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Back Pain in Seniors

Back pain is one of the most frequently encountered problems in adults, particularly in seniors. It may occur as an acute episode or become persistent and worsen over time. It is estimated that nine out of ten patients suffer from back pain at least once in their lifetime. The pain may be felt in the back anywhere starting from the back of the neck to the tail bone (coccyx). Usually back pain is a self-limiting condition easily managed but sometimes back pain can indicate to underlying medical or surgical problem.

Back Pain Symptoms

Back pain is a symptom of some underlying problem. It may be experienced as :

  • Constant or intermittent pain.
  • It can be dull ache, burning, shooting or a cramping pain.
  • Sometimes pain can radiate to the legs, arms and even to the head.
  • Can be associated with numbness and tingling sensation.
  • Inability to control bowel and bladder can arise with back pain.
  • Progressive weakness of the legs.

Causes of Back Pain

There are several problems that can cause back pain. It is often difficult to isolate a cause without further diagnostic investigation. Back pains usually arise from muscles, nerves, bones and joints.

Muscle

  • Strained muscles (pulled muscles).
  • Muscle spasm usually elicited by injury.
  • Abnormal movements or stretching which involves the tendons as well.

Nerve

Nerve root compression, like sciatica, may occur with bone spurs from the vertebrae or fracture of the vertebral bones.

Bone

  • Vertebral fracture due to injury (fall).
  • Bone thinning (osteoporosis) due to aging, low calcium and drug intake like corticosteroids.
  • Spread of cancer to bone – metastasis from cancer of lungs, breast or prostate.
  • Arthritic changes (degenerative diseases) of the bone like rheumatoid arthritis or osteoarthritis.
  • Herniated disc.
  • Skeletal abnormality (from birth with bending of vertebral column sideways (scoliosis) or “hunchback” (kyphosis).

Joints

Inflammatory joint diseases like ankylosis spondylosis.

Others

  • Intervertebral disc disorder. These discs act as cushions between vertebrae. Sometimes due to injury the discs may rupture or bulge (herniate) leading to severe back pain.
  • Narrowing of spinal canal (spinal stenosis).
  • Infection: osteomyelitis or tuberculosis of spine.
  • Due to co-existent medical conditions:
    – Kidney stones
    – Leaking abdominal aortic aneurysm
    – Pregnancy
    – Female reproductive organ disorders: fibroid of uterus, ovarian cancer, cyst or endometriosis.

Risk factors

  • Lifting heavy weights.
  • Lack of exercise.
  • Poor posture leading to shortening, tightening, lengthening or weakening of the back muscles.
  • Occupational activities is one major risk factor for muscle strain leading to back injury.  In the elderly, a lifetime of poor posture and muscle strain associated with an occupation, as well as the development of other causative conditions with age, may contribute to back pain in the senior years.

Treatment

Rest is one of the best means of treating and easing back pain. However, it does not mean that the pain will not recur shortly thereafter. Other measures may also be necessary.  Back exercises may be helpful to strengthen muscles and improves posture.  Back braces may also be helpful depending on the cause of the back pain.

  • Medication :
    – anti-inflammatory drugs like acetaminophen and NSAIDs such as ibuprofen
    – muscle relaxants
    – analgesics (painkillers)
    – tricyclic antidepressants (sometimes)
  • Physical therapy using heat therapy, ultrasound and electrotherapy.
  • Surgery is only considered as the last option for releasing pressure on the nerve roots.

 


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