Lower Back Pain in older adults

By avn
6:06 am Posted April 16, 2016
In Back Pain

The prevalence of low back pain is estimated to be more than 70% and is the most frequently reported musculoskeletal problem, in the population over 75 years of age. For 5 to 10% it can be a serious problem. Lower back pain can be acute or chronic in nature. Acute low back pain is the one that lasts less than 3 months and chronic low back pain may last for more than 3 to 6 months. Lower back pain among senior citizens lasting more than week should be investigated and should not be neglected.

Symptoms of Lower Back Pain in Older Adults

  • A heightened pain in the mornings and evenings, sometimes accompanied by stiffness.
  • Disrupted sleep due to pain.
  • Tenderness (Pain on touching) when the area of the spine is pressed.
  • Pain in the lower back that is increases on extended activity
  • Finding relief quickly after sitting down
  • Loss of flexibility in the back
  • Developing leg pain while walking a small distance
  • Weight loss
  • Deformity and disability

Causes of Low Back Pain in Older Adult

  • Facet joint osteoarthritis or degenerative arthritis or osteoarthritis of the spine, is a degenerative joint disease that arises due to the degradation of joints, articular cartilage (a covering sheet over the bones that allow the bones to slide smoothly against each other) and subchondral bone, as a result of mechanical pressure on the area, over time. The pain is caused by the breakdown of the cartilage between the facet joints in the spine.
  • Fever with back pain could mean possibly a serious infection, such as epidural abscess, septic discitis, osteomyelitis, Bacteraemia, or Bacterial endocarditis.
  • Prolonged back pain with weight loss or anorexia could be an indication of the presence of a malignancy, particularly in people with a history of cancer.
  • Low back pain could be a sign of Metastatic cancer too, which is a cancer that spreads to other parts of the body, starting from the part of the body where it started.
  • Spinal compression fracture could be a cause of back pain, especially in post-menopausal women with osteoporosis. In a person with osteoporosis, even a small amount of force put on the spine, as from a sneeze, may cause a compression fracture.
  • A bowel or bladder dysfunction raises the probability of spinal cord disease, and that could be a cause of lower back pain.
  • Some medications too have Low back pain as an adverse effect. For example, if you are taking corticosteroid medications, the back pain may be related to a vertebral compression fracture. Anticoagulant drugs may also lead to low back pain caused by retroperitoneal hemorrhage.

Diagnosis of Lower Back Pain in Older Adults

  • Firstly, the Medical practitioner will initiate an Initial Observation. The location of the pain, its occurrence, its duration, etc. is firstly noted.
  • Physical Examination is the next step towards diagnosis. The goal of the examination is to obtain key information to confirm or reorient the initial clinical impression.
  • Diagnostic studies are conducted further, if the treatment resorted to with the initial diagnosis does not help. This would help to confirm if any injury is the cause of the back pain. This would be particularly useful to pinpoint the source and extent of the injury to assist in the diagnosis and development of an appropriate treatment plan for your back problems. This would include:
    • X-ray
    • CT Scan
    • CT Scan with Myelogram
    • Electromyography
    • Somatosensory Evoked Potentials
    • Discogram
    • Bone Scan
    • DEXA Scan

Treatment for Lower Back Ache

Once the cause of your back pain is determined, the pain could be treated in three ways —

  • with medications,
  • therapeutic treatments or “physical medicine,” and
  • Surgery

Medications for back pain relief include:

  • Aspirin or acetaminophen
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen
  • Steroids, which can be injected or taken orally
  • Narcotics such as codeine or morphine

Therapeutic Treatments or Physical medicine include:

  • Rest or restricting certain activities
  • Physical therapy, including active therapy (stretching, weight lifting, aerobics) and passive therapy (heat, ice, massage, ultrasound, electrical stimulation.)
  • Braces, usually wrapped around the back and stomach
  • Traction (although scientific evidence of its effectiveness is lacking)
  • Stress relief such as Pilates, yoga, or meditation

Surgical options are:

  • Spinal fusion to eliminate the motion between bone segments
  • Disk replacement (similar to knee or hip replacement)

Ayurvedic Treatment for Lower Back Pain in Older Adults

  • Ayurvedic medication – to strengthen the back and relieve pain and other symptoms
  • Ayurvedic Medicated Oil application
  • Ayurvedic Therapies are very effective in preventing surgery, preserving function and relieving pain and other symptoms associated with low back pain even is severe cases.

If you do experience back pain, even if you think the cause is aging, do not ignore it. It could be a sign of a serious, but a treatable disease. You don’t have to live with back pain. But please keep in mind that you run a higher-than-average risk of side effects from all drugs, including analgesics like nonsteroidal anti-inflammatory drugs (NSAIDs). There is also a risk that any medications may interact with those that you are already on. So please do consult your doctor and consider various options available to you.

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