"Oh, My Aching Back!"
A majority of older adults will experience lower back pain, at least periodically. Medication isn't the only treatment available.
Lower back pain is a side effect of modern living, anthropologists tell us. Standing up all day, sitting in chairs, and even today's overloaded backpacks all put undue burden on that part of the back where we're most likely to feel pain from the strain.
The structure of our lower backs is pretty complicated! If something injures or strains this arrangement of vertebrae, discs, muscles, tendons and ligaments, we can suffer from pain and disability—most often short-term, but sometimes chronic.
If you have suffered from lower back pain, you are in good company. According to the National Institutes of Health (NIH), 80 percent of adults will experience lower back pain sometime during their lives, and during any given three-month period, 25 percent of us will have a degree of pain in that area.
Sometimes when we feel back pain, we know exactly what happened: We "pull a muscle" while lifting a heavy object, or feel something go "out of whack" while playing sports, or have sudden pain after a fall, auto accident or other injury. Other times, the pain develops gradually, perhaps coming and going from day to day, beginning with no particular incident. Lower back pain can stem from a strained muscle, a problem with a disc or bone, a herniated or ruptured disc, or compression or inflammation of a nerve. With all these possible causes, it can be difficult for the doctor to pinpoint the specific cause, even with the help of an X-ray, MRI, CAT scan or other imagery.
Lower back pain can strike us at any age, but after years of wear and tear on the spine, it's not surprising that it's most common among older adults. Indeed, the NIH lists age as the No. 1 risk factor! Seniors are more likely to have degenerative changes in the spine, as well as arthritis and osteoporosis. If you're one of our younger readers, don't feel immune—according to the American Academy of Orthopaedics, degenerative changes to our spine can begin when we hit the ripe old age of 30.
Lower back pain can be miserable. It's one of the leading causes of job-related disability and absenteeism. It disrupts our sleep and dampens our ability to enjoy life. It can rob seniors of their independence. And though back pain often clears up on its own, if it persists, it’s time to seek help. (Note: if back pain is severe and sudden, or accompanied by fever, chills, loss of bowel or bladder control, don't wait—call the doctor right away.)
Treatment for back pain includes …
Medications. Over-the-counter drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs) and topical ointments and creams may be recommended. Antidepressants may help with intractable pain. Some medications are injected directly into the spine. Opioid (narcotic) drugs have traditionally been prescribed, but today there is a new emphasis on treatments other than drugs. (The newly formed National Pain Strategy is addressing this as part of an ongoing focus on dangerous prescription drug abuse.)
Exercise. Sometimes when people have a sore back, they think that remaining immobile—lying down or sitting—is the best way to recover. In the old days, bed rest was recommended for back pain, but we now know that inactivity usually makes things worse. The doctor most likely will tell us to avoid movements that put strain on the back, but also will recommend a safe, appropriate exercise program to build up the back and abdominal muscles that support the spine, which includes aerobic, strengthening and flexibility activities. It's important to keep at it regularly to avoid "weekend warrior syndrome," when a person who's usually a couch potato suddenly decides to overdo the exercise—and their back pays the price!
Nutrition and weight control. Eating well has a good effect on most aspects of our health, and spinal wellness is no exception. Nutritionists recommend that we get enough calcium, potassium and vitamin D to support bone health. And maintaining a healthy weight is especially important. Carrying around extra pounds, especially in the midsection, burdens our lower back.
Practicing good body mechanics. The way we move, stand and sit, and even our sleep position, affect our lower backs. It's important to learn good posture habits and to arrange desk furniture properly. Lifting heavy objects is a top culprit when it comes to back injury. If you're lifting something heavy or awkward, don't bend over the item; instead, with a straight back, bend at the knees and let your legs and hips do the lifting. Better yet, get someone to help you.
Physical therapy. Your doctor may recommend physical therapy as you're recovering from a back injury, and to protect against further back problems. Physical therapists use hands-on treatments such as heat and cold and electrical stimulation to relieve pain. They supervise and train patients in good body mechanics as mentioned above and can prescribe a series of exercises to improve mobility and strengthen the muscles that protect the back.
Surgery. For certain types of lower back pain (such as a tumor, a ruptured disc or spinal stenosis), surgery may be recommended. In most cases, the doctor won't recommend surgery until nonsurgical treatments have been tried.
Smoking cessation. You might not think of a quit-smoking program as being a treatment for back pain, but research shows that smoking makes it harder for our bodies to absorb calcium and build new bone. Smoking also cuts down blood flow to the discs, making people who smoke more susceptible to degeneration of the discs.
Complementary therapies. In March 2016, the University of Pittsburgh School of Medicine released a study showing that mindfulness meditation might be useful in helping older adults cope with back pain. And in earlier studies, yoga and tai chi showed promise. Some patients also try other complementary therapies such as spinal manipulation, traction, massage, spinal mobilization, acupuncture and biofeedback. The National Center for Complementary and Integrative Health emphasizes that it's important to talk to your doctor about any complementary health practices you are considering.
Many seniors think lower back pain is just a part of growing older, but much can be done to treat the causes and the pain. Talk to your doctor if lower back pain is having an impact on your life.
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The information in this article is not intended to replace the advice of your healthcare provider. Talk to your doctor if you are experiencing lower back pain, and before beginning an exercise or diet program.