Back Pain and Getting Older
Before we get started on the real topic of this post we need a quick lesson in spinal anatomy. The spine itself is an inherently unstable structure; it’s just a bunch of bony blocks called ‘vertebrae’ stuck on top of each other. Now to stop this tower from tumbling down, you have a variety of structures to keep everything in place:
- Intervertebral disc – These sit between the vertebrae; their main role is as a shock absorber for the spine, but they also help to hold the vertebrae together.
- Ligaments – These are thick fibrous pieces of tissue that connect bones to other bones. A whole host of these run between the vertebrae in your back and help hold everything in place.
- Facet joints – These are the joints in between the vertebrae and although they primarily allow for movement, they also help support the spine.
- Muscles – The muscles in your back play a hugely important role in movement, stability and control of the spine. A large number of muscles control the spine, ranging from big postural muscles to small intrinsic muscles that help with control and stability.
As you age your spine will naturally age with you. Over time the intervertebral discs begin to thin, ligaments loose some of their tension and facet joints begin to wear. This is a natural process and it begins to happen to us all sometime in your late 20s or early 30s.
What this does mean is that often when people reach their mid 30s and late 40s they begin to notice achy low back pain or episodes of acute low back pain. This occurs because 3 out of the 4 structures that support the spine aren’t as effective as they used to be, putting more pressure on the muscles of the back. This can lead to an increased risk of acute injuries and increased likelihood of experiencing muscular aches. Furthermore at this age people generally have a lot of family and work commitments, and tend to not look after themselves as well as they used to. I end up seeing a lot of patients following a similar pattern.
So how do we treat this? Usually patients will present with an acute episode of low back pain. The first goal is to remove the initial pain, which we can normally achieve in the first couple of sessions. Since we can’t do a huge amount to affect the aging of spinal joints, ligaments and discs we focus on what we can change, the muscles! I encourage people to take up more general exercise and prescribe some specific exercises to promote spinal stability and spinal control. This helps prevent further flare ups and helps to combat the nagging day to day ache that can become a real problem.
If you’re suffering from a painful low back and think it’s just because of your age, good news! There is something you can do about it and it isn’t something you have to live with.
by Joe Rudland M.Ost