Special Considerations For Low Back Pain Management Of Seniors
While comprehensive history taking, self-reports of pain characteristics and pain-related disability, as well as proper physical examination all are necessary for differential diagnosis among older adults with LBP , attention should be also given to assessment and treatment of seniors with LBP so as to optimize pain management .
Self-reported pain assessments
While patients with mild-to-moderate dementia can reliably report pain intensity using traditional visual analog scale or Numeric Rating Scale , other self-reported pain assessment tools have been developed and validated in the older population to improve pain evaluation . The 11-point NRS is commonly used in clinical settings, where 0 means no pain and 10 means the worst pain imaginable . Faces Pain Scale and Revised Faces Pain Scale comprise different facial expressions indicating different severity of pain experienced by patients . They have been validated among different older populations and were rated as preferred tools over the NRS by Chinese and African-Americans . The Iowa Pain Thermometer is a descriptor scale presented alongside a thermometer to help patients conceptualize pain intensity as temperature levels . Compared to the FPS, Verbal Descriptor Scale, and visual analog scale, the IPT is deemed to be the most preferred scale among older adults .
When To Contact A Medical Professional
- Back pain after a severe blow or fall
- Burning with urination or blood in your urine
- History of cancer
- Loss of control over urine or stool
- Pain traveling down your legs below the knee
- Pain that is worse when you lie down or pain that wakes you up at night
- Redness or swelling on the back or spine
- Severe pain that does not allow you to get comfortable
- Unexplained fever with back pain
- Weakness or numbness in your buttocks, thigh, leg, or pelvis
Also call if:
- You have been losing weight unintentionally
- You use steroids or intravenous drugs
- You have had back pain before, but this episode is different and feels worse
- This episode of back pain has lasted longer than 4 weeks
The Most Common Causes Of Lower Back Pain Are A Strain Or Sprain
Whether you notice it or not, your lumbar spine gets put to work throughout the entire day.
Amid all of this work and motion, a lower back sprain or strain can result from an acute injury, such as one experienced while falling, lifting something too heavy or playing sports. A sprain or strain can also develop over time due to repetitive movements or poor posture.
“Straining a muscle or spraining a ligament are the most common causes of lower back pain,” says Dr. Palmer. “While they can be serious, these common causes of lower back pain aren’t long-lasting taking anywhere from a few days to heal or, at most, a few months.”
Your doctor can help you determine the particular course of self-care that can help heal your lower back pain.
“The treatment for a pulled back muscle or strained back ligament is fairly simple and can include pain and anti-inflammatory medications, muscle relaxers, ice to help reduce inflammation, heat to promote healing, and avoiding strenuous activity until the pain recedes,” explains Dr. Palmer. “The best course of care will depend on the severity of your injury as well as your overall core and lower body strength.”
If your lower back pain persists despite treatment, it may be time to consider other causes of lower back pain.
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Back Pain In Women In The Perimenopausal Period
PubMed databases were investigated. After the search was narrowed to menopausal status, back pain, 35 studies were found.
The selected studies were analyzed to verify whether they described the perimenopausal period of life, correlated back pain and menopausal status, divided the study group into sub-groups depending on the menopausal status .
Twenty-eight papers were excluded due to lack of information about back pain and menopausal status. Seven studies, which suited our area of research best, were thoroughly analyzed.
Most studies divided women into five groups:
Premenopausal women who had had a regular period in the past three months.
Early perimenopausal women who had an irregular period in the past three months.
Late perimenopausal women who had menstruated irregularly in the last 12 months but not in the last 3 months.
Postmenopausal women who had not menstruated in the last 12 months.
A separate group of women who have hormone replacement therapy.
All analyzed studies showed that women who are experiencing or experienced menopause suffered from increased joint and spine pain.
A long-term study by Szoeke et al. established that in the period of 8 years, the number of women suffering from back pain grew from 44% to 59%. Most women who took part in this study went from the premenopausal to postmenopausal stage during the study. The authors of the study also noticed a direct association between increased BMI and increased spine pain.
Bloated Stomach And Back Pain
Other causes of bloating and back pain are
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Potential Causes Of Low Back Pain
Non-specific or mechanical low back pain
Like among young adults, the majority of LBP among older adults has no definite pathology and is diagnosed as non-specific LBP. These patients experience LBP that is altered by posture, activity, or time of the day. Non-specific LBP may originate from different pain sources . Disc degeneration on magnetic resonance imaging is more prevalent with age progression and as such in older adults however, it is less likely to be the pain source as compared to young adults . Conversely, facet joint pain in seniors may present as localized LBP with or without posterior thigh pain during walking. The pain may be aggravated during trunk extension, ipsilateral lateral flexion, and/or rotation . Lumbar degenerative spondylolisthesis is common among women aged 60 years or older and is usually associated with facet hypertrophy . The presence of degenerative spondylolisthesis alongside facet hypertrophy and thickening of ligamentum flavum may results in pain, spinal stenosis, and neurological deficits in older adults . Although spinal degenerative changes may induce LBP, not all anomalies on lumbar medical imaging are related to LBP because abnormal imaging phenotypes are ubiquitous among asymptomatic older adults .
Radiculopathy
Osteoporotic vertebral fractures
De novo degenerative lumbar scoliosis
Tumors/cancers
Spinal infection
Visceral diseases
Cauda equina syndrome
When To Call A Doctor
911 or other emergency services immediately if:
- Back pain occurs with chest pain or other symptoms of a heart attack. Symptoms of a heart attack include:
- Chest pain or pressure, or a strange feeling in your chest.
- Sweating.
- Feeling dizzy or lightheaded.
- A fast or uneven heartbeat.
- You have a new loss of bowel or bladder control.
- You have new or worse numbness in your legs.
- You have new or worse weakness in your legs.
- You have new or increased back pain with fever, painful urination, or other signs of a urinary tract infection.
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Manage Every Day Stress
Stress causes the body to release hormones that causes muscles to tense, which can lead to back pain. It might surprise you, but reducing stress levels could actually be beneficial in reducing lower back pain.
“Find coping mechanisms that help you to cope with everyday stresses, for example, yoga, cooking or enjoying time outside,” suggests Dr Powles. Try yoga nidra, sleep-guided meditations or breathing exercises to help you relax in moments of stress. Make time for yourself every day, whether that’s doing your favourite hobby or reading a book before bed.
Change Your Sleeping Position
Extended bed rest causes muscles to seize up and weaken so it’s best to avoid lying down when you have back pain, and stick to sitting or standing up, instead.
If you’re suffering back pain at night, place a pillow under your knees to ease the strain on your spine, or between your knees if you’re lying on your side. You could also invest in the best pillow for back pain depending on your sleeping position, and put this to use when pain strikes.
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Back Pain Treatment For Women In West Jersey
Contrary to what you may have been led to believe, back pain is not part of aging. If you are living with chronic back pain, seek help from an orthopedic doctor.
At the Orthopedic Associates of West Jersey, our talented orthopedic team can provide immediate relief from pain and recommend the appropriate treatments for the condition causing your back pain. Our goal is to get you the best results possible, which is pain-free living.
To schedule a consultation with an orthopedic surgeon, call the Orthopedic Associates of West Jersey at 989-0888 or request an appointment now. Our friendly staff is excited to serve you in our Dover clinic.
Frequently Asked Questionsexpand All
Once other causes for your pain are ruled out, your ob-gyn or other obstetric care provider may recommend that you see a rehabilitation specialist or a physical therapist. He or she also may recommend a maternity girdle or brace if you arent already using one.
Yes, exercises for the back can:
Strengthen and stretch the muscles that support your back and legs
Promote good posture
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Cystitis Or Urinary Tract Infections
Cystitis refers to inflammation in the bladder due to a bacterial infection. This happens because vaginal, rectal, or skin bacteria can enter the urethra and make their way to the bladder.
A urinary tract infection is one that can occur anywhere in the system, while cystitis occurs only in the bladder.
Both conditions are common in women. These infections will sometimes clear up on their own, but a short course of antibiotics will typically treat cystitis and other UTIs.
Talk Openly With Your Partner
As for back pain and sex difficulties between partners, âItâs something thatâs really important to discuss,â Marks says. Over the years, his patients have confided that they are reluctant to tell their partners that they canât have sex because it hurts too much or that they want to change longstanding sexual positions to ease the pain.
Chronic back pain can also lead to moodiness or depression. âWhen youâre depressed, itâs hard to perform,â Marks says.
When a couple starts having less sex without any discussion, not only the relationship, but a sense of trust, erodes. One of Marksâ patients who failed to explain that back pain caused their loss of interest discovered to their dismay that their partner suspected them of having an affair.
Sometimes, not only does a back patient fear pain, but a partner also worries about hurting the person during sex, according to Lauren Hebert, DPT, OCS, a physical therapist in Dixfield, Maine, and author of Sex and Back Pain. â can be just as disabling,â he says.
In contrast, when partners are open about the problems, they can find alternatives to keep sex enjoyable.
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Causes Of Hip Pain In Women
When a female patient comes to Dr. Siegrist complaining of hip pain, she considers the patient’s age, build, and activity level. If the patient is a thin 20-year-old runner or a heavy, sedentary 80-year-old grandmother, the possibilities at the top of my list will be different, she says.
Among the most common causes of hip pain in women are:
1. Arthritis Chronic hip pain in women is often due to arthritis, particularly osteoarthritis, the wear-and-tear kind that affects many people as they age. The ball-and-socket joint starts to wear out, Siegrist says. Arthritis pain is often felt in the front of your thigh or in the groin, because of stiffness or swelling in the joint.
2. Hip fractures Hip fractures are common in older women, especially those with osteoporosis . Symptoms of a hip fracture include pain when you straighten, lift, or stand on your leg. Also, the toes on your injured side will appear to turn out, a sign that can aid your doctors preliminary diagnosis.
Possible Cause: Spinal Compression Fracture
As a general rule, the possibility of compression fracture should be considered after any sudden onset of back pain in adults over age 50, especially in post-menopausal women with osteoporosis and in men or women after long-term corticosteroid use. In a person with osteoporosis, even a small amount of force put on the spine, as from a sneeze, may cause a compression fracture.
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Ready To Address Your Back Pain
The University of Maryland Spine Network can help you put your pain behind you. With convenient locations throughout the state, the UM Spine Network is home to the region’s leading spine surgeons and specialists that can help you identify the source of your pain and put an end to it for good.
Put an end to your back pain. Find a spine specialist near you.
In This Section:
What Is Upper And Middle Back Pain
Upper and middle back pain can occur anywhere from the base of your neck to the bottom of your rib cage.
Your ribs attach to a long, flat bone in the center of the chest called the sternum and attach to and wrap around your back. If a nerve in this area is pinched, irritated, or injured, you may also feel pain in other places where the nerve travels, such as your arms, legs, chest, and belly.
The upper and middle back has:
- 12 vertebrae. These bones attach to your rib cage. They make up the longest part of your back.
- Discs that separate each vertebra and absorb shock as you move.
- Muscles and ligaments that hold the spine together.
See a picture of thespine.
Upper and middle back pain is not as common as low back pain or neck pain, because the bones in this area of the back don’t flex or move as much as the bones in your lower back or neck. Instead, they work with the ribs to keep the back stable and help protect vital organs, such as the heart and lungs.
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Sports Hernia Vs Traditional Hernia
Although it is similarly named, this particular syndrome differs from a traditional hernia, which involves the bulging of fat or organs through a weak area of muscle or connective tissue.
Sports hernias, like adductor strains, traditionally occur while playing activities like hockey or soccer that involve a lot of cutting or quick changes in direction.
The groin pain associated with athletic pubalgia is usually severe while playing sports or exercising, but better with rest.
Unlike a traditional hernia, there is not a palpable bulge in the area of injury .
Ultimately, your primary healthcare provider typically treats this condition similar to an adductor strain with:
- The RICE principle
- Over-the-counter pain medications
- Physical therapy to help build strength in your core, improve flexibility, and gradually reintroduce cutting and sports-related activities.
What Causes Lower Back Pain
Many injuries, conditions and diseases can cause lower back pain. They include:
- Strains and sprains: Back strains and sprains are the most common cause of back pain. You can injure muscles, tendons or ligaments by lifting something too heavy or not lifting safely. Some people strain their back by sneezing, coughing, twisting or bending over.
- Fractures: The bones in the spine can break during an accident, like a car crash or a fall. Certain conditions increase the risk of fractures.
- Disk problems: Disks cushion the vertebrae . Disks can bulge from their position in the spine and press on a nerve. They can also tear . With age, disks can get flatter and offer less protection .
- Structural problems: A condition called spinal stenosis happens when the spinal column is too narrow for the spinal cord. Something pinching the spinal cord can cause severe sciatic nerve pain and lower back pain. Scoliosis can lead to pain, stiffness and difficulty moving.
- Arthritis: Osteoarthritis is the most common type of arthritis to cause lower back pain. Ankylosing spondylitis causes lower back pain, inflammation and stiffness in the spine.
- Disease:Spine tumors, infections and several types of cancer can cause back pain. Other conditions can cause back pain, too. These include kidney stones and abdominal aortic aneurysm.
- Spondylolisthesis: This condition causes the vertebrae in the spine to slip out of place. Spondylolisthesis leads to low back pain and often leg pain as well.
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