, and more, your gift will be life-changing.