What is peculiar about osteoarthritis, for example of the lumbar spine, is trying to predict who will and won't suffer from pain symptoms. Studies have repeatedly shown that some arthritis sufferers have significant ‘wear and tear’ of the lumbar joints but experience no pain at all - whereas others may have more mild wear and tear changes yet suffer from debilitating pain and dysfunction.
As such there is poor correlation between the extent of the arthritis and the severity of the pain symptoms which may arise. For this reason we also need to be careful to avoid putting all back pain suffered by those in their more senior years as being ‘arthritis’ as this may not be the case.
Indeed arthritis may be the cause, but there are many other reasons someone may be suffering from back pain. At times arthritic changes seen on MRI for example may be a chance finding and not actually the cause of the pain at all. A good clinical assessment is usually able to determine whether the pain is arthritis related.