Arthritis in the spine is common—especially as we age. But here’s the key point: Many people with significant “wear and tear” on imaging have little to no pain.
So what gives? Pain is less about the presence of arthritis, and more about the overall health of the system it exists in. Things like physical activity, sleep, nutrition, stress, and our beliefs about pain all influence whether those structural changes become meaningful. This is good news—because much of what drives symptoms is modifiable.
Exercise helps—but not simply because it “fixes” strength deficits or improves core stability. It helps because it builds a more adaptable, resilient, and well-functioning system.
And while arthritis doesn’t mean a life of pain is inevitable, we have to acknowledge when joint changes are more advanced, pain can be more likely, and additional support (including things like medication, injections, and even surgery) can be appropriate.
If we focus on improving overall health and the capacity of our system, we often improve pain too.