Back and neck pain: a normal part of aging?

February 3, 2023

Back and neck pain are often considered a natural part of aging. But how much pain is normal and when could the discomfort signal something more serious?

While occasional aches and stiffness are typically harmless, certain symptoms could indicate an underlying medical condition, such as a tumor, infection, or nerve compression. Recognizing the warning signs can help ensure timely intervention and appropriate treatment.

Normal or not?

Mild back or neck pain is common as people grow older. Studies suggest up to 85 percent of people will experience some form of this pain in their lifetime. Most begin noticing discomfort between the ages of 40 and 60, although some may feel the effects of an aging spine as young as 30.

“Back pain is one of the top reasons people visit their doctors,” said Penn Medicine neurosurgeon James Thurmond, MD. “Besides the discomfort and impact on quality of life, it causes thousands of hours of missed work each year and interferes with time with family, friends, and hobbies. In addition, back pain has the potential to create dependency on prescription pain medications.”

When to see a doctor

Back or neck pain that is so severe it’s debilitating needs to be checked out by a physician, especially if you have significant pain when you do things you normally do, like exercise or work.

You should also talk to your doctor if you’re experiencing the following symptoms in addition to back or neck pain:

Fevers
Unexplained weight loss
Increased pain at night
Bladder or bowel incontinence
Pain that shoots down the legs
Numbness or tingling
Weakness
Severe pain that doesn't improve after you've rested
Pain that occurs after you've taken a fall or injured yourself

Even if you don’t have these symptoms, seeking medical advice can provide peace of mind and ensure you receive the appropriate care.

Managing and treating back and neck pain

While some level of discomfort may be unavoidable, chronic or severe pain doesn’t have to interfere with your daily life. Without treatment, back or neck pain can make it difficult to work, stay active, or enjoy your favorite activities.

To relieve pain, your physician might prescribe:

Medications to reduce pain and inflammation
Injections for targeted pain relief
Physical therapy to improve strength and mobility
Surgery in cases where other treatments are ineffective

What causes back or neck pain?

Many parts of the back can cause pain, including bones in the spine (vertebrae), discs, muscles, ligaments, nerves, and facets (the joints between each of the spinal bones).

Discs

Many times, back or neck pain comes down to discs, the gel-like cushions that rest between the vertebrae. They help maintain the natural curvature of your spine and allow your back to flex or bend. Most importantly, discs absorb shock as you walk or run.

When a disc ruptures, leaking its jelly-like center and irritating nearby nerves, it’s called a herniated disc. While herniated discs are probably the most common cause of back pain in younger people, they are still a common cause of pain in older patients.

As you get older, the discs dry out and become less spongy and pliable. They become rigid, increasing your risk of having a herniated disc.

Arthritis

Osteoarthritis—a "wear-and-tear" type of arthritis—is another common cause of back or neck pain.

The joints that connect the vertebrae are lined with cartilage, a flexible, elastic tissue. When you age, the cartilage fades away. At the same time, the discs lose water and become narrow, adding more pressure to the joints. This pressure causes inflammation and can lead to back pain.

When spine pain is primarily in the neck, it could be due to cervical spondylosis (arthritis of the neck). Cervical spondylosis develops when there is abnormal wear on the bones and cartilage in the neck.

Spinal stenosis

Spinal stenosis occurs when one or more areas of the spine narrow. The narrowing puts pressure on the spinal cord or nerves, causing pain, numbness, or cramping.

Aging is one of the biggest risk factors for spinal stenosis, but this condition can also be caused by:

Arthritis
Bone disease
Herniated discs
Tumors
Spinal cord injuries

Prevent back pain before it starts

Even though some back pain is to be expected with age, there are ways to lower your risk of severe pain.

Stay physically active

“Exercise can help delay or prevent back pain by strengthening the supporting structure of the spine,” said Thurmond. “Walking, stretching, and low-impact exercise help keep muscles strong and flexible. Too much rest leads to stiffness and weakness.”

Just be careful—if activity is causing more pain, talk to your physician. Anything that causes pain is bad. Pain is the body’s natural, built-in mechanism to tell you it doesn’t like what you’re doing. You should never do something that puts you in pain.

Maintain a healthy weight

Every pound on your body puts pressure on your musculoskeletal system. In general, each pound puts about four pounds of pressure on the system when you’re walking, and eight pounds when you’re running. The less pressure you can put on your back, the better. That's why it’s incredibly important to maintain a healthy weight.

Proper lifting and posture

Lifting with your legs, keeping the weight close to your body, and avoiding bending at the waist, puts less strain on your back. Also, good posture—sitting up straight with your shoulders back when standing—puts the least amount of strain on muscles and ligaments.

Don't smoke

“People who smoke are much more likely to develop chronic back pain than those who don’t smoke,” said Thurmond. “Smoking negatively affects the small blood vessels that send nutrients to the discs and joints of the spine. There are many reasons to stop—or better yet never start—including your back health.”

Just as the causes of back and neck pain are unique, so are the appropriate treatment strategies to successfully prevent and manage it. A medical exam and several tests can help your doctor identify the source of your pain, confirm a problem, rule out certain serious conditions, and then determine the best treatment.