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I think of myself as a reasonably healthy woman. I walk almost every day, I get together friends, I play pickleball. And yet there are days when back pain has prevented me from doing all these things. I’m far from alone. Up to 70 percent of older adults suffer from some form of back pain. Lower back pain (LBP) is especially common in older women. (Thanks a lot!)
Leaving out accidents, there are a myriad of potential causes of LBP, and they often overlap. Here’s my personal litany: I have scoliosis and two degenerative discs, mild arthritis and osteoporosis in my spine. Nevertheless, I’m fine, really. Until I’m not.
Older women are more susceptible to lower back pain for a number of reasons. Among the most common causes are degenerative discs that occur when the discs between the vertebrae and spine begin to break down and so no longer provide enough cushioning. Also at play are changes in posture that throw alignment off, a sedentary lifestyle, osteoarthritis and the hormonal changes that take place post-menopause and that can cause compression of the vertebrae.
It’s important to see your doctor to rule out other medical conditions including spinal tumors, (which are rare), and to stay up to date on DEXA scans to monitor the strength of your bones.
“Osteoarthritis is more common in women than men,” says Dr. Elaine Arata, a Maryland-based internist with a specialty in geriatric medicine. “One component of it is the formation of bony growths called bone spurs or osteophytes. These can put pressure on the spinal cord or on the nerves as they exit the spine, which causes nerve pain in addition to the arthritis pain.”
Arata adds that as our bones thin with age there is a higher risk of spinal compression fractures, which involve a collapse of the front of the vertebra. She recommends that every woman over 60 have a DEXA scan to determine if she has osteoporosis. “Unfortunately, you may not have any symptoms until you break a bone. Plus, the drugs used to treat osteoporosis significantly reduce the risk of a fracture," she said.
Falls can cause lasting back pain and damage to the spine even in women who don’t have thinning bones. One friend, 70, recently took a tumble onto a hard tile floor that resulted in three spinal compression fractures, despite the fact that she doesn’t have osteoporosis or osteopenia. Three months later, she still suffers from intermittent back pain, though she is up and moving again.
When to see a doctor
Like many of us, I spent too long assuming back pain was something I just had to learn to live with at this stage of life. In fact, it often goes untreated because we accept it is an inevitable part of getting older. That’s unfortunate, because there are things we can do to prevent and/or lessen back pain.
After a particularly bad flare-up that left me unable to walk without severe pain, I finally saw my doctor who ordered X-rays and MRIs to ferret out the root causes. That was the first step to getting help that made a huge difference in my quality of life. After cortisone shots relieved the acute pain, I embarked on three months of physical therapy.
I was lucky enough to have a talented therapist who helped me realign how I was standing, walking and sitting. She showed me exercises that can help correct imbalances (some as simple as marching in place) and just as important, taught me what not to do (rotating my spine is a no-no). I’m happy to be back on the pickleball court, even if my game hasn’t improved.
“It’s important to stay as active as possible since strong muscles help both back pain and arthritis pain,” Arata says. “I would also emphasize that surgery should be avoided unless there's a specific problem being addressed.”
If you take nothing else away from this article, pay attention to this: Consult with your doctor if back pain prevails. You should never suffer in silence.
The Cleveland Clinic has the following suggestions for the treatment of age-related back pain:
What to do when your back acts up:
· Ice comes first: Reach for an ice pack first when back pain strikes. Applying ice (20 minutes on, 20 minutes off) can help quiet painful inflammation or muscle spasms.
· Then go for the heat: After two or three days, consider using a heating pad or taking warm baths. This can relax your back muscles and stimulate blood flow. But, remember to turn your heating pad off as you are falling asleep to avoid getting burned.
· Get an Rx for physical therapy: Physicians can prescribe a back-healthy exercise program to help you gain strength and improve balance and flexibility. (Most insurance pans will cover a number of visits.)
· Over the counter anti-inflammatories — ibuprofen, naproxen and aspirin — can dull inflammatory pain.
· Start walking as soon as possible. It’s tempting when your back hurts to lie down and, well, not get up, but gentle exercise like walking is usually recommended during episodes of mild pain and can help the healing process.
How to prevent future flare-ups:
· Strengthen your back and abdominal muscles: Strengthening your core and back muscles will make your spine more resilient and help to prevent falls. Never start a new exercise program when you are in pain but do consider a Pilates class at the gym or online when you are ready. Remember to start slowly and talk to the teacher ahead of time about your limitations.
· Keep moving: Staying active may also help to prevent back pain. Walking for 30 minutes a day on most days and taking part in strength training twice a week may help ward off flare-ups.
· Sit up straight: All those lectures about posture when you were younger may have been annoying then but sitting up straight does help prevent back pain.
I wish I could tell you that my back has never acted up again, but that would be wishful thinking. What I can tell you is that being more conscious of my everyday movements and keeping up with the exercises I learned in physical therapy have kept me active. And, for now, my heating pad remains in the closet.
Do any of you suffer from back pain? What do you do about it? Let us know in the comments below.
Stocksy
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