By David Wilkening, Contributing Writer
REGION – Back pain for older people is not unusual. But managing it can be difficult because it’s often characterized medically as “non-specific.” Meaning that it may be the result of several conditions, according to medical doctors.
So here are some suggestions for preventing it, treating it and other tips to help you understand it.
Start with prevention
First of all, it’s far from unusual. It’s one of the most common complaints for older people when visiting their family physicians, said Dr. Mina Safain, assistant professor of neurosurgery and attending neurosurgeon at Tufts Medical Center/Melrose/Wakefield Hospital.
“The best therapy is actually preventative,” he said. That means “maintaining a good and healthy weight. And concentrating on core strengthening exercises, which means focusing on good abdominal and lower back muscle strength,” he said.
Working with a physical therapist or exercise trainers in a workout setting can be very useful to get started with a later home-based exercise program.
How much exercise is needed?
“Regular exercise three or four times a week is a good practice. Clear your exercise regimen with your primary care doctor,” Safain recommended.
Walking has also proven to be good for back health.
“Aiming at 10,000 steps a day is often seen as a good goal but you should consult with your physician,” he said.
A valuable substitute for individuals who have difficulties for conventional workouts: aerobic exercises.
Massachusetts General Hospital also has a variety of tips for preventing back pain that, not surprisingly, include the already mentioned maintaining a healthy weight and regular exercise.
They also suggest not smoking and finding ways to reduce stress, which may cause muscle tension.
Food choices can help
If you’re prone to back pain, consider vegetables, urge some experts. Try an anti-inflammatory diet of mostly plant-based foods, especially eaten in combination with omega-3-rich cold-water fish like salmon and sardines, black cod and tuna.
The diet could help avoid inflammation. “Deeply colored fruits and vegetables are a key part of an anti-inflammatory diet,” said Dana Greene, MS, RD, LDN, a nutritionist in Brookline. If you’re looking for foods that reduce back pain and are loaded with nutrition, she suggested trying carrots, beets, sweet potatoes, cherries, berries, grapes and red wine, pomegranate, and watermelon. Herbs and spices, including basil, cinnamon, ginger, rosemary, garlic, curcumin, onions, oregano, and turmeric tend to be especially rich in anti-inflammatory agents, so she suggested seasoning generously. Also, drink healthy herb teas and true teas (green, oolong, and white), according to Greene.
Other good food choices for an anti-pain diet: avocados; nuts (walnuts, almonds, pecans, and Brazil nuts); lean proteins, such as chicken and turkey; beans; and cocoa.
Another tip from Dr. Jason Yong, an anesthesiologist and medical director of the Pain Management Center at Brigham and Women’s Faulkner Hospital, is that not all back pain requires treatment from a physician.
“Patients with acute low back pain (lasting less than three weeks), for example, can often get sufficient relief by using over-the-counter anti-inflammatory pain medications, physical therapy exercises, and temporary restrictions on lifting while the body heals itself,” he said on the hospital website.
When to see a doctor
Generally, treatment by a physician is advised when pain is limiting a patient’s ability to walk, sit, or stand for prolonged periods of time, or if pain is greater than a 6 (on a scale from 0 to 10), he said. Spinal surgery is usually considered for patients with intense, unrelenting pain (10 on a scale from 0 to 10), weakness, incontinence, or structural instability.
“Red flag” signs of when to consult with a physician “include unintentional weight loss (which can be a sign of a malignancy) fevers and chills (can be signs of infection), shooting leg pain associated with weakness or numbness (can be signs of infection on the lower back nerves),” said Safain.
The “good news,” if that should be termed about back pain, is that there are a variety of effective treatments. Dr. Safain said those include “physical therapy, anti-inflammatory medications, steroid injections and sometimes surgery.”
One of these mentioned by Yong involves steroid injections for short-term pain. They can be combined with other forms of therapy. An injection may be provided, for example, prior to physical therapy to help a patient complete a regimen of exercises.
Patients today also have access to a wide range of implantable pain management devices. These include intrathecal pumps that infuse medication into the spinal fluid and use much lower doses of medications compared to other therapies, Jong said.
Medical providers such as Yong also recommends patients who have persistent back pain―particularly those considering spinal surgery―should work with a multidisciplinary team of specialists with expertise “because it may be caused by many conditions.”
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