Back and neck health later in life

The spine changes with age, just like skin, eyes and joints elsewhere in the body. Those changes are common and often cause no trouble at all, but they help explain why backs and necks can feel different later in life, and why staying active matters so much to older adults.

How the spine changes over time

The American Academy of Orthopaedic Surgeons explains in its OrthoInfo page on low back pain that the spine ages along with the rest of the body, and that ageing causes degenerative changes in the spine that can make people prone to back pain, especially if they overdo their activities. The same page is careful to add that these changes do not keep most people from leading productive and generally pain-free lives, and it offers the example of the older marathon runner whose back shows exactly those changes.

The main changes described in public health sources are these:

• Discs lose water and height and become less springy. MedlinePlus, in its guide to lifting and bending the right way, notes that the disks that act as cushions between the bones of the spine become less elastic with age.
• Muscles and ligaments become less flexible, which the same MedlinePlus page links with a greater chance of back injury when bending and lifting.
• Facet joints at the back of the spine can develop the same wear-and-tear changes as other joints, which is what people often mean by arthritis of the spine.
• The spinal canal can narrow in some people as discs, joints and ligaments change, a condition called spinal stenosis.

Changes on a scan are not the same as pain

One of the most reassuring points in this area is that the changes above are very common in people who have no pain at all. A scan report full of words like "degenerative", "spondylosis" or "disc bulge" often describes ordinary ageing. A health care provider will weigh those findings against your symptoms and examination rather than treating the report on its own as a diagnosis. The glossary explains many of these words.

Staying active later in life

MedlinePlus's page on exercise for older adults says that exercise and physical activity are good for just about everyone, including older adults, and describes the kinds of activity usually recommended:

• Endurance activities, such as brisk walking, dancing, swimming and cycling, which raise the breathing and heart rate;
• Strength exercises, such as lifting weights or using a resistance band;
• Balance exercises, which practise steadiness;
• Flexibility exercises, which stretch the muscles.

The same page notes that people who have not been active can start slowly and work up to their goal, and that how much exercise a person needs depends on their age and health, so it is worth checking with a health care provider about what is right for you. That advice applies with particular force to anyone with a heart or lung condition, osteoporosis, or a history of falls.

Everyday comfort

Older adults who stay comfortable often describe a handful of habits rather than any single secret: moving a little every day, even on days when the back feels stiff; breaking up long spells in a chair; keeping up the strength to get in and out of chairs, cars and the bath; and adapting jobs around the house rather than giving them up. Gardening from a kneeling pad rather than bending from the waist, carrying shopping in two lighter bags rather than one heavy one, and keeping often-used items between waist and shoulder height all reduce the load on the lower back. The lifting and carrying and staying active pages cover these ideas in more detail.

Sleep, rest and everyday stiffness

Many older adults notice that their backs feel stiffest first thing in the morning or after sitting for a long time, and loosen up once they start moving. Getting up slowly, moving around gently before tackling heavier jobs, and changing position regularly through the day are common ways people work with that pattern. A mattress and pillow that keep the spine comfortable, and a chair with good support that is easy to rise from, matter more as the years go by.

Falls and bone health

Falls are a particular concern later in life, both because they can injure the spine directly and because bones can become thinner with age. A fall followed by back pain, or new back pain in someone known to have thin bones, is worth getting checked promptly rather than waiting to see whether it settles. Sudden back pain after a minor strain, a cough or a sneeze in an older adult is another reason to see a provider. The When to see a doctor page lists other warning signs.