I think of myself as a reasonably healthy woman. I walk almost every day, I get together friends, I play pickleball. And yet there are days when back pain has prevented me from doing all these things. I’m far from alone. Up to 70 percent of older adults suffer from some form of back pain. Lower back pain (LBP) is especially common in older women. (Thanks a lot!)
Leaving out accidents, there are a myriad of potential causes of LBP, and they often overlap. Here’s my personal litany: I have scoliosis and two degenerative discs, mild arthritis and osteoporosis in my spine. Nevertheless, I’m fine, really. Until I’m not.
Older women are more susceptible to lower back pain for a number of reasons. Among the most common causes are degenerative discs that occur when the discs between the vertebrae and spine begin to break down and so no longer provide enough cushioning. Also at play are changes in posture that throw alignment off, a sedentary lifestyle, osteoarthritis and the hormonal changes that take place post-menopause and that can cause compression of the vertebrae.
It’s important to see your doctor to rule out other medical conditions including spinal tumors, (which are rare), and to stay up to date on DEXA scans to monitor the strength of your bones.
“Osteoarthritis is more common in women than men,” says Dr. Elaine Arata, a Maryland-based internist with a specialty in geriatric medicine. “One component of it is the formation of bony growths called bone spurs or osteophytes. These can put pressure on the spinal cord or on the nerves as they exit the spine, which causes nerve pain in addition to the arthritis pain.”
Arata adds that as our bones thin with age there is a higher risk of spinal compression fractures, which involve a collapse of the front of the vertebra. She recommends that every woman over 60 have a DEXA scan to determine if she has osteoporosis. “Unfortunately, you may not have any symptoms until you break a bone. Plus, the drugs used to treat osteoporosis significantly reduce the risk of a fracture," she said.
Falls can cause lasting back pain and damage to the spine even in women who don’t have thinning bones. One friend, 70, recently took a tumble onto a hard tile floor that resulted in three spinal compression fractures, despite the fact that she doesn’t have osteoporosis or osteopenia. Three months later, she still suffers from intermittent back pain, though she is up and moving again.
When to see a doctor
Like many of us, I spent too long assuming back pain was something I just had to learn to live with at this stage of life. In fact, it often goes untreated because we accept it is an inevitable part of getting older. That’s unfortunate, because there are things we can do to prevent and/or lessen back pain.