Lower back pain in older adults – an osteopaths approach by Holly Clarkson, Osteopath, M.Ost, DO, ND, BPA


Back pain is most common in people between the ages of 40 and 80, with older adults being defined as people aged 60 years and over (https://www.ncbi.nlm.nih.gov/pubmed/22231424). As such, effective treatment and management of lower back pain is in high demand amongst older people.

Because our bodies change over time as we age, the types of problems that can occur also change. This makes your age, life history and current position within the aging process, a big consideration for osteopaths working with lower back pain.

So what’s unique about lower back pain in the over 60’s?

1. Age related changes are the most likely cause of lower back pain in this age group. As with any age group, certain things are more likely to be the cause of a problem than others. In the over 60’s the most likely causes of back pain are age related changes such as osteoarthritis (arthritis for short) or small spinal fractures which can occur if you have osteoporosis (decreasing of the density of the bones). There are many other possible causes of back pain which, although less likely, will be considered when listening and examining you. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5395891).

2. Lower back pain won’t always mean the problem is in the back. Common conditions can show up in very different ways compared to those of younger generations. Therefore, special attention must be paid to your recent experiences and long-term story as they describe how you are feeling and what is causing your difficulty.

3. Other diseases could be making the lower back pain worse. You are more likely to have other diseases and conditions which may be adding to your pain. These are known as comorbidities. For example, a patient who is awaiting a hip replacement and is limping badly may be experiencing more pain than usual in their back due to the limp. Similarly, someone who doesn’t feel confident on their feet may spend more time sitting rather than moving around and walking. This prolonged sitting may be contributing to their back pain. Some medications can cause muscle aches and pains which may be contributing to the pain that is felt in the lower back.

Piecing it together
Once the main cause of back pain and other contributing factors have been identified then a tailored plan can be made for you. A management plan should always include treatment in the clinic as well as suggestions for your daily life outside the treatment time. Only a plan which incorporates these two elements can be effective in helping you move towards better function and reduced pain.

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