Lower back pain in older adults - an osteopathic approach
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 a patient’s age, their life history, and their 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?
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 the patient has osteoporosis (decreasing of the density of the bones). There are many other possible causes of back pain in this age group which, although less likely, will be considered when listening to the patient and examining them (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 in this age group can show up in very different ways compared to those of younger generations. Therefore, special attention must be paid to the patient's’ recent experiences and long-term story as they describe how they are feeling and what is causing them difficulty.
3. Other diseases could be making the lower back pain worse
This age group are more likely to have other diseases and conditions which may be adding to their back 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 osteopathic plan can be made for the patient. A management plan will always include treatment in the clinic as well as suggestions for life outside the treatment time. In my experience; only a plan which incorporates these two elements can be effective in helping a patient to move towards better function and reduced pain.
The content of this blog is copyright of Holly Elliott registered osteopath GOsC 9607 15a Clayton Road, Jesmond, Newcastle upon Tyne NE2 4RP.