Discover This Little Known Hidden Culprit For Low Back Pain With Older Adults

For the past decade I’ve been primarily focusing on coaching middle age and older adults and without question, the most common issue that gets brought up in PAR-Q’s (physical activity readiness questionnaire) is suffering at times with some degree of low back pain.

Now this probably won’t surprise anyone, but have you ever stopped to wonder why low back issues are so common once we get on the south side of forty? I mean it’s not like everyone injured their back in an accident or suffers from a degenerative condition.

How do we explain the commonplace for low back pain with some many individuals who never had issues when they were younger? Well, I believe there’s a simple explanation for this, but it may not be what you think.

We can find clues in looking at how most people go about treating their low back pain. Whenever I ask individuals about their previous solutions, I hear all kinds of things from getting chiropractic care to inversion tables, massages, heat wraps, muscle relaxants, stretches, etc.

Now many of these things can be helpful, but far too often I see a BIG mistake being made when it comes to identifying the real underlying root problem. And identifying the root problem will be necessary if we’re going to seek a long-term solution, not just a temporary fix to relieve the pain.

The low back hurts so therefore we must treat the low back, right?

Herein lies the problem. We tend to treat ONLY what “hurts” instead of ALSO looking for why something hurts in the first place.

Now before I go any further, let me make sure to preface I’m not talking about legitimate injuries to spinal vertebrae with things like a herniated or ruptured disk. These are issues for a spinal health professional and not the scope of this article.

I’m talking more about that nagging stiffness that persists in your low back for example. Or perhaps occasional nerve pain that radiates down one side, like with sciatica. Maybe acute or chronic discomfort when sitting for long periods. And/or finding yourself frequently twisting or turning the wrong way doing something simple and then suddenly feeling like your back is “out.” Suffering with the pain and discomfort until the muscles release and things calm down (sometimes taking days or even weeks).

Now while these could be indicators of a legitimate degenerative condition or more serious issue, it also could also be simply due to muscular imbalances and joint mobility issues.

Obviously, when it doubt get it checked out.

But just FYI, if you go to your family physician for low back pain, you’re likely wasting your time. That is unless you’re lucky enough to have an old school doctor that still practices medicine (instead of just prescribing it) and doesn’t see seventy-five patients a day. I’m being kind of sarcastic, and kind of not.

Seriously though, I’d recommend you start by seeing a reputable Doctor of Chiropractic over a general practice physician for low back pain. They’ve simply got more specialized training in spinal health to give you a clearer picture of what’s going on.

So, for the purpose of this discussion, let’s just assume we’re not dealing with an injury or degenerative condition with spinal vertebrae. So, what’s really up with all this frequency of low back issues with older adults?

I believe there’s a simple explanation for the vast majority of these cases. The technical term used in the exercise physiology is “lower crossed syndrome” but that makes it sound like some condition a person was born with. It’s not, rather it’s basically a condition where the following things happen.

• The muscles and connective tissue in and around the anterior part of your hips get really tight.
• The glutes (your butt muscles) get weak.
• The hamstrings get super tight because your hips are being pulled forward.
• The deep core muscles that support your pelvis, back, and rib cage get weak.

The above combination is a recipe for…..you guessed it, low back pain.

Why?

Well because, that’s the weak link in the chain where all the tension goes due to other guys not doing their jobs. The paraspinal muscles and lumbar erectors (low back muscles) aren’t supposed to be bearing the brunt of the majority of stabilization to the spine or being prime movers with things like hip extension and rotation.

When this all gets out of balance, things like muscle strains are more likely to occur, pelvic displacement (one side of your hip hiking up higher than the other) may happen, vertebrae can get compressed, and any of this can lead to nerve endings getting pressed, thereby triggering pain.

Ok, obvious next question, why does this lower crossed syndrome condition happen? What causes it?

Again, not a single reason, but more likely a combination of the following:

• Spending too much time sitting down instead of being ambulatory (moving about). The more you sit, the longer your hips get put into an anterior tilt, thereby triggering the muscular imbalances associated with lower crossed syndrome. Whether it was sitting a desk for work, behind the wheel, or in the Lazy-boy, do this for long enough (the more years, the more we compound the imbalances) and you’ll find yourself having some back issues. Period.

• Decreased physical activity. The less you move about the weaker you’ll get. Not talking about exercise exclusively here, just being on your feet moving about through functional patterns. Reaching, bending over picking things up, hinging, squatting, pushing, pulling, etc.

• Not doing resistance based exercise (strength training) for the muscles that support the hips and lumbar spine. The primary group being the glute muscles that often get overlooked. You must, must, must strengthen the glutes or you’ll have back issues. They help draw your hips back into a posterior tilt and provide the tension for hip extension (hinging from your hips and bending over to pick something up). And just FYI, no walking won’t do jack to strengthen the glutes. That is unless you’re going up an incline while carrying something heavy in both hands. Bottom line is when individuals stopped or never started for that matter, working on strengthening the glutes with resistance exercise, they simply get weak over time as we age and the imbalance does and will promote low back pain.

• Not doing core strengthening and stabilization exercises OR doing the wrong ones. A weak core equals low back problems. Let’s just make this simple. You need to provide stability to your pelvis and lumbar spine which comes from the glutes and deep core muscles. Think about things like planks or farmers walks instead of sit-ups and crunches. A lot of folks, if they do core work at all, will attempt to work their abs with flexion-based exercises like sit-ups or ab machines which only make the anterior hip tightness worse! I did a post on this recently which was titled “Why middle age and older adults should avoid ab machines.” Check it out to learn more.

• Degeneration of fascia and connective tissue due to inflammation and oxidation. This doesn’t get nearly enough attention, but it’s huge and a significant factor in people dealing with joint pain in general along with arthritis, etc. You see throughout our body we have this connective tissue called fascia (which is basically a thin fibrous band of connective tissue that wraps around and supports muscles, joints, and internal organs). Now when you’re younger, this fascia is pliable, spongy, and has a lot of flex. As we age it tends to get stiffer. But here’s the kicker. What we do as we age regarding nutrition and lifestyle plays a huge difference.

If you want to keep fascia healthy you need to do things like stay adequately hydrated, consume natural whole foods rich in antioxidants, get plenty of oxygen to the cells with regular physical activity / exercise. Basically, live a healthy lifestyle.

How do you gum up this fascia and make it stiff and rigid? You guessed it, by doing things that promote inflammation and oxidation. You know, eat crappy foods, drink too much alcohol, use tobacco, don’t stretch or exercise regularly, and basically do the opposite of living a healthy lifestyle.

Bottom line... 

Hopefully, this is starting to click. Low back problems are often the result of habits, routines, and lifestyle choices made over years, not days and weeks.

While the PAIN shows up in the low back and this obviously needs to treated, far too often, once the pain is dealt with, people go back to the same habits and routines. The ones that triggered the low back pain in the first place.

You can try and stretch the low back all you want and get various treatments and adjustments until the cows come home, but often times this is dealing with the symptoms instead of the problem.

When I meet with a new client for the first time, before we ever start working out, I always do a movement assessment to evaluate for muscle imbalances and joint mobility issues. This helps to uncover the issues that could be triggering things like sciatica. A comprehensive plan of strengthening what needs strengthened, stabilizing what needs stabilized, and mobilizing the joints that need more mobility, can often eliminate low back pain altogether.

Also, sometimes the most effective thing to do for low back pain is focusing on losing weight. Seems obvious, and it is, but don’t overlook the huge benefit of taking added tension off the lumbar spine by reducing the extra weight pulling on the other side (belly). That plus the reduction in inflammation and improved mobility can be a game changer.

I want to encourage you if you’re someone dealing with low back pain. While you can’t control all the variables, especially if you’re dealing with an injury or degenerative condition, you can focus on what you do have control over (and that’s what you do with nutrition, exercise, lifestyle habits, etc).

I’ve witnessed numerous success stories where individuals went from debilitating back problems to being pain free by focusing on the root problems and not just the symptoms.

I get it that it can be hard to know what to do and navigate finding solutions, especially with today’s broken model of what we call “heath care.” That’s why I strongly recommend searching out individuals who are highly knowledgeable in their respective field of practice, but also have a heart for serving and caring for others. It may take some work, but it will be worth it.

Get a broad base of input from those who focus on treating the root problems and not just the symptoms. If I can be of assistance in any way please don’t hesitate to let me know. Even if that’s just for a movement assessment evaluation and referral to a good chiropractor, physical therapist, or other professional, I’m happy to help in any way. Until next time, be blessed. - S

Shane Doll is a certified Charleston personal trainer, strength and conditioning coach, and founder of Shaping Concepts Personal Training Studios. He has over 24 years' experience with fitness coaching and consulting and specializes in training programs for middle age and mature adults. If you live in the Charleston, SC area you can schedule a no-obligations consultation.