There Is a Better Way to Manage Chronic Back Pain - At Any Age
IN SHORT
Chronic back pain is common as we get older and can affect much more than comfort. It can make standing, walking, getting out of a chair, climbing stairs, or getting dressed more difficult. Back pain can be related to tight or weak muscles, differences in leg length, arthritis, past injuries, or changes in the way someone stands or walks. When pain leads to less activity, strength can decline and everyday movement can become even harder.
What Is Back Pain?
Back pain is common, especially as we get older. It can range from an occasional ache to pain that lasts for months and begins to interfere with everyday life.
Chronic back pain does not always have one clear cause. Muscle tightness, weakness, arthritis, past injuries, and changes in the way someone stands or walks can all play a role.
For an older adult, chronic back pain can become about much more than pain. It may make everyday activities harder and can lead to doing less - and becoming weaker over time.
What Can Cause or Contribute to Back Pain?
Back pain has many possible causes. Some common factors include muscle tightness, muscle weakness, differences in leg length, arthritis, previous injuries, and changes in movement.
Tight Leg and Back Muscles
Muscle tightness can be part of the back-pain picture, but it isn't always where people think to look. Tightness in the hamstrings, piriformis, hip flexors, and trunk muscles can affect how the hips, pelvis, and back move together.
When these muscles are tight, standing, walking, bending, or getting out of a chair may become harder and can place extra stress on the back. Improving flexibility in these areas, along with building strength, can help improve how the body moves and may reduce some of the demands placed on the back.
Weak Leg and Trunk Muscles
The body needs a certain level of leg and trunk strength to support you comfortably through everyday movement. When these muscles are weak, the back may have to do more of the work, which can contribute to pain and difficulty moving.
Pain can also lead to weakness. When people move less because movement hurts, they gradually lose strength, creating a cycle of pain, less activity, weakness, and greater difficulty moving.
Building enough strength to support the body can help reduce the demands placed on the back.
Differences in Leg Length
A difference in leg length can occur naturally or develop after a hip or knee replacement, surgery, or a leg fracture. Sometimes the difference has been present for many years without causing problems.
As the body gets weaker or muscles become tighter, however, it may have more difficulty compensating for the difference. This can change the way someone stands or walks and may contribute to back pain, balance problems, or difficulty moving.
A leg-length difference does not necessarily cause pain, but it can be one factor to consider when looking at how someone moves and why they may be experiencing discomfort.
Treating Back Pain Is Often Layered
Back pain is rarely about just one thing. Tight muscles, weakness, movement patterns, balance, and endurance can all play a role - and they may need to be addressed at different points along the way.
Progress is often layered. As flexibility improves, there may be more opportunity to strengthen the muscles that need to provide support. As strength improves, exercises can become more challenging and focus on helping the body use that strength during everyday activities.
Strength and endurance are also different. A person may have enough muscle strength to stand in a good position, but not yet have the endurance to maintain that position for very long. Building both strength and endurance takes time and practice.
The process may involve working on one area, moving to another, and then returning to an earlier area as the person's abilities change. Progress may have ups and downs, but each step can build on what has already been gained.
How Can Strength Training Help With Back Pain?
Strength training can be an important part of managing chronic back pain.
For older adults, the focus should not be only on the back. Strengthening the legs and trunk is especially important because these muscles provide the strength and stability needed to support the body.
When the legs and trunk become stronger, the back may not have to work as hard to provide support. Strength training can also help address the weakness that develops when chronic pain leads to reduced activity.
Research supports exercise as part of managing chronic low back pain in older adults. A 2023 systematic review and meta-analysis of 18 randomized controlled trials involving adults age 60 and older found that exercise therapy improved pain, disability, and several quality-of-life measures.
Research specifically on progressive resistance training in older adults with low back pain also found improvements in physical function, although the evidence for reducing back pain itself was less conclusive. This supports focusing on strength and function rather than promising that strengthening alone will eliminate pain.
Because strength is not permanent, continuing to exercise is important for maintaining those gains. Exercise should be individualized and progressed gradually based on a person's abilities, symptoms, and goals.
Walking is important for staying active, but walking alone does not provide the same resistance needed to build and maintain muscle strength. For a closer look at the difference, see Walking Doesn't Keep You Walking.
https://tandemsb.com/news/walking-doesnt-keep-you-walking/
I'm Afraid Exercise Will Make My Back Pain Worse. What Should I Know?
This is a common concern. When your back hurts, it can be difficult to know whether exercise will help or make things worse.
The goal is not to push through pain. Exercises and stretches should be appropriate for your current abilities and adjusted if they are increasing your symptoms. Stretching should feel like a gentle pull, not pain.
Progress with chronic back pain is also rarely perfectly steady. There may be good days and harder days, and sometimes a person needs to return to an earlier exercise or reduce the challenge before moving forward again.
A physical therapist can help determine what exercises are appropriate, how much challenge is right, and how to adjust the program as your symptoms and abilities change.
The goal is to gradually improve flexibility, strength, and endurance while keeping exercise safe and manageable.
Why Is It So Hard to Manage Back Pain on Your Own?
One of the challenges of chronic back pain is that much of the work often falls on the person between therapy visits. A home exercise program can be helpful, but doing the exercises consistently can be difficult - especially for an older adult who is dealing with pain, weakness, or other health concerns.
Exercises may need to change as strength, flexibility, and symptoms change. What was appropriate a few weeks ago may no longer be the right level of challenge.
Having ongoing guidance can make it easier to stay consistent, know what to work on next, and keep making progress rather than trying to manage everything alone.
How Tandem Strength & Balance® Can Help With Chronic Back Pain
Chronic back pain can make it harder to stay active, build strength, and keep doing the things that matter. At Tandem Strength & Balance®, we provide private-pay, in-home physical therapy to help older adults address the strength, flexibility, and movement challenges that may be contributing to back pain and limiting everyday activities.
Each session is one-on-one with the same physical therapist. We can adjust the program as your flexibility, strength, endurance, and symptoms change, gradually progressing your exercises as you are able. Because we come to you, we can also work on movement in the environment where you actually live.
For older adults who find it difficult to manage chronic back pain and exercise on their own, ongoing guidance can provide the support and consistency needed to keep working toward greater strength, mobility, and independence.
You don't have to accept chronic back pain as a normal part of aging. If back pain is limiting what you can do, there may be more you can do to improve how you move and function.
Contact Tandem Strength & Balance today to schedule a Free In-Home Consultation. We'll come to you, complete a comprehensive assessment, and develop a personalized program based on your needs, abilities, and goals.
Research & Resources
World Health Organization. WHO guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings. 2023.
Zhang SK, et al. Effects of exercise therapy on disability, mobility, and quality of life in the elderly with chronic low back pain: a systematic review and meta-analysis of randomized controlled trials. Journal of Orthopaedic Surgery and Research. 2023;1
Syroyid Syroyid I, et al. Effects of Resistance Training on Pain Control and Physical Function in Older Adults With Low Back Pain: A Systematic Review With Meta-analysis. 2023.