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Living with back pain

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June 5th, 2015
walking couple
walking couple

Back pain, especially lower back pain, is a fact of life. According to the National Institute of Neurological Disorders and Stroke (NINDS), up to 80% of adults experience low back pain at some point in their lifetimes. For many people, this pain is short-lived (acute), but for seniors, this type of pain is typically ongoing, or chronic.

For older adults, the prevalence of back pain is likely higher than 80%, mainly due to wear and tear over the years. “The gel-filled discs that act as shock absorbers in the back deteriorate over time,” says James McGowan, M.D., pain management specialist at the Center for Interventional Pain Medicine at Mercy Medical Center in Baltimore, Md. “The pain from this process spreads outward to other structures and muscles in your back. The discs can eventually become compressed and bulge or rupture.”

In many seniors, arthritis is another cause. “Arthritis can develop in the back joints at any level,” McGowan adds. “Having arthritis can predispose you to other back problems.”

Along with underlying chronic processes, seniors may experience flare-ups of pain for other reasons. “Older adults may have muscle strain or sprains from unaccustomed activity,” says Vrinda Suneja, M.D., medical director at Fox Run, an Erickson Living community in Novi, Mich. 

Other sources of pain can be related to nerve injury or inflammation and in rarer cases, infection or tumors. 

Individualized medical treatment

Back pain may be common, but treatment should be based on the severity of the cause and how much the resulting pain affects your daily life. 

“Physical therapy is a mainstay treatment,” McGowan says. “The exercises strengthen the supporting structures of your back, which takes the pressure off your discs.”

“Oral or topical medications may be necessary,” Suneja says, “any of which carry risks of adverse effects. Ask your doctor before you try anything—even over-the-counter drugs.”

Examples of medications for treating back pain include anti-inflammatories, anticonvulsants (which stabilize nerves), antidepressants, analgesics, and counterirritants (topical medicines).

“Steroids, which can reduce inflammation significantly, can be injected directly into the problem area,” McGowan adds.  “In some cases, when someone has significant pain or debilitating numbness or weakness that isn’t relieved by other measures, surgery may be necessary.”

Some people find relief with complementary medical treatments such as chiropractic care, acupuncture, biofeedback, and yoga.

Do-it-yourself options

How you live your life can affect the severity of your pain and daily functioning. “For people who are carrying extra pounds, weight loss is almost always beneficial,” McGowan says. “Each pound puts significant extra strain on your back.”

“You should also maintain an upright posture when standing or sitting. This keeps the pressure off your spine,” McGowan adds.  

And while bedrest used to be the norm for people with back pain, research shows that the opposite is true. While a doctor may advise a short period of bedrest after certain types of surgery or trauma, most people with chronic back pain should get up and move. “Regular exercise helps you maintain flexibility and muscle strength,” McGowan explains.

In addition, studies show that daily physical activity may facilitate the release of so-called “feel good” chemicals in your brain, which can lessen your perception of pain.

But what can you do if exercise is painful? “It’s normal for pain to be worse temporarily when you begin an activity program,” McGowan explains. “The pain will usually subside as you build your strength. Make sure you gently stretch your muscles before exercising.”

Consult a physician or a physical therapist for a list of age-appropriate and low-impact exercises that are designed to strengthen lower back and abdominal muscles.

More suggestions

If you smoke, one of the best things you can do for your back is quit. According to NINDS, smoking reduces blood flow to the spine, which can contribute to disc problems. Smoking also impedes the healing process. “Most people are not aware of the strong link between smoking and back pain,” Suneja says. 

NINDS experts also recommend that you sleep on firm surfaces, sleep on your side with your knees drawn up, avoid lifting heavy objects, and maintain a healthful diet.   

Because of the significant health burden of back pain, researchers continue to investigate causes, prevention, and treatment. Because disc degeneration is so common, some scientists are working on ways to help discs regenerate themselves, including stem cell mechanisms. Scientists are also evaluating the most effective exercises and alternative treatments. Other studies examine the connection between brain and body with regard to pain perception. Check out ClinicalTrials.gov if you are interested in participating in a study.

Overall when it comes to your back, trust your instincts. “Listen to your body,” McGowan says. “Pain is a very individualized experience for each person, and you’ll eventually discover what works best for you.”

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