With age comes wisdom and experience. Unfortunately, aches and pains tend to tag along for the ride.
Spinal aging may be a fact of life, but that doesn’t mean you have to grin and bear it. Pain management specialist Ellen Rosenquist, MD, shares some of the most common reasons why back pain can develop as you age — and 13 possible ways to address it.
Causes of age-related back pain
Your spine is a column of 24 bones stretching from your skull to your tailbone, encasing your spinal cord. Its bones, or vertebrae, are linked by tiny joints called facets. In between, disks filled with a jelly-like substance serve as a cushion. Rope-like ligaments stabilize your spine.
The three most common reasons for developing back pain after age 50 are:
- Degenerative changes in disks and joints. Loss of moisture and resilience can make disks less effective as shock absorbers.
- Spinal stenosis. The canal through which your spinal cord passes can narrow because of disk degeneration, thickened ligaments or arthritic facet joints (usually in the lower back).
- Spondylolisthesis. One spinal vertebra can slip forward or backward onto the vertebra below.
Any of these conditions can cause inflammation, pressure on nerves or pain — and it isn’t unusual to have more than one of these conditions. The good news? There are lots of ways to treat age-related back pain, ranging from quick fixes to minimally invasive procedures.
13 things you can do to ease back pain
Pain is personal. So is pain relief. Different approaches work for different people — and most people require a combination of therapies to get relief.
When trying to deal with age-related back pain, there are three categories of approaches providers can take before considering surgery: conservative therapies, complementary therapies and advanced therapies.
Conservative or conventional therapies are the first rung in the pain relief ladder — the things you think of first when you’re hurt or injured, like:
- Being more physically active. “Motion is lotion” for your spine, says Dr. Rosenquist. The more active you are, the better you’ll feel. Stay active and you’ll bounce back sooner from episodes of back pain.
- Doing 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.
- Taking medications. Nonsteroidal anti-inflammatory medications (NSAIDs) — ibuprofen, naproxen and aspirin — 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. Rosenquist. She adds that opioid pain relievers aren’t recommended for chronic back pain.
- Applying 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. (That old standby, a trusty bag of frozen peas, will also do the trick!)
- Applying 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. But 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, too.
- Resting up … but only for a while. 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,” Dr. Rosenquist explains.
If age-related back pain doesn’t improve with conventional treatment, complementary medicine techniques may be added to the mix, including:
- Acupuncture. Acupuncturists insert fine needles into your skin at specific body points and manipulate them. This can relieve chronic pain by stimulating your body’s healing process.
- Osteopathic manipulation. Osteopathic doctors (DOs) or chiropractors use their hands to mobilize, adjust, massage and stimulate your spine and its surrounding tissues.
If your pain becomes chronic and persistent despite the interventions listed above, Dr. Rosenquist urges you not to wait too long to see a back pain specialist.
“Back pain does not have to destroy your quality of life,” she adds. There are more advanced treatments available that may help, including:
- Nerve blocks and injections. Steroids — with or without anesthetics — can be injected to reduce back pain and inflammation at the source, whether it’s 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 six 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 your spinal cord. These mask or divert pain signals so that they don’t reach your brain.
- Minimally invasive lumbar decompression. This outpatient procedure specifically treats lumbar spinal stenosis caused by ligamentous tissue overgrowth. It’s 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,” explains Dr. Rosenquist.
“Combining a wide array of approaches — including conservative therapies — in a comprehensive pain management plan can reduce pain and improve functionality,” she continues.
In other words, you may not find relief from a single treatment. After all, back pain often has more than one cause. That means you may have to mix and match conservative, complementary and advanced therapies with your provider for a while to find the pain management plan that works for you.
It can be discouraging to try therapeutic approaches that don’t help or only help a little. But finding the best treatment option for you is worth the effort and experimentation.
What if you’re still in pain?
If combinations of the 13 therapies we’ve listed here aren’t making a dent in your chronic, age-related back pain, don’t despair. Instead, Dr. Rosenquist suggests letting your provider know. You may be a good candidate for surgery. It’s a last resort, but — for the people who really need it — spinal surgery can make a big, positive difference in quality of life.
Get your back back in business
The three most common causes of age-related back pain are degeneration of the disks and joints in your spine, stenosis and spondylolisthesis. You could be experiencing one or more of these, too. And there are plenty of other issues and circumstances that could further exacerbate your discomfort.
But despite Father Time’s best efforts, you can find back pain relief. And while back pain often requires a combination of pain-relief techniques, a healthcare provider can help you find the approaches that will work best for you.