What is the cause and what you can do about it

Back pain is very common, whether it is a chronic condition of old age or comes on suddenly after improperly straining the spine to lift something heavy. Regardless of the cause — arthritis, spinal stenosis (narrowing around the nerve roots), blunt injury, or something else — along with the common cold, back pain is one of the most common reasons Americans over 45 see a doctor, explains Ronald Tolchin, DO, medical director of the Spine Center of the Miami Neuroscience Institute.

Ronald Tolchin, DO, Medical Director of the Miami Neuroscience Institute’s Spine Center.

“Back pain can certainly be a sign of a problem,” explains Dr. Tolchin. “But it could also be age-related degenerative changes in the lumbar spine. We know that the spine degenerates with age.”

Why does the spine degenerate over time? This has to do with the wear and tear of the cartilage between the vertebral bodies. This cartilage is called an intervertebral disc. It has a cartilage component on the outside and a soft, gel-like material called the core on the inside.

“Over time, the cartilage dries out, which can lead to tears in the outer part of the disc and thus pain,” says Dr. Tolchin. “It can also put more stress on some of the small joints at the back of the spine called the facet joints — and cause them to degenerate over time.”

dr Tolchin offers further insight into back pain and ways to alleviate or prevent debilitating ailments.

What is the best exercise to counteract degenerative changes in the spine as we age?

dr Tolchin:

“The best way to counter some of these changes is to work on core muscle strength. This is a group of 29 muscles in the front and back that surround the entire spine. These include your abs, your back extensors, your pelvic muscles, etc. – and these can all take over the movement and relieve some of the pressure on the spinal elements. You can strengthen these muscles throughout your life, unlike the degenerative changes in the spine, which are not reversible.

“It is particularly problematic for overweight people. They put more stress on the spine, and so the degenerative changes in this situation are amplified. It’s a growing problem as we generally live longer and there are more arthritic changes with age. So we really need to take care of our spine and do proper exercise to offset some of the age-related changes.”

How debilitating can back pain get—even when the cause of the pain doesn’t require surgery or something extreme?

dr Tolchin:

“Back pain can be pretty debilitating. It depends on the exact cause. For example, herniated discs that put pressure on the nerve can result in extreme lower back pain, but also pain that radiates into the lower extremities – like burning, tingling, and numbness, which can also be very debilitating. It can cause weakness in the lower extremity and especially the foot, making someone prone to falls.

“A fall can lead to other problems, such as a hip fracture or a compression fracture in the spine, depending on age, if someone also has osteoporosis. Other examples of debilitating back pain occur in the small joints called the facet joints. These are small joints that guide movement in the lower back and when overloaded due to a lack of strong muscles around the spine. They can become quite arthritic and cause debilitating back pain.

“Other examples of debilitating pain can include a condition called spinal stenosis. This is where the spine narrows around the nerve roots, causing pressure over time due to arthritic changes. This usually happens in older adults. Initially, it can start with back pain; However, as the condition worsens, patients suffer from both weakness, fatigue and sensory loss in the lower extremities, which can be profoundly debilitating. “

What are some of the most common causes of back pain that readers can avoid?

dr Tolchin:

“Some common causes of back pain are herniated discs. This is a tear in the outer ligament of the disc that allows the gel-like material to escape from the confines of the disc and press on the nerve. This can occur, for example, when someone lifts more weight than they should, or when they bend and twist at the same time while lifting weights. It can also happen simply because of weakness in the outer ligament of the disc, which can occur at any time.

“To try to avoid increased stress on the spine, with proper body mechanics, a person can lift and use the leg muscles when, for example, bending forward, such as when bending forward. B. doing a squat or lunge to get to the ground to pick something up. Also, it is important not to bend forward with a rounded back to reduce stress on the spine. Instead, a flat back position or arched back would put more stress on the hip joint when bending and can be very helpful in preventing spinal pain.”

Keywords: Back Pain, Miami Neuroscience Institute, Spine Center