9 Respuestas a las preguntas más frecuentes sobre el dolor lumbar

No hay que limitarse a sonreír y aguantar. Find out what might be causing your lower back pain - and what treatments can help.

For seniors, lower back pain is a common and sometimes debilitating problem. It can get worse over time, too. Since your back plays a key role in pretty much everything you do, this type of pain can prevent you from fully enjoying your life.

The good news: Lower back pain does not have to be a normal part of aging. Addressing the problem can make you feel much better. Here's a look at what causes back pain and the many ways it can be treated.

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What’s the difference between acute and chronic lower back pain?

There are two different kinds of back pain, acute and chronic. Here's how they are different:

• Acute pain comes on suddenly and feels sharp. It has a specific cause, such as injury or infection. Maybe you fell off a ladder or twisted in an awkward way while you were doing chores and now your back hurts. If so, that’s acute pain.
• Chronic pain can start out as acute pain. But it sticks around longer than six months and can hurt some days more than others. Sometimes that’s because of your activity level. You may feel slight back pain in the morning. Carrying heavy groceries into the house in the afternoon can make it hurt more.It doesn’t have to be a sharp pain for it to be chronic. A dull ache or stiffness counts too. These might also be paired with muscle weakness, poor range of motion, swelling, trouble sleeping or crunching or popping noises in your spine.

It’s possible to have both acute and chronic pain at the same time. You could have chronic pain due to an ongoing issue like osteoarthritis. But if you then injure your back, that pain would be acute.

How is lower back pain diagnosed?

A doctor will take a complete medical history and give you a physical exam. This may include a functional assessment. That checks your ability to sit, stand and walk easily. You may also be tested to see if you can comfortably lift one leg and then the other. These tests help the doctor find out where the lower back pain is coming from. It also checks your range of motion.

The doctor may also order these imaging tests to get a better look at what’s going on:

• X-ray
• Magnetic resonance imaging (MRI)
• Computed tomography scan (CT or CAT scan)
• Blood test to determine possible infection
• Bone scan to look for tumors or compression fractures
• Nerve study to check for nerve compression

With lower-back pain, it's not always possible to figure out what's causing it. X-rays or other imaging tests may not find enough damage to explain the amount of pain you feel. If that happens, it's called nonspecific back pain.

What are the causes and risk factors for lower back pain?

Lower back pain can happen to anyone, but the problem is even more common among older adults. This is partly because there are more risk factors and potential causes as you age. Those can include:

• Age-related changes in the spine, such as narrowing space between disks
• Multi-joint pain involving the neck, hip, and/or knee
• Osteoarthritis and rheumatoid arthritis
• Inactivity
• Bulging or ruptured disks
• Muscle or ligament strain
• Osteoporosis
• Excess weight
• Smoking

There is also a strong connection between emotional health and back pain. Decades of research suggests this relationship may go both ways. Stress and anxiety can cause back pain. But being in pain can also deepen those feelings, which is a tough cycle to break.

Recommended FREE SilverSneakers On-Demand Class: Morning Back Strength Routine for Seniors

I'm not sure my pain is bad enough to see a doctor. When do I really need to go?

It's understandable that you may want to wait before consulting a health professional. Many times, back pain improves within a few weeks with home treatment and self-care, according to Mayo Clinic.

However, these symptoms should alert you that it’s time to schedule an appointment:

• The pain is the result of a fall or injury
• The pain doesn’t improve or gets worse
• It lasts more than a few weeks
• You feel pain shooting down one or both legs, particularly if it reaches your calf or shin
• One or both legs are numb, weak or tingle
• You have a fever
• You’ve developed new bladder or bowel problems
• Unexpected or involuntary weight loss
• Reduced mobility

Being brave about your pain doesn't win you any awards. See a doctor rather than wishing it will go away. Although back pain is common in older adults, it's not inevitable-and it's not untreatable.

What medications or products can bring relief?

There are a wide range of pain relief options - from simple ice packs and over-the-counter (OTC) pain relievers to prescription medications. It's important to work with your doctor to determine the best treatment option for you. This is especially true if you take medicines for other health conditions. As with other types of pain, there is no one-size-fits-all treatment plan.

These options include:

• Topical gels and creams, both OTC and prescription
• OTC pain relievers, such as ibuprofen
• Ice packs, particularly for acute pain and injury
• Heating pads
• Muscle relaxers
• Cortisone Injections
• Narcotic medications such as oxycodone or hydrocodone
• Antidepressants, which can ease chronic back pain even if you don’t have depression

If you have chronic back pain, talk with your doctor about what type of OTC or prescription treatment might be right for you.

What alternative therapies can help relieve lower back pain?

From acupuncture to chiropractic care, there are many complementary and alternative therapies that can help. There is good research that supports acupuncture as a complementary treatment for chronic lower-back pain. Be sure to look for a licensed and certified acupuncturist.

Your doctor may also recommend physical therapy to help strengthen the muscles around the spine. Building muscle can improve your range of motion, so you don’t tweak your back when you move in certain ways.

Resting your back used to be common pain relief advice. But newer research finds that too much resting can make back pain worse. Often, gentle movement is recommended to maintain flexibility and strength in your spine.

Because back pain is so common, there are a lot of non-medical products on the market that promise relief. But some of these fixes are more hype than help. For example, the Mayo Clinic says there isn't one type of mattress that helps everyone with lower back pain. You should choose what feels most comfortable to you.

Recommended video: Find Your Place: Check Your Spine Health

Can exercise make lower back pain feel better?

When you're hurting, moving more sounds like a bad idea. But it's not. Taking it easy can make the pain worse and make it even harder to get around.

As you become more sedentary, the muscles around the spine become weaker. This can make you feel unstable and cause stiffness, which make falls and injuries more likely.

That said, you shouldn't start just any fitness plan. Talk with your doctor about what type of exercise might be right for your situation. This is especially true if you have problems in more than one joint or have arthritis.

In some cases, you may want to try physical therapy first so you can find out what type of movement would be most helpful to you.

Once your doctor says it’s OK, here are some move-more options to consider:

• Gentle stretching, such as SilverSneakers LIVE Gentle Stretch (Express)
• Restorative yoga, including SilverSneakers Yoga
• Pilates
• Tai chi or SilverSneakers EnerChi
• Swimming or water aerobics
• Biking
• Caminar
• Strength training using lighter weights and more repetitions

Although SilverSneakers classes are high energy, they aren’t high impact. That means they won’t put too much stress on your lower back. What’s more, SilverSneakers instructors are specially trained in senior fitness and happy to help modify any moves that cause strain to your back if you ask them.

What other lifestyle habits might ease the pain?

Exercise is a big part of maintaining good spine health. But there are other many other lifestyle habits that can help too.

These include:

• Maintain a healthy weight: Every extra pound puts more strain on your spine and joints. It also raises your risk for injuries and osteoarthritis.
• Reduce stress: Easier said than done, we know. But there is a strong connection between emotional health and spinal health. Finding ways to recharge and beat stress can be a powerful step to reduce pain and keep it from getting worse. Deep breathing exercises, socializing and doing hobbies you enjoy may help.
• Eat foods that reduce inflammation: Some foods contain healthy compounds that can lower inflammation throughout the body. This can help ease lower back pain. Make sure you have nuts, seeds, fatty fish, fruits, vegetables, beans and olive oil on your weekly grocery list.
• Stop smoking: Not just for back pain, but for every part of your body. Research shows that lighting up can harm cartilage and lead to more pain.
• Improve your posture: Being aware of how you sit and stand can reduce lower back pain. Slouching can put pressure on the lower-back muscles. And staying in one position too long can make you feel stiff and sore. Here are 7 Easy Exercises to Improve Posture — and Prevent Back Pain.

These lifestyle changes can be a big adjustment. But it's worth it. They can help lessen your pain and may even lead to other positive health effects too. For example, you might also notice that you catch fewer colds than usual, have more energy, sleep more deeply, and have better emotional resilience.

Are there more advanced treatments?

Yes. If your pain doesn't get better with any of the treatments above, your doctor may suggest more advanced options. These include:

• Radiofrequency neurotomy. In this procedure, a fine needle is inserted toward the source of your pain. Radio waves travel through the needle to disrupt pain signals that are sent to the brain.
• Implanted nerve stimulators. This is when devices are implanted under your skin to deliver electrical impulses to certain nerves. This can help block pain signals to the brain.
• Back surgery. If you have serious, on-going pain, you may be a candidate for surgery. Mayo Clinic notes that surgical procedures are usually reserved for pain related to structural problems with the body. That could be a narrowing of the spine or a herniated disk. Even then, other therapies will be tried first. Surgery is rarely the first thing doctors will do unless there is a traumatic injury to the spine.

See our sources:
Facts about lower back pain in older adults: Scoliosis and Spinal Disorders
Prevalence of lower back pain in older adults: The Journal of Pain
Acute vs. chronic pain: Cleveland Clinic
Risk factors, diagnosis, treatment of lower back pain: Mayo Clinic
Stress and chronic lower back pain: Scientific Reports

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