Father Time isn’t always kind to our spines. They are as vulnerable to aging as the rest of us. But we can take steps to prevent and manage back pain.
The spine is a column of 24 bones stretching from our skulls to our tailbones, encasing the spinal cord. Its bones, or vertebrae, are linked by tiny joints called facets. In between, discs filled with a jelly-like substance serve as a cushion. Rope-like ligaments stabilize the spine.
After age 50, back pain is usually caused by:
- Painful changes in discs and joints — Loss of moisture and resilience that make discs less effective as shock absorbers.
- Spinal stenosis — Narrowing of the canal through which the spinal cord passes due to disc degeneration, thickened ligaments or arthritic facet joints (usually in the lower back).
- Spondylolisthesis — Slippage of one spinal vertebra forward onto the vertebra beneath.
Any of these conditions can cause inflammation, pressure on nerves or pain. When this happens, Cleveland Clinic back pain specialists recommend:
Physical activity — “Motion is lotion” for the spine, notes E. Kano Mayer, MD, of Cleveland Clinic’s Center for Spine Health. The more active you are, the better you’ll feel. Stay active, and you’ll bounce back sooner from episodes of back pain.
Physical therapy — Physicians can prescribe a back-healthy exercise program to help you gain strength, and improve balance and flexibility. Strengthening your back and abdominal muscles — your “core” — will make your spine more resilient.
Medications — Take nonsteroidal anti-inflammatory medications (NSAIDs) —ibuprofen, naproxen, aspirin— or acetaminophen as directed to halt inflammatory pain. “Pulsed dosing — consistently taking the medicine two to three times per day for five to 10 days, even after pain has subsided — is more reasonable than ‘as-needed’ dosing,” says Dr. Mayer.
Cold — Reach for an ice pack first when back pain strikes. Applying ice (20 minutes on, 20 minutes off) helps to quiet painful inflammation or muscle spasms. (A frozen bag of peas will also do the trick.)
Heat —After two or three days, consider using a heating pad, taking warm baths or lying briefly under a heat lamp. This can relax your back muscles and stimulate blood flow, explains Dr. Mayer. Don’t overuse heat (by falling asleep on a heating pad, for instance) or you may get burned. Stretch warmed muscles to prevent muscle spasm after the heat source is removed.
Bed rest — Aging tends to slow our recovery from injuries. But if your back “goes out,” limit bed rest to just one or two days. Prolonged immobility will aggravate back pain and slow the pace of recovery.
When the pain becomes unbearable
If your pain becomes chronic and persistent, don’t wait too long to see a back pain specialist.
“Back pain does not have to destroy your quality of life,” notes Ellen W. King, MD, a specialist in the Department of Pain Management. “Combining a wide array of procedures — including the conservative therapies above— in a comprehensive pain management plan can reduce pain and improve functionality.”
More intensive treatments can make rehabilitation from a back injury easier:
- Nerve blocks and injections. Steroids — with or without anesthetics — can be injected to reduce back pain and inflammation at the source, whether it is a spinal nerve root or a facet joint, says Dr. King.
- Radiofrequency ablation. A carefully guided radiowave wand can be inserted to block painful nerve signals for an extended period using high-frequency current. This may relieve chronic back pain for nine months or longer in carefully selected people.
- Spinal cord stimulators. Stimulating a portion of the spinal cord can change the perception of pain in some people. A small electrode array — similar to multiple pacemakers — is implanted to send mild electrical impulses to the spinal cord. These mask or divert pain signals so that they don’t reach the brain.
- Intraspinal drug pumps. Computerized pumps can be implanted to deliver local anesthetics or other pain medication continuously to the spinal cord.
If age-related back pain does not improve with conventional treatment, complementary medicine techniques may be added to the mix. These include:
- Osteopathic manipulation. Osteopathic doctors (DOs) or chiropractors can use their hands to mobilize, adjust, massage and stimulate the spine and its surrounding tissues.
- Acupuncture. Acupuncturists insert fine needles into the skin at specific body points and manipulate them. This can relieve chronic pain by stimulating the body’s healing process.
When these measures fail, a limited number of people may benefit from surgery for chronic age-related back pain.
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