Did You Know Chronic Back Pain is Preventable?
Keeping the back healthy means more time spent being active and less time in pain, on meds, or in the OR.
Welcome to the Healthy Aging Newsletter, a free publication translating trustworthy medical research into simple habits to age well, free of chronic disease. I’m Dr. Ashori, a family medicine doctor turned health coach.
Nothing puts you down harder than a few weeks or months of acute low back pain. It often comes out of nowhere and affects your daily routine, sleep, and sanity.
Few back pain cases are serious enough to need surgery - though unfortunately many end up with exactly that. Even worse, many get addicted to pain medication and muscle relaxers trying to cure this pain.
The key to a healthy back over your lifetime is flexibility, core stability, and strong hips.
Keeping the Back Healthy
The ability to control the abdominal, hip, and lower back muscles is the trifecta of having a healthy back as we go through our healthy aging process. The soft tissue in this area hardens over time, joints become both lax, and muscle mass decreases.
Back Spasms vs. Arthritis vs. Disc Herniation
Most of the patients who end up with surgery had nothing more than spasms. Spasms happen when the muscles around the spine, especially the lumbar region, don’t have adequate mobility or strength to protect our movements. Add to that a weak abdominal muscle complex and back pain can be debilitating.
Spasms (the most common) often happen randomly and show up as gripping pain in the lower back. Often worse with movements and worse with pressing on the tight muscles. They tend to get a little better with some movements and strengthening but worse after waking up from sleep.
Arthritis happens along the sides of the spine, often near the facet joints and can be worse with flexing the abdominal muscles or twisting the torso, lifting heavy weights, or jumping.
Finally, disc herniation, often causes nerve issues lower in the legs and eventually it can cause some pain in the lower back. Certain movements like bending forward or kneeling can set off the numbness or tingling in the lower legs, feet, or toes.
Avoiding Back Surgery
The number one way to avoid back surgery is to not develop back pain. The number one way to avoid developing back pain is to regularly exercise the back. It’s rarely a “back injury” that sends patients to the surgeon, it’s often the chronic pain that becomes unbearable.
MRI of the Back
An MRI is rarely helpful because most of the MRIs taken will show something abnormal, enough abnormal to warrant surgery. But that’s just the limitation of the MRI as a way to assess back pain.
Once you see all the abnormality on your MRI, it’s hard to unsee it. Of course, when imaging is absolutely needed, there’s no question.
Last Resort - Surgery
Surgery should be the absolute last resort and should be the first option for someone with severe neurologic function loss. But that’s rarely the people who end up getting surgery. Often those who are having back spasms and milder stenosis and disc herniations end up with surgery which may result in future unnecessary surgeries.
Only you and your doctor know what’s right for you. I want to empower you to know that there are other options. From exercises, physical therapy, aquatics, acupressure, acupuncture, topical treatments, injections, massage, etc.
Aging Healthy With Your Back
As we get older we lose more muscle mass, become more sedentary, and lose flexibility, all of which lead to much higher risk of back pain. What I always focus on when I talk about healthy aging is avoiding the common things that people are afflicted with as they age. Back pain, as one of them.
The best way to prevent complications from back pain is to focus on the mobility of the lower back and improve the muscles of the lumbar and hip girdle. These help protect the discs in the back and prevent us from losing our form when doing daily activities.
1. Pay Attention to Posture
Extended drives or sitting at a desk is problematic for most people, especially those prone to back pain. Breaks are a must.
2. Don’t Ignore Pain
At the first sign of pain or discomfort, find a trusted back professional who can help you understand what’s causing it. Often you’ll need to loosen tight muscles but sometimes you just need some tightening with specific exercises.
3. Learn to Manage Without Medications
Medications can mask the pain but won’t fix the underlying mechanic problems.
4. Stretch Lightly
When you stretch do it lightly. This is even more important for those of you who generally lift very heavy.
5. Lift Intentionally
When you walk, move, or lift weights, pay attention to your body mechanics. Awkward angles and positions tend to be more aggravating.
What do you do for your back regularly to prevent it from causing problems in the future?