Prevention and treatment of low back pain in the elderly

Author Fan Bifa Wang Wen

Editor health care jun

The trouble of low back pain

Low back pain is one of the physical discomforts that the elderly often encounter. It is estimated that more than 80% people have had various low back pains in their lives. Low back pain not only affects the overall health of the elderly, but also affects daily activities.

Some elderly people often misunderstand low back pain, thinking that it is a normal phenomenon of human aging and can be tolerated. There are also some elderly people who are worried about drug addiction or adverse drug reactions and are unwilling to use analgesic drugs.

Then, how should we correctly understand low back pain and how should we correctly prevent and treat it?

Correct understanding of low back pain

First of all, we should know that low back pain is a very common phenomenon among people, but for many people, low back pain is self-limiting, which can be relieved without special treatment and often disappears by itself within a few weeks.

But for others, low back pain will recur or exist for a long time, which will affect work and life in severe cases.

Therefore, the elderly who are experiencing low back pain need not worry too much. But if there are the following situations at the same time, you need to go to the hospital in time.

Have a history of cancer, osteoporosis or diabetes.

Long-term use of hormonal drugs such as prednisone.

Have recently fallen or suffered back injuries.

There are numbness and weakness in the legs, abnormal defecation, unexplained weight loss, fever or other discomfort.

The pain is mainly at night, and it is difficult to carry out normal activities because the early treatment is ineffective or the pain is severe.

Low back pain did not improve within 4 weeks, or new pain appeared.

Who is prone to low back pain?

Generally speaking, people who are older, female, obese, smoking, engaged in heavy manual labor or sedentary for a long time will have a higher incidence of low back pain.

Causes of low back pain

The range of diseases related to low back pain is very wide, and the specific causes of most people cannot be accurately determined. Some people may be caused by muscle strain, some may be caused by spinal fractures, some may be early manifestations of serious spinal diseases, and even more may be the reaction of pathological changes in other parts of the body.

Nonspecific low back pain

Most patients with low back pain who come to the hospital are nonspecific low back pain, and many of them have musculoskeletal pain. After several weeks of conservative treatment or self-care, they can usually be relieved and improved.

There is no particularly serious reason.

In a few cases, patients have specific causes that are not too serious, such as mild vertebral compression fracture, lumbar disc herniation or lumbar spinal stenosis.

Serious systemic diseases

In rare cases, low back pain is a precursor to serious diseases, such as metastatic cancer and spinal infection.

Other possible reasons

Other causes may include ankylosing spondylitis and sacroiliitis.

Of course, low back pain may also originate from other parts of the body, such as pancreatitis, kidney calculi's disease, pyelonephritis, abdominal aortic aneurysm or herpes zoster. These patients usually have other accompanying symptoms besides low back pain.

What kind of low back pain do you have?

If you want to know what kind of low back pain you belong to, the elderly who are experiencing low back pain can classify and judge according to the length of pain, which is helpful for subsequent treatment.

Acute low back pain

The duration of low back pain is less than 1 month.

Subacute low back pain

The duration of low back pain was 65438 0.3 months.

Chronic lumbago

Low back pain lasts for more than 3 months.

How to treat low back pain

Acute low back pain

Physiotherapy, massage, acupuncture and massage are generally recommended;

Keep active and avoid staying in bed for a long time. Although you should not lift heavy objects or take part in sports when you have low back pain, you should try your best to engage in daily activities as long as you can bear it.

For patients who are ineffective in non-drug therapy or who prefer drug therapy, follow the guidance of professional medical personnel to use drugs, including oral or external analgesic drugs or muscle relaxants. Patients who have not improved after 4 weeks of drug treatment should see a doctor in time.

Subacute low back pain

Exercise therapy is recommended, including walking, aerobic exercise, stretching, Pilates, yoga, Tai Chi, core muscle training, spinal stability training, rehabilitation and so on.

Chronic lumbago

It usually starts with rest and pain relief, and then exercises to restore the strength of the back.

If these treatments fail, or if the pain is caused by some disease or injury, surgery may be needed.

Specific methods to prevent and treat low back pain

Ice compress

It is recommended to apply ice within the first 24-48 hours after the onset of acute low back pain.

Specifically, put the ice cubes in a plastic bag and put a towel between the skin and the ice pack, and ice them for 20 minutes each time, 2-3 times a day.

heat

The specific method is to use a wet hot compress bag or a heating pad and put a towel between the skin and the heat source for 20 to 30 minutes each time. If the skin turns bright red, please remove the heat source to ensure no pain or burning sensation.

Take a hot bath.

Avoid sedentary or standing for more than 30 minutes.

Avoid heavy physical labor, such as lifting heavy objects.

In order to maintain a healthy weight, obesity will bring too much pressure on the back and accelerate the aging and degeneration of the lumbar spine.

Maintain correct sitting and standing posture, sit up and stand up straight, and avoid leaning forward when sitting or bending over when standing.

When standing, keep your upper back and neck straight and your shoulders open to avoid drooping head and shoulders;

When sitting, keep your back straight and your shoulders relaxed. Don't hold your chest out or stretch your shoulders back.

When working, the body is close to the table, the neck is straight, the chin is contracted, and the elbow is bent 90;

When driving, the body is close to the steering wheel and the seat is raised. You can put a lumbar support on the seat.

When lifting a heavy object, you should use proper lifting skills, that is, bend your knees to keep the object close to your body and stand upright.

Proper exercise.

Take as many short trips as possible on a flat road and try to increase the walking time every day;

Lying or standing to rest is usually better than sitting to rest;

When taking a long break, you can do some light activities or stretching between breaks to help prevent stiffness and pain.

Following the advice of professionals, properly exercising the lower back muscles to keep the muscles strong and flexible is helpful to prevent low back pain or relieve the existing pain.

When doing this kind of exercise, if you have low back pain or discomfort, exercise 2 ~ 3 times a day; When the pain improves, exercise 1 time every day, but increase the number of repetitions of each exercise step; To prevent the recurrence of low back pain, exercise 1 time every day.

It is normal to feel slight stretching, stretching, tightness or discomfort during exercise, but if you feel sudden pain or aggravated pain, you should stop exercising immediately.

1. cat and cow style

Repeat the following steps until the waist becomes more flexible.

Hands and knees on the floor, hands shoulder width apart, knees under the hips.

Bow your head and hold your chest, contract your abdominal muscles, with your coccyx pointing to the floor and waist like a cat's back.

Hold this position for 5 seconds.

Slowly raise your head, relax your abdominal muscles, point your coccyx to the ceiling, and arch your waist like a cow's back.

Hold this position for 5 seconds.

2. Ascending dog style

Repeat the following steps 5 10 times.

Lie prone on the floor, palms on both sides of your head, shoulder width apart.

Relax your back as much as possible, keep your legs on the floor, push your arms slowly at the same time, lift your shoulders and upper body, and don't pull up your upper body with your back muscles. You can adjust the position of your hands to increase your comfort.

Hold this position for 5 seconds while keeping your back relaxed.

Slowly return to the prone position.

3. Bridge type

Repeat the following steps 10 times.

Lie flat on the hard floor, knees bent, feet flat on the floor, arms flat on your sides.

Tighten the hip muscles, lift the hip from the floor until the waist is almost the same height as the knee joint, and feel the muscles at the back of the hip and thigh exert force.

Hold this position for 3 5 seconds.

Slowly lower your hips, return to your original posture, and let your hip muscles relax completely.

Authors: Fan Bifa, Chief Physician of Pain Department of China-Japan Hospital, and Wang Wen, Attending Physician.

For more information about low back and leg pain in the elderly, please read the magazine Health Care for the Elderly all year round.

Expert introduction

Fan Bifa, chief physician, professor and doctoral supervisor. Director of Pain Department of Sino-Singapore Friendship Hospital, Director of National Pain Diagnosis and Treatment Research Center, Visiting Professor of American State University, and Deputy Director of National Engineering Laboratory of Neurocontrol Technology in Tsinghua University. President of Pain Physician Branch of Chinese Medical Doctor Association, Chairman of Pain Professional Committee of Chinese Association of Integrated Traditional Chinese and Western Medicine, Chairman of Pain Branch of former Chinese Medical Association, Director of Beijing Pain Treatment Quality Control and Improvement Center, editor-in-chief of China Pain Medicine Journal, editor-in-chief of Chinese Pain Journal, etc. He published more than 100 papers and edited 9 professional books.

Main direction: minimally invasive interventional therapy for neuropathic pain, cancer pain and chronic pain with neuromodulation technology.

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