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  • Andrea Cziprusz

Optimizing Back Health for Older Adults

Low back pain (LBP) is the most common musculoskeletal condition and leading cause of disability worldwide. Age-related physical and psychosocial changes can contribute to LBP, increasing the prevalence of chronic LBP in older adults. Identifying modifiable risk factors, embracing lifestyle changes, and prioritizing self-care are crucial steps in promoting back health.

The most common causes of chronic LBP in older adults include:

Osteoarthritis: Wear and tear of the cartilage between facet joints in the spine, which may result in stiffness and pain.

Lumbar Spinal Stenosis: A narrowing of the spinal canal that can lead to pain and nerve compression.

Degenerative Disc Disease: A loss of cushioning in the discs that increases the potential for disc herniation, nerve irritation, and osteoarthritis.

Muscle Strain/Sprain: Muscle pain/tenderness.

Spinal Compression Fractures: Typically associated with osteoporosis.

While age-related changes might be unavoidable, there are a number of modifiable risk factors that can help mitigate the likelihood of chronic lower back as you age. Recognizing these risk factors and embracing lifestyle changes can significantly improve back health and overall well-being.

1. Physical Activity: Engaging in regular exercise is key! Physical activity improves muscular strength, cardiovascular endurance, flexibility, posture, and balance. An active lifestyle also helps maintain a healthy weight

2. Smoking Cessation: Quitting smoking improves blood flow and promotes healing of damaged tissues, reducing the risk of chronic low back pain.

3. Mental Health: Effectively managing stress, anxiety, and depression can alleviate muscle tension and pain. Consider stress-reducing techniques like mindfulness and meditation or take it a step further by incorporating mind-body exercise like yoga and tai chi.

4. Sleep: Prioritize good sleep hygiene to support back health and overall well-being, as poor health can exacerbate the pain cycle.

5. Target a Healthy Weight: Excess weight can place undue strain on the back and is correlated with a higher incidence of low back pain. Maintaining a healthy weight through a balanced diet and regular exercise is paramount. Consider incorporating anti-inflammatory foods into your diet and seek guidance from a registered dietitian if needed.

When faced with back pain, opting for non-invasive pain management strategies can effectively alleviate symptoms.

1. Self-Care: Use proper body mechanics to reduce the strain on your spine. Spread more strenuous activities throughout the day/ week so you don’t overdo it. Don’t underestimate the importance of listening to your body. If you are hurting, be proactive in self-management strategies to take care of your back.

2. Heat/Cold Therapy: Heat can reduce joint stiffness and pain. Heat is a great choice to warm up muscles pre-activity. Try a microwavable heating pack or electric heating pad for 10-20 minutes prior to activity. Cold is a helpful modality to reduce swelling and/or pain, and is the preferred choice post-activity or for an acute injury. Never place hot or cold packs directly on the skin and be mindful of the temperature to protect skin integrity. ​

3. Exercise: Gentle exercise aids in pain reduction. Movement is medicine. Light stretching, core exercises, and a progressive walking program can help you overcome an acute episode of low back pain.

4. Bracing: A flexible lumbar brace provides compression and light support. A brace is best reserved for acute episodes of low back pain or strenuous tasks.

5. Medication: Judicious use of over-the-counter medications can aid in symptom management. Topical pain medicines (such as lidocaine patch, biofreeze), oral analgesics (like Tylenol), and anti-inflammatories (such as Advil or Aleve) can assist in managing symptoms. It’s always best to to consult your doctor for recommendations and dosing.

6. Physical Therapy: Physical therapists use an individualized approach, utilizing evidence-based techniques for pain management through education, exercise, and tailored interventions.

Optimizing back health for older adults involves a combination of lifestyle changes and non-invasive pain management techniques. By adopting a consistent exercise routine, maintaining a healthy weight, managing stress, and seeking professional advice when needed, older adults can take proactive steps to enjoy a pain-free and active lifestyle. Always consult with healthcare professionals before making significant changes to your exercise routine or pain management strategies to ensure they are suitable for your individual needs and health conditions.

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