Back pain in older adults: what is normal and what is treatable

Back pain is common as we get older, but “common” isn’t the same as “nothing can be done”. Most age-related spinal pain responds well to gentle hands-on treatment and the right movement — and a lot of the stiffness people accept as inevitable is treatable.

What usually causes it

• Spinal osteoarthritis. Wear in the small facet joints of the spine. Typically stiff and achy in the morning, easier once you’re moving, worse after long sitting.
• Disc degeneration. Discs lose water content with age, reducing shock absorption. Often painless — but it can make the back less tolerant of prolonged loading.
• Spinal stenosis. Narrowing around the nerves. The hallmark is leg heaviness or aching that comes on when walking and eases when you sit or lean forward, such as on a trolley.
• Muscle deconditioning. Less activity means less support for the spine, which then hurts sooner — a cycle that quietly reinforces itself.

What scan findings really mean

X-ray and MRI reports of “degenerative change” are extremely common in people over 60 who have no pain at all. Findings describe the picture, not your capacity. How well you move, how strong you are and how much you do day to day predict comfort far better than a scan report does.

Movement that helps

Little and often, every day, is the aim. Build to these gradually and stop short of sharp pain:

1. Walking — short, frequent walks. If your legs ache when walking, use intervals and a seat to rest.
2. Sit-to-stand from a chair — 8 to 10 repetitions, twice a day. The single best exercise for independence and safe lifting.
3. Knee rolls lying down — 10 each side to ease lumbar stiffness in the morning.
4. Heel raises holding a worktop — 10 to 12 repetitions for calf strength and balance.
5. Single-leg stand at the kitchen counter — 20 to 30 seconds each side for balance and fall prevention.

Gentle treatment options

Osteopathic treatment for older adults is adapted, not forceful — soft tissue work, gentle joint mobilisation, and articulation to restore movement, alongside advice on daily loading. Where joints are inflamed or arthritic pain is persistent, K-Laser therapy can reduce inflammation without medication, which matters if you already take several prescriptions.

Symptoms that need prompt medical attention

• Numbness around the saddle area, or loss of bladder or bowel control — seek urgent medical care.
• Unexplained weight loss, fever, or night pain that won’t settle.
• Back pain following a fall, especially with osteoporosis.
• Progressive weakness in a leg or repeated stumbling.

Otherwise, if pain has lasted more than a few weeks or is limiting what you do, an assessment is worthwhile. We treat patients well into their eighties and nineties, and the goal is always practical: walk further, sleep better, stay independent.