You may have breezed through your 20s, 30s, and even 40s without experiencing back pain. The downside is now that you’re in your 50s or older, you’re experiencing back pain more often. You might wonder whether back pain is a normal part of aging, and why you’re suddenly dealing with it more often. What’s causing that nagging back discomfort? Here are some of the most common reasons people have more frequent back pain after 50.
Degenerative Disc Disease
Degenerative Disc Disease (DDD) is a common cause of low back pain (LBP) and often shows up during the second half of life. Doctors usually suspect DDD if history, physical exam, x-rays, and imaging studies show no other likely cause of back pain. So, it’s often a diagnosis of exclusion.
Disc degeneration is where the cushioning between the bones that make up the vertebrae dry out or crack from a lifetime of wear and tear. The pain is often in the lower back and feels worse when sitting. It usually gets better if you get up and walk around or change positions. It often comes and goes; you might experience no discomfort for a few weeks, and then it rears its ugly head again. It can be a nagging problem that comes and goes for decades.
You’re more likely to have degenerative disc disease if you’re overweight, have a history of back injury, or do manual labor. Studies show people who work in occupations that require stooping, bending, or lifting are at a greater risk of developing lower back pain and degenerative disc disease. Before menopause, women are less likely to have disc degeneration relative to men, but women play catch-up after menopause, as estrogen declines and the discs become dryer. In the years after menopause, women have a higher rate of back pain from degenerative changes and wear and tear than men.
Are there treatments for DDD? Physical therapy, supervised exercise, and improvements in posture and alignment may help reduce back pain from degenerative disc disease. Eating an anti-inflammatory diet can also reduce pain and inflammation. If you’re overweight, shedding those extra pounds reduces pressure on the spine.
Vertebral Compression Fractures in Women
Another cause of back pain after menopause is small fractures of the vertebrae, the bones that support the spinal column, due to osteoporosis. Osteoporosis is a disease where bones become thinner and more fragile, thereby increasing the risk of bone fractures, including spinal fractures. A vertebral fracture is a break or crack in any of the bones that make up the spine. Some compression fractures in the spine are small and cause few symptoms other than back pain, but other fractures need immediate treatment. How common are these breaks? Up to one in four women experience vertebral compression fractures after menopause.
Why are fractures of the spine more common after menopause? The hormone estrogen helps maintain healthy bone tissue. After menopause, estrogen decreases significantly, and bone density goes down, as there’s less production of new bone. As bone density drops, the bones become thinner and weaker to the point they can fracture. With osteoporosis, minor trauma like coughing forcefully or making a sudden twisting movement of the body can cause a break.
Exercise before the age of 20 helps build greater bone density, so you’re less at risk of osteoporosis later in life, but high-impact exercise and strength training even as an adult reduces bone loss. Some studies even show you can modestly increase bone density during middle age and later through exercise.
A lifetime of poor posture can catch up with you as you get older. Examples of activities and postures that bring on back pain include slumping or slouching when you sit or stand. Gazing down at a tablet or phone many hours per day can lead to upper back or neck pain. Looking down multiplies the force placed on your neck and upper back.
Also, lifting items incorrectly by flexing your back rather than bending your knees, and lifting with your legs can trigger or aggravate back pain. Maintaining good posture requires awareness of how you’re sitting and standing and a conscious effort to change those habits.
Other Causes of Back Pain After 50
Other possible causes of back pain after 50 include a ruptured disc in the spine and spinal stenosis (narrowing of the spinal canal). These problems are more common after the age of 50. Less commonly, something like a tumor compresses the nerves of the spine and causes back pain.
If you have a more serious cause of back pain, the pain is likely to be more severe and associated with other symptoms like muscle weakness, numbness or tingling in the extremities, or problems urinating or walking. These are all signs you need immediate medical attention. If you have back pain that lasts more than 7 days, talk to your doctor.
The Bottom Line
For back pain caused by degenerative disc disease or poor posture, physical therapy can help. Strengthening the muscles that support the spine will help protect against future episodes of back pain and improve your posture. Also, if you have chronic back pain, it’s a good time to consider a new mattress. A firm mattress that supports the spine can lower the risk of repeat episodes of back discomfort.
Some doctors also prescribe medications, usually non-steroidal anti-inflammatory (NSAID) drugs, but these only temporarily relieve the symptoms and have side effects. An alternative approach is a massage to help loosen the tight muscles in the back. It’s also a relaxing way to ease stress. Most people can use more of that! But exercise, too, is vital for strengthening the muscles in your back.
Wong AY, Karppinen J, Samartzis D. Low back pain in older adults: risk factors, management options, and future directions. Scoliosis Spinal Disord. 2017 Apr 18;12:14. doi: 10.1186/s13013-017-0121-3. PMID: 28435906; PMCID: PMC5395891.
“Degenerative Disc Disease | Johns Hopkins Medicine.” hopkinsmedicine.org/health/conditions-and-diseases/degenerative-disc-disease.
“Common Causes of Back Pain – Types & Treatment | NIAMS.” niams.nih.gov/health-topics/back-pain.
“Low Back Pain Fact Sheet | National Institute of ….” ninds.nih.gov/disorders/patient-caregiver-education/fact-sheets/low-back-pain-fact-sheet.
Kozinoga M, Majchrzycki M, Piotrowska S. Low back pain in women before and after menopause. Prz Menopauzalny. 2015 Sep;14(3):203-7. doi: 10.5114/pm.2015.54347. Epub 2015 Sep 30. PMID: 26528111; PMCID: PMC4612559.
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