“Low back pain is ubiquitous in our society, especially among older adults,” says Peter Wang, associate professor of orthopedics and rehabilitation at Yale University School of Medicine in New Haven, Connecticut. “This is due to degenerative changes that occur over time.”Age etc. osteoarthritis Or a worn disc. ”
That said, there are effective treatments for pain, most of which don’t require medication, says Hamza Khalid, a spine specialist at the Cleveland Clinic. Consider the following steps:
Although it may not be appealing to exercise when your lower back hurts, staying active can actually reduce pain and help prevent future pain. “Moving your body increases blood flow to your spinal tissues and joints, which makes you feel better,” says Colleen Rowe, a physical therapist and co-founder of His Evidence in Motion in San Antonio. Masu.
Lu says you can start with pool aerobics or simply walking in the pool. These are gentle on your joints and increase strength and confidence. “When people understand that they can function without pain, they feel more confident when they get out of the water,” she says. Other options include gentle yoga and tai chi, which trains the mind and body with slow, gentle movements. “Not only will it lengthen and strengthen your back muscles, but it will also make you feel more comfortable moving around.”
You can also ask your doctor if seeing a physical therapist is appropriate for you. Your PT can provide you with a personalized exercise program and help you find ways to move with less pain.
“Older people tend to take shorter strides because their center of gravity has changed,” Lowe says. “However, short, narrow strides can worsen lower back pain. We can work with them to help them take larger steps more comfortably and increase blood flow to the spinal area.” ”
A physical therapist may be able to teach you the “neural glide technique,” Lu says. This is a gentle exercise that stretches and soothes inflamed nerves in your back.
use the power of your heart
Some doctors may recommend talk therapy to change your response to pain and encourage you to set and work toward activity goals.a Small survey in 2021 For example, Pain Reports focuses on psychophysiological symptom relief treatments that address stress that can cause pain. At the end of six months of such treatment, almost 64% of patients reported complete pain relief.
“This therapy is a good option for patients who have tried other conservative treatments, such as physical therapy, but have not seen improvement in their symptoms,” says Khalid.
Ask your doctor where you can get talk therapy for back pain. You may be able to find pain management programs at large medical centers. You can search for information on the American Psychological Association. therapist finder In the same way.
Dealing with daily stressors and getting enough sleep are also important, says David Hanscom, a retired spine surgeon and author of Back in Control: A Surgeon’s Roadmap Out of Chronic Pain.
a 2022 survey A paper published in Frontiers in Neuroscience found that sleep problems can cause back pain and vice versa.
Don’t rely solely on massage
Several complementary treatments may be used for chronic low back pain. These include massage, spinal manipulation (where a chiropractor moves the spinal joints beyond their normal range of motion), and acupuncture (where very thin needles are inserted into specific points on the body).
do they work? For short-term lower back pain, the American College of Physicians (ACP) recommends acupuncture, heat, massage, and spinal manipulation. But “I don’t consider massage or acupuncture to be first-line treatments,” Wang says. “These are more passive treatments, unlike active treatments like physical therapy, which teach you how to stretch your back and keep your core strong.”
Especially when it comes to massage. 2015 Cochrane research review They concluded that although it helps improve back pain, the quality of the evidence is low. We also found that massage does not necessarily improve the function of the entire back. Additionally, note that the above treatments are not always covered by insurance and can be expensive.
According to ACP guidelines, if additional symptom relief is needed, over-the-counter anti-inflammatory medications such as ibuprofen (Advil and generic) are the first choice. But Jesse Chernoff, a physical therapist at the New York Hospital for Special Surgery, says it’s often not suitable for older people, who may be at higher risk for side effects such as gastrointestinal bleeding.
Acetaminophen (Tylenol and generics) may be safer if you keep it below 3,000 mg daily, he says. Diclofenac topical (Voltaren Arthritis Pain and Generic), an over-the-counter anti-inflammatory cream, also reduces symptoms. (However, this drug and other anti-inflammatory drugs may not be suitable for people taking blood thinners.)
Another option is an OTC patch that contains the numbing agent lidocaine. Ask your doctor how often and for how long you can use all of the above.
If you don’t see improvement after treatments such as PT and medications like those listed above, talk to your doctor, as ACP recommends the prescription antidepressant duloxetine (Cymbalta and generics).
Prescribing muscle relaxants such as cyclobenzaprine (Flexeril and generic) can make you drowsy and increase your risk of falls, so talk to your doctor about your situation. Avoid using prescription opioids, which can lead to dependence. According to one researcher, it is not as effective as a placebo for short-term low back pain. Research in Lancet magazine in 2023can cause side effects such as constipation and dizziness, which can be more pronounced in older people, Chernoff says.
Alleviation of acute inflammation
Doctors say these four strategies can help you feel better when your discomfort increases.
Move, but do it slowly. Even when you’re in severe pain, it’s important to continue doing low-stress activities, such as walking or doing some light stretching. “The biggest mistake people make is bed rest,” Chernoff says. “You’ll recover faster if you stay active. Move your body in a way that’s comfortable, and increase the amount of activity you can tolerate with slow steps.”
Try heating it up. You can place a heating pad or wrap on the affected area. Apply several times daily for 15-20 minutes at a time.
Take this medication as needed. Acetaminophen (Tylenol and generics) is usually safe to use for 3 to 5 days, according to the dosage directions on the package.
Adjust your position so that you can sleep comfortably. Try sleeping on your side with your knees bent and a pillow between your knees. This will minimize stress on your spine.
Let your doctor know if your discomfort is interfering with your daily life. Do the same if you have taken some of the steps above and her severe back pain has persisted for more than four weeks with no improvement.
Call your doctor right away if you have back pain when lying down, or if the pain radiates to your lower legs, or if it is accompanied by fever, leg weakness, or bowel or bladder incontinence. The same is true if you have a history of cancer or osteoporosis, or if you have lower back pain from a fall or accident. These symptoms and conditions may indicate a potentially serious problem, such as a fracture that compresses the nerves at the base of the spine or cauda equina syndrome. Your doctor may want to see you right away or may advise you to see a specialist.
Copyright 2024, Consumer Reports Inc.
Consumer Reports is an independent, nonprofit organization that works with consumers to create a fairer, safer, and healthier world. CR does not endorse products or services or accept advertising.read more ConsumerReports.org.
