With time, change is inevitable. Due to the natural aging process, this universal truth applies to your physical health and, unfortunately, the health of your spine.
Age-related changes to the spine make older adults more prone to a variety of back problems. This article will discuss these prevalent spinal tissues and what can be done to resolve them.
How Does The Spine Change With Age?
You likely know that people tend to shrink as they get older. But, do you know why this occurs?
While multiple factors can contribute to getting shorter with age, one of the key culprits is shrinking spinal discs. The aging process causes the discs that cushion the vertebrae of the spine to dry out. These discs are located in between each vertebra, so as they dry out and become thinner, the entire spine loses height.
Additionally, aging leads to wear and tear on the cartilage of the spine. Cartilage is a type of connective tissue that protects your joints from damage due to impact and friction. When the cartilage in the spinal joints starts to break down, it can cause pain and stiffness, among other symptoms.
The natural aging process can also lead to thickened bony and soft tissue in the spinal canal. This excess tissue can encroach and even press on spinal nerves, often leading to pain and neurological symptoms.
These age-related spinal changes can increase your risk of developing spinal conditions in older age.
What Are The Most Common Back Issues Among Older Adults?
Lower back pain is the most prevalent health issue that causes pain and disability in older adults. In some cases, this pain may only linger for a few days or weeks and resolve with at-home therapies. In other cases, however, lower back pain can become chronic.
Some of the most common causes of chronic lower back pain in older adults include:
Spinal stenosis is one of the most widespread degenerative spine conditions. It typically occurs in individuals over the age of 60, though it develops due to genetic spinal defects in a small percentage of cases.
The spinal canal houses the spinal cord and spinal nerves. Age-related spinal degeneration can cause the open space in the spinal canal to diminish. As a result, soft and bony tissue draws closer to the spinal nerves.
As spinal stenosis becomes more advanced with time, tissue in the spinal canal may start to press on the spinal canal and/or nerves. Known as nerve impingement, this can cause back pain and neurological symptoms including sciatica, numbness, tingling, and/or weakness in the extremities.
Osteoarthritis of The Spine
Osteoarthritis of the spine progresses over time. It causes the cartilage that protects the joints in the spine to break down, often leading to persistent back pain. An estimated 89% of adults aged 65 years or older develop spinal osteoarthritis, making it a predominant cause of lower back pain in older adults.
In its earlier stages, spinal osteoarthritis may only cause intermittent pain. However, as it becomes worse over time, it can cause more severe pain. Pain that disrupts your sleep worsens in the morning and at night, and is exacerbated by extended periods of physical activity is common in osteoarthritis patients.
Spondylolisthesis occurs when a vertebra in the spine slides out of position, settling on the vertebra beneath it. This condition can develop as a result of age-related changes to the spine, typically in the L4-L5 spinal segment.
Symptoms of spondylolisthesis include:
- Lower back pain and stiffness
- Hamstring muscle spasms
- Trouble standing or walking for prolonged periods
- Neurological symptoms (namely weakness, numbness, and tingling in the foot)
The misaligned vertebrae associated with spondylolisthesis can lead to other spinal problems, namely spinal stenosis.
Degenerative Disc Disease
Degenerative disc disease is a diagnosis used for back pain caused by wear and tear on an intervertebral disc. Disc degeneration typically results from the aging process and worsens over time.
Usually, degenerative disc disease causes mild to moderate chronic pain with occasional flare-ups of severe pain. It may also trigger weakness, numbness, and radicular pain (pain that radiates from the back and hips to the legs).
Additionally, degenerative disc disease can contribute to other spinal conditions, including spinal stenosis, spondylolisthesis, and osteoarthritis of the spine.
How Are Degenerative Back Problems Treated?
Chronic back pain in older individuals can usually be resolved without surgery. Conservative treatment options include:
- Physical therapy
- Chiropractic care
- Lifestyle adjustments (targeted exercise routines, improved diet, quitting smoking, etc.)
- Heat and cold therapy
- Pain medications
- Epidural steroid injections
In some cases, patients’ symptoms don’t improve after several months of non-surgical treatment. In these cases, surgery may be required for complete symptom relief.
Spinal Decompression and Fusion Surgery
Spinal decompression surgery paired with spinal fusion is widely used for cases of spinal stenosis and spondylolisthesis that don’t resolve with a conservative treatment approach.
During spinal decompression surgery, the surgery removes spinal structures or tissues that are impinging on nearby nerves. There are multiple types of spinal decompression, depending on which part of the spine is removed.
For example, laminectomy is a type of spinal decompression that involves removing some or all of the lamina (the bony tissue that forms the roof of the spinal canal).
Spinal fusion is used to prevent instability after decompression surgery. It involves using bone graft material to fuse two adjacent vertebrae. Unfortunately, fusion eliminates all motion in the fused segment, which can severely restrain patients’ mobility.
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Patients who require spinal stenosis treatment may consider innovative non-fusion implants. These advanced devices can alleviate chronic back pain and neurological symptoms without preventing all motion at the affected segment.
If you’re struggling with persistent back pain in your later years, contact a spine specialist to learn about the treatment options available to you.