Spinal Stenosis
Back pain, especially in older adults, can become a debilitating condition. Advanced degeneration of the spinal elements can lead to incapacitating symptoms. In this article, we explore the challenges faced by older adults with spinal stenosis, herniated discs, and other factors that contribute to low back pain in this population.
Degenerative Changes and Spinal Stenosis
As we age, our backs and their segments undergo a series of wear and tear known as degeneration. This is a normal process that occurs over time. When we reach an advanced age, spinal stenosis may appear. Vertebral degeneration reaches a critical point where the elements of the back increase in volume and may begin to occupy the space through which the nerves must pass. The pain no longer only affects the back, but radiates down the legs, forcing people to stop due to the weakness it causes in the lower extremities.
Herniated Discs
Another issue that arises in adulthood is the appearance of herniated discs, which become more frequent as we age. A herniated disc is the result of a rupture of the vertebral disc, which can compress nerves as it exits the spinal canal, causing leg pain. Distinguishing between back pain and sciatica is crucial. Sciatica occurs when a nerve is compressed by some structure, either stenosis or a herniated disc.
The Importance of Exercise
Contrary to popular belief, a herniated disc itself does not cause pain. The presence of multiple herniated discs in a patient does not necessarily cause low back pain. They become symptomatic when they compress a sensitive structure.
One of the challenges is convincing patients with these ailments of the importance and necessity of exercise to compensate for this weakness in the disc. Combining medicine with physical exercise is a fundamental part of pain treatment.
Osteoporosis
Another common pathology in older adults that adds a layer of complexity is osteoporosis. The fragility of bones caused by their decalcification means that everyday tasks can result in microfractures. The simple act of bending down to open a drawer can put pressure on the vertebra and cause a fracture. When faced with severe back pain in patients around 70 years of age, the initial suspicion should include the possibility of a vertebral fracture, even if there is no obvious history of falls.
A Multidimensional Approach
Addressing back pain in the elderly is a complex and multidimensional challenge. From spinal stenosis to osteoporosis-related vertebral fractures, each case requires personalized treatment.
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