Treatments include medications and exercise, but, surprisingly, a positive attitude can also help.
As we age, we can experience more back pain for several reasons, including wear and tear on our body over time. As your main structural support, the spinal column has to be strong enough to support you but flexible enough for a range of movement. Between each of the 24 vertebra in our spine, small joints allow your spine to move, and disks with jelly-like centers act as shock absorbers that prevent bones from rubbing against each other (from Everyday Health)
As we age, the disks between the vertebrae wear away and shrink, which causes pain and stiffness as the bones start to rub against each other. In addition, the space around our spinal cord narrows over time. Known as spinal stenosis, this condition also puts pressure on the cord and spinal nerves, causing pain. Stenosis and osteoarthritis are two of the most common causes of lower back pain in older adults.
Facet joint osteoarthritis, also called degenerative arthritis or osteoarthritis of the spine, is a degenerative condition that develops gradually over time. The breakdown of cartilage between the spine’s facet joints can cause intermittent pain at first but can later develop into steadier lower-back pain, and may eventually cause sciatica pain into your legs (Spine-health)
How to Alleviate Back Pain
Short-term treatment for back pain, particularly in the lower back, includes medication, limited rest and heat, and ice packs. Surprisingly, in the long term, two other practices can ease pain: a positive attitude and exercise. Before you do anything, though, consult with your healthcare practitioner and figure out your options. See sidebar, “Ask Questions Before Getting Treatment.”
Pain medications are available either over-the-counter or by prescription. Some medications reduce inflammation, which often causes pain, while others stop the pain signals from reaching the brain. Each medication has risks, possible side effects and drug (or food or supplement) interactions, which a physician needs to evaluate.
Older adults have a higher-than-average risk of side effects from medication, including analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs). Also, because many seniors take numerous medications, there is greater risk that pain medication can interact with other drugs.
Exercise the Pain Away
While it might seem counter-intuitive, because moving can be painful, exercise can help ease back pain. Medical experts recommend that you start moving as soon as possible, as long as it’s in moderation. Studies have shown that those with short-term lower-back pain who rest too long and avoid exercise, even walking, feel more pain and have a harder time with daily tasks than those who stay active. Exercise rehabilitates the spine and helps alleviate back pain. When done slowly and progressively, back exercises distribute nutrients into the back’s disc space and soft tissues to keep the discs, muscles, ligaments and joints healthy.
Before you start exercising, develop a regimen with the help of a professional, such as a physical therapist or chiropractor. Include aerobic conditioning, stretching and strengthening. Focus on your core, as stronger abdominal muscles can reduce lower-back strain. Exercise can also improve your posture, another common reason for back pain.
Stretching helps with flexibility and relieves the tension and tightness that can cause discomfort. Because your back pain likely took months, if not years, to develop, it can take weeks or months of exercising to find relief.
Researchers from the University of Sydney found that people who had symptoms of depression had 60 percent greater incidence of back pain compared with those who were not depressed (AARP). Although the link between back pain and depression isn't clear, one theory is that people who are depressed are less likely to exercise and more likely to have disturbed sleep, both of which contribute to back pain.
Whatever the reason, pessimistic people feel more pain than optimists (Harvard Health Blog). On top of that, it’s easy to get depressed when you lose physical mobility, especially if exercise is an important part of your life. In a continuous loop, psychological distress can worsen the pain, which makes you feel more depressed and more intensely in pain. Eventually, the pain becomes all-consuming.
In fact, prolonged pain can rewire your brain, according to the Harvard Health Blog. When pain first occurs, it connects with your pain-sensitivity brain circuits. However, long-lasting pain can switch brain activity from the “pain” circuits to those that process emotions, making emotional control that much more difficult.
To break this cycle, psychological therapies can help lessen your emotional distress and therefore your back pain. The treatment with the greatest supporting evidence (for all chronic pain syndromes, not just back pain) is mindfulness, according to the Harvard Health Blog. A recent study demonstrated that a technique called mindfulness-based stress reduction can help reduce back pain and also improve emotional control by increasing blood flow to the brain’s frontal lobe.
Other mental techniques include cognitive behavioral therapy (CBT), a type of psychotherapy in which you challenge negative thought patterns to alter unwanted behaviors. CBT also treats mood disorders such as depression. Another technique, progressive muscle relaxation, increases the awareness of tension in your body.
Ask Questions Before Getting Treated
Before you decide on a course of treatment, keep this advice in mind.
Numerous alternative treatments may ease back-pain symptoms.
- Chiropractic care. A chiropractor hand-manipulates joints using a controlled, sudden force to improve range and quality of motion, which can ease pain.
- Acupuncture. This ancient Chinese practice uses needles to improve the body’s energy flow. One recent review of 22 acupuncture studies showed that it provided short-term relief from chronic back pain (WebMD).
- Massage. If tense or overworked muscles cause your back pain, massage might help.
- Yoga and Pilates. Yoga can stretch and strengthen muscles and improve posture, although you might need to modify some poses if they aggravate your symptoms. Pilates is another form of exercise that can help strengthen core muscles. Both Pilates and yoga can reduce stress, which can lessen pain.
- Electrical stimulation. A non-invasive technique, electrical stimulation can ease short-term back pain. The most common form is transcutaneous electrical nerve stimulation therapy, which works by flooding a pathway with low-level stimulation that keeps pain signals from reaching the brain.
“Understanding Back Pain—Basics,” WebMD.
“The Psychology of Low Back Pain,” April 25, 2016, Harvard Health.
“Low Back Pain in Older Adults,” Spine-Health.
“The Link Between Aging and Back Pain,” Everyday Health.
“Medications,” Mayo Clinic.
Blog posting provided by Society of Certified Senior Advisors