Your questions on exercise and arthritis

Q) I've been told by the physiotherapist that stiff lower back joints and muscles have compressed the discs, which are now pressing on nerves. I've been coping for almost a year now with painkillers, sleeping tablets and physiotherapy. I'm also experiencing problems with my neck. I have considerable discomfort a lot of the time and quite a lot of restrictions on my activities. Although still motivated, I can't do as much as in the past. I'm 69 and have had osteoarthritis for the past 20 years. I'd welcome your comments.

Kathleen, Hitchin, Herts - 2010

A) As a fellow sufferer I sympathise with your problems. Osteoarthritis typically affects a number of joints both in the spine and the limbs. When it occurs in a knee or hip it can cause considerable disability but, on the plus side, there's usually an effective surgical solution to this problem. There's no such simple surgical solution to similar problems in the spine I’m afraid. Why is this? Well, the anatomy of the spinal joints is much more complex and the very close position of the spinal nerves makes attempts at surgery hazardous. Occasionally, when pressure on the nerves is severe, surgeons will try and relieve this pressure, but only a small percentage of patients are suitable for this procedure. All is not doom and gloom, however. It's very important to keep moving and to keep your back as mobile and strong as possible by land-based exercises and by swimming. To do this you may need to use painkillers, the strength of which can be varied according to your needs. However, it's important to realise that painkillers are given to help you exercise and to keep going.

This answer was provided by Dr Philip Helliwell in 2010, and was correct at the time of publication.

Q) An article in Yours magazine says that swimming breaststroke is not good for osteoarthritis of the hips and knees. I’d be grateful if you could tell me the reason for this.

George, Matlock, Derbyshire - 2015

A) People with knee replacements are certainly advised to avoid breaststroke swimming and this extends to arthritic knees and hips. Swimming breaststroke puts excessive side-to-side and rotational forces on the joints and may be difficult to do if the joint is unstable. The preferred direction of force is in flexion (bending), which is why a kick, as done in front crawl and backstroke, is recommended. However, for most people breaststroke is the preferred stroke and they simply can’t do the other strokes.

In a busy pool it is difficult to adapt and experiment, but you could try using a float between the legs if you prefer to use the breaststroke arm action and then do the ‘kick’ either with the float in your hands on while holding on to the side of the pool. You may also be able to do many of the aquarobic exercise classes that are available, although you should talk to the instructor first.

This answer was provided by Dr Philip Helliwell in 2015, and was correct at the time of publication.

Q) I'm 52 years old and have had bad back pain for the last few years. An MRI scan showed I have arthritis in my discs and my hip.

I've been going regularly to hydrogym which has helped a lot but I’m still always in pain. My doctor has told me to exercise to keep my muscles strengthened but any other advice I can get would be very much appreciated.

Joan - 2017

A) I agree with the advice your doctor has given you. The joints in our spines, like the other joints in our body, benefit from a mix of:

• flexibility exercises like stretching and yoga to keep a good range of movement
• resistance or strengthening exercises to increase strength and support a healthy posture
• aerobic exercise like walking and swimming to help with muscle endurance.

Research has also found yoga to be beneficial for long-term back pain.

However, you should also speak to your GP about different painkillers that may help, particularly if you're having a bad day with pain. It’s tough trying to keep going when you're experiencing pain constantly.

I’d recommend taking a look at our guide on living with long-term pain, as it has useful advice on the range of treatments available and things you can try to help manage the pain and keep going.

This answer was provided by Dr Tom Margham in 2017, and was correct at the time of publication.

Q) Will tennis and swimming help or hinder my sore wrists and thumbs? I've been diagnosed with osteoarthritis in both hands, but I still play tennis matches and swim hard, and love both! I'm female, in my late 60s and fit as a fiddle!

Annie - 2016

A) My advice is to keep going with the sport, particularly as you enjoy it so much. In particular, the mix of swimming – low impact, aerobic, and resistance exercise – with the tennis – high-impact and multi-directional (as well as social) – is a great mix for your bone and joint health.

This answer was provided by Dr Tom Margham in 2016, and was correct at the time of publication.