As your spine ages, you may start feeling some aches and pains. Here’s why back pain can develop as you age, and what you can do about it.
The spine is a column of 24 bones stretching from your skull to your tailbone, 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.
The three most common reasons for developing back pain after age 50 are:
Degenerative changes in discs and joints — Loss of moisture and resilience can make discs less effective as shock absorbers.
Spinal stenosis — The canal through which your spinal cord passes can narrow because of disc degeneration, thickened ligaments or arthritic facet joints (usually in the lower back).
Any of these conditions can cause inflammation or pressure on nerves or pain. When this happens, Cleveland Clinic back pain specialists recommend:
Be more physically active. “Motion is lotion” for the spine, notes spine specialist E. Kano Mayer, MD. The more active you are, the better you’ll feel. Stay active, and you’ll bounce back sooner from episodes of back pain.
Do 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.
Take medications. Nonsteroidal anti-inflammatory medications (NSAIDs) — ibuprofen, naproxen, aspirin — or acetaminophen can halt inflammatory pain. “Pulsed dosing — consistently taking the medicine two to three times per day for five to 10 days, even after pain subsides — is more reasonable than ‘as-needed’ dosing,” says Dr. Mayer. (Opioid pain relievers are not recommended for chronic back pain.)
Apply cold. Reach for an ice pack first when back pain strikes. Applying ice (20 minutes on, 20 minutes off) helps quiet painful inflammation or muscle spasms. (A frozen bag of peas will also do the trick.)
Apply 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) to avoid getting burned. Stretch warmed muscles to prevent muscle spasm after the heat source is removed.
Rest up. Aging tends to slow our recovery from injuries. But if your back “goes out,” gentle stretching is superior to bed rest. “Any bed rest beyond 48 hours can increase the duration and intensity of back pain, and slow the pace of your recovery,” he notes.
2 complementary therapies
If age-related back pain does not improve with conventional treatment, complementary medicine techniques may be added to the mix, including:
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.
Osteopathic manipulation. Osteopathic doctors (DOs) or chiropractors use their hands to mobilize, adjust, massage and stimulate the spine and its surrounding tissues.
More advanced options from back pain specialists
If 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 pain management specialist Ellen Rosenquist, MD.
“Combining a wide array of procedures — including the conservative therapies above — in a comprehensive pain management plan can reduce pain and improve functionality.”
Drs. Rosenquist and Mayer agree that more invasive treatments can make rehabilitation 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. Rosenquist.
Radiofrequency ablation. A carefully guided needle capable of transferring radio waves can be inserted to block painful nerve signals 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 — can be implanted to send mild electrical impulses to the spinal cord. These mask or divert pain signals so that they don’t reach the brain.
Minimally invasive lumbar decompression. This outpatient procedure specifically treats lumbar spinal stenosis caused by ligamentous tissue overgrowth. It is performed through a tiny incision requiring no general anesthesia and no stitches.
Minimally invasive vertebroplasty or kyphoplasty: This procedure can be used in specialized cases when an acute spine fracture inhibits function. “We insert cement into a broken vertebral body to relieve pain and rapidly return the patient to full function,” says Dr. Mayer.
When such measures fail, a limited number of people may benefit from surgery for chronic age-related back pain.