Are you one of the millions of people living with chronic low back pain?
Have you been told by a medical provider your pain is due to arthritis? That you have the spine of an 80 year old? Or there is nothing that can be done about your back pain?
If so, you aren't alone. And unfortunately, what is often left out of this discussion is the fact that aging of the spine is perfectly NORMAL. Yes, it's not even abnormal to start to see signs of arthritis on imaging as young as age 30.Arthritic changes within your joints do not automatically lead to chronic pain and limited quality of life.
So, what gives and where is your back pain really coming from?
Age causes an increase low back pain for a variety of other reasons. About one in three older adults will experience low back pain. As we stated above, there are normal and expected changes in the spine that come with age include changes in posture, decrease in strength, signs of arthritis in the joints, and changes in flexibility. The great news is that any of these can be prevented or easily reversed with the right approach.
That's not the whole picture though, because research shows us that pain is more complex than just physical changes...
The majority of low back pain in older adults is not due to a specific problem, like broken vertebrae or bulging discs. Most people who report pain to their doctor will be given a diagnosis of "non-specific low back pain". Which, in terms of figuring out how to treat your pain is pretty useless.
Some medical providers might even order an MRI for persistent low back pain, but this can cause more harm in most situations. It's highly likely that any of us will show some kind of damage within the spine. But more often than not the physical changes detected with imaging are not really the source of pain. Research has shown spinal changes associated with aging detected on an MRI have no correlation with low back pain, especially with age. For example, spinal disc breakdown is more likely to show up on an MRI as people age but is less likely to be a source of pain in older adults than younger adults.
And in taking a closer look, there is really not much difference in pain between younger and older adults. So, pain is likely NOT being caused by joint changes that come with age.
Similar to symptoms of back pain in a younger population, the pain older adults experience changes depending on time of day, with specific activities, or position changes. A study comparing older and younger adults with low back pain found no difference in pain intensity and level of disability between the two age groups.
With all of that being said, older adults are statistically more likely to experience chronic low back pain. This has more to do with changes in pain perception that come with age as well as other risk factors including low income, prior work exposure, anxiety, and depression.Old age on it's own does not increase the risk of low back pain, but incidence of other risk factors correlated with pain increases with age.
It's also important to note most cases of acute, or new, back pain go away on their own within several weeks. Only a small percentage of those with acute low back pain will develop chronic pain, which continues for 3 months or more.
Now that we let you in on the secret that the aging of your spine is normal, let's talk about what options that leaves you with for your back pain. The great news is there are MANY options for steps you can take to both lower the risk of back pain and improve your symptoms.
Activities as simple as walking for 30 minutes 5 or more days per week and strengthening exercise 2 or more days per week lowers the risk of chronic low back pain. Managing other risk factors, like poor sleep, anxiety, and depression through conservative treatments, like counseling and meditation, is one of the most important pieces of the puzzle! To get a jump start, check out this wonderful guide and workbook walking you through your chronic pain (it's totally free and we can't recommend it enough).
If you are not sure where to start or have other health conditions, a physical or occupational therapist can help safely establish a plan of attack for your back pain. Remember, changes within the spine are a normal part of aging but should never limit how you live your life!