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Is Back Pain Just Part Of Getting Older? It Doesn’t Have To Be.  

Avoid Back Pain As You Age

Nearly everyone will experience some form of back pain at some point in their lifetime.

The National Center for Healthcare Statistics has found that more than 44% of adults ages 45-64 have suffered back pain in their last three months. That number increases to almost 46% over the age of 65. 

The National Institutes for Health estimates that 70% to 85% of adults will experience an acute episode of back pain- particularly low back pain- at some point. A whopping 90% of these individuals will have more than one episode. The United States spends more than $100 billion on low back pain-related healthcare each year. So, naturally, most people assume with statistics like these, that back pain is inevitable as we age. As we’ll see below, this doesn’t have to be true in most cases!

THORACIC OUTLET3

Back pain is widespread in the adult population. Let’s get some basic background as to why:

Our spines are made up of 33 bones (vertebrae) and discs and is an incredibly designed machine that enables us to stand, walk, and carry out daily tasks.  

The discs are similar to cushiony, tough gelatin. Our nice supple discs start to dry out as we age and no longer cushion the bones. Without the cushioning action of the discs, our spinal cord or the nerve roots alongside the spine (or both) may begin to become pinched or compressed. The condition is called aging degeneration- or disc degeneration. The older a person is, the greater their risk.  

Symptoms of the pressure on the nerve roots or spinal cord cause back pain but will vary depending on which nerves are under pressure.  In rare cases like these, there are several treatment options, including:

  • Non-surgical care, including physical therapy, over-the-counter pain relievers, back braces, or other approaches that are not invasive
  • Invasive pain management such as epidural injections or nerve root injections
  • Surgery

Here are some of the most common conditions as we age that MAY cause back pain (but not always!)

Bulging discs affect many people. However, it rarely causes actual back pain symptoms.  

A bulging disc, is one of the most frequent causes of neck, back, and leg pain as we age. The National Institute of Health indicates that adults between 25-55 years old have an approximately 95% chance of bulging discs occurring in the lumbar spine (low back). BUT of those, only 1% – 3% notice symptoms! The issue affects men twice as often as women. In it’s worse case, a bulging disc can rupture, becoming a herniated disc. This is a much more serious condition, as it may nudge the spinal cord and nerve roots, leading to severe pain and problems with mobility.

Risk factors include lifting overly heavy objects, sitting for extended periods in one position, repetitive motions for work or sports, smoking, and high body mass. Symptoms to look for:

  • Back pain
  • Prickling or numbness of the legs and/or feet
  • Muscle weakness
  • Pain that travels to the shoulder, arm, or the hand and fingers
  • Neck pain, particularly in the back and sides of the neck
  • Pain that increases when turning or bending your neck
  • Numbness or tingling in the arm(s) – usually indicates more of a herniated disc.

 

Spinal stenosis & sarcopenia are a growing concern in aging populations causing back pain

Sarcopenia is an age related, involuntary loss of skeletal muscle mass and strength.  It can be a serious condition that can significantly impact a person’s quality of life and can lead to other health problems/complications such as: 

  • Increased risk of falls and fractures
  • Higher occurrence and length of hospitalizations
  • Increased post-surgical complications
  • Risk of death from falling

Sarcopenia is not uncommon (10 – 20% of older adults are estimated to have sarcopenia). Many people aren’t diagnosed or treated for the condition as it tends to creep up gradually.

Spinal stenosis is caused by narrowing the spinal canal, joints, and bones surrounding the spinal cord and nerve roots. Spinal stenosis can occur at any point on a person’s spine, but the most common areas are the cervical (upper) and lumbar (lower) areas. You might notice that walking for an extended period is challenging. For example, some individuals may have to grab a shopping cart to lean on when they go to the supermarket.  The most common symptoms of spinal stenosis include:

  • Pain in the neck and back
  • Numbness, weakness, cramping, or pain in the arms, legs, feet, or buttocks

 

Atrophy & Osteoporosis

Spinal atrophy is characterized by weakness and shrinking of the muscles we need for movement.  Symptoms of spinal atrophy include:

  • Muscle weakness and decreased muscle tone
  • Limited mobility
  • Breathing problems. The muscles along the ribs aren’t as strong as they once were
  • Scoliosis (curvature of the spine)

Spinal osteoporosis happens when the bones that make up your spine (vertebrae) weaken to the point that they crumple and collapse, resulting in back pain, height loss, and often hunching over. Bone fractures are severe complications of osteoporosis.

Ankylosing Spondylitis is an inflammatory condition that, over time, may cause the bones of the spinal vertebrae to fuse together. The fusing bones make the spine less flexible and can result in a hunched posture. Men tend to develop ankylosing spondylitis more often than women.  

In cases of severe ankylosing spondylitis, new bone forms, eventually fusing sections of spinal vertebrae. Those sections of the spine turn stiff and inflexible. This fusing may also stiffen the rib cage, restricting lung capacity and making it difficult to breathe deeply.

What really causes back pain in aging adults?

GMB cooking pain

All the above conditions MAY cause back pain. However, in the majority of cases, most ongoing back pain that lasts “For as long as you can remember,” is caused by:

  1. Persistent inflammation:  Inflammatory back pain is a long-term condition usually associated with a subtle onset of pain in the lower back and buttocks. It is thought to be caused by systemic inflammation. Inflammatory back pain differs from ‘normal’ back pain by its gradual onset, improvement with exercise, lack of improvement with rest, and pain at night that improves with rising and movement. 
  2. Sedentary lifestyle: Longer sitting time and low physical activity are closely associated with the increased risk of chronic low back pain in populations over 50. Moreover, excess body weight and smoking are also associated with the development of back pain.
  3. Poor movement patterns:  When there is a weakness of the abdominal muscles or perhaps issues with the hips, we may slide into less than proper movement patterns. Back pain may develop, prompting physical adjustments to get rid of the pain, which then causes you to hurt more, not less. It becomes a vicious cycle of back pain that may be difficult to heal without help.
  4. Lack of quality care before small issues become bigger problems:  Back pain is the single most common diagnosis responsible for sick leave, long-term disability, and early retirement. Back pain is therefore associated with substantial loss of quality of life and an increased economic burden. Early intervention (physical therapy, movement training, etc.) for adult patients suffering from back pain can make it much easier to mitigate the issue before it requires invasive procedures like surgery, costing much more in time and money.  
  5. Genetic factors:  Researchers have trouble ruling out environmental factors (e.g., activities, injury, stress, smoking, diet) as primary causes of back pain. There is evidence, though, that genetics play an important role in back pain. A growing number of studies are finding that chronic back pain may have a strong genetic link. 

What can you do about unresolved back pain?

GMB walking

Maintain a nutritious diet and healthy weight  Being overweight increases the strain on your lower back, especially as you get older, and the foods you eat (and don’t) can determine how well your body fights painful inflammation. Follow guidelines and recommendations for diet and exercise, and aim to keep your weight within a healthy range for your height.

Stay active  If you’re suffering from lower back pain, resist the temptation to stay still. Think of the complete opposite: moving around and engaging in gentle stretching can help your lower back muscles heal faster. However, be careful to move within your comfort zone, avoiding strenuous activities that cause pain. Start slow, and try tracking your movement with an app or log. This allows you to note what works and what causes pain. Slowly increase your activity and endurance – i.e., start walking one block, then two blocks, and so on.

Mind your posture  Sit up straight, stand up straight, and move. These tips might seem obvious, but you might be surprised at how many people move through their day-to-day slouching, stuck in unsupportive chairs, and not caring for their back. Get up and moving if you feel like you’re starting to slump or slouch or if you find it hard to find a comfortable position. Spreading your weight evenly across both sitz bones (when seated), and legs (when standing) helps to maintain proper posture and may help you feel more comfortable sitting and standing. 

Wear proper footwear  Supportive footwear can improve your gait, increasing stability and decreasing the risk of lower back pain. A professional can help you choose the correct footwear for your activities. Prolonged or frequently wearing unsupportive shoes like flip-flops or heels can put increased pressure on your lower spine, causing hip and back pain.

Sleep on a quality mattress  Back pain sufferers may benefit from sleeping on a medium-firm mattress. Notwithstanding, your regular sleep position(s) should also influence your mattress selection. Side sleepers might consider a softer mattress. Back and stomach sleepers can try a firmer mattress. If you do have back pain already, it’s generally a good idea to avoid sleeping on your stomach. Try sleeping with a pillow under or between the knees to keep a neutral pelvis and spine.

See a back pain specialist at Healthy Consumer PT  Our expert physical therapists look at the whole person, creating treatment plans unique to your individual needs. We offer individualized, one-on-one therapy to get you back to doing the activities you love without surgery, intense pain medications, or surgery.

WHAT OUR PATIENTSS SAY ABOUT OUR BACK PAIN TREATMENT:

“I’ve had intermittent lower back pain for a long time. After an initial consult to determine the cause of my pain and what he thought it would take to make it better, he gave me exercises/physical therapy that finally stopped my constant, nagging pain.

Once I had more mobility, he gave me additional exercises to make me less likely to have this issue recur. I was impressed by the attention he gave to ensuring I could perform all exercises well before I left, that he communicated clearly what my movement “assignments” were, and that at the beginning of every visit he made sure I was progressing like he thought I should be before talking about next steps.

Working with Chris has been a great experience, and I’d recommend him to anyone!”

-Erin M.

 

“I have just finished my second course of treatment with Chris, for separate issues. I obviously returned to his care because I was very impressed with his knowledge and approach to PT. His initial intake exam is comprehensive and integrated with the primary problem.

Multiple modalities were used for my hip and low back problem, in addition to exercise and stretching. The bottom line was almost complete resolution of my pain. I plan on continuing to see Chris periodically for tune up sessions.

Highly recommend seeing Chris for your PT needs.”

-Ray H.

 

Are you suffering from back pain as you age? If back pain prevents you from doing what you really love, then you may worry about what might happen if things worsen.

You might hope that things ‘fix themselves,’ but you also fear the risks of surgery if you don’t heal on your own and aren’t sure what to do to correct the problem. If this sounds like you, then now is the time to get the support you need.

Chris S
AUTHOR

Dr. Chris Sovey

Healthy Consumer PT

"We Help Adults 40+ Living With Pain, Stiffness, Or Loose Joints Get Healthy, Age Stronger, And Get Back To The Activities They Love, Even If Past Treatments Have Failed"

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