Almost everyone experiences back pain at some point in life. Nearly 8 out of 10 adults will experience significant low back pain during their lifetime, making it one of the leading causes of disability worldwide.¹
For many adults over 50, back pain becomes much more than an occasional ache. It begins interfering with everyday activities such as golfing, playing pickleball, traveling, gardening, walking the beach, sleeping comfortably, or simply picking up grandchildren.
The encouraging news is that most episodes of back pain improve without surgery, and many people can significantly reduce pain and improve function through education, exercise, lifestyle changes, and individualized treatment.²
In this guide, you’ll learn:
- Why back pain develops
- The most common causes
- When back pain is serious
- Evidence-based treatment options
- Exercises that often help
- How to prevent recurring episodes
- When to seek professional care
How Common Is Back Pain?
Low back pain affects more than 600 million people worldwide, and experts project that number will grow to roughly 843 million by 2050 as populations age.³
It is also one of the leading reasons adults seek medical care and one of the most common causes of disability across the globe.¹
Fortunately, research shows that remaining appropriately active during recovery often leads to better outcomes than prolonged rest.⁴
Understanding Your Spine
The spine is remarkably strong. It is designed to bend, twist, absorb force, and support the body throughout daily life.
Pain does not necessarily mean something is “out of place.” Modern pain science has shown that many episodes of back pain result from irritated tissues becoming temporarily more sensitive rather than from severe structural damage.²
What Causes Back Pain?
Muscle or Ligament Strain
Muscle and ligament injuries remain the most common cause of acute back pain. They often occur after:
- Lifting
- Yard work
- Prolonged sitting
- Sudden increases in activity
- Awkward movements
Most improve substantially within several weeks.⁴
Degenerative Disc Changes
As we age, spinal discs naturally lose water content. This process is considered a normal part of aging, much like wrinkles or gray hair. Studies consistently demonstrate that many adults with disc degeneration have little or no back pain at all.⁵
Arthritis
Facet joints in the spine can develop arthritis similar to that seen in the knees or hips, and bone spurs can form on the vertebral endplates next to the discs.
Symptoms commonly include:
- Morning stiffness
- Pain after standing
- Discomfort during walking
- Reduced flexibility
Exercise remains one of the most effective conservative treatments.²
Herniated Disc
A herniated disc occurs when disc material pushes outward and may irritate nearby nerves. Symptoms may include:
- Leg pain
- Numbness
- Tingling
- Weakness
However, MRI studies show that many healthy adults without pain have herniated discs, demonstrating that imaging findings do not always explain symptoms.⁵
Sciatica
Sciatica describes irritation of the sciatic nerve. Pain commonly radiates into the buttock, thigh, calf, or foot rather than remaining isolated in the lower back.
Spinal Stenosis
Spinal stenosis becomes increasingly common after age 60. It refers to a narrowing of the openings through which spinal nerves pass as they exit the spine — most often caused by a combination of bone spurs, thickened ligaments, and bulging discs.
People often report:
- Pain while walking
- Improvement when sitting
- Feeling better while leaning over a shopping cart
Many individuals improve with individualized exercise programs and conservative treatment.²
Why Imaging Often Doesn’t Tell the Whole Story
Many people believe they need an MRI immediately after developing back pain. Current clinical guidelines recommend otherwise.⁴
Large research studies have shown that adults without pain frequently have:
- Bulging discs
- Arthritis
- Spinal stenosis
- Degenerative discs
These findings often represent normal age-related changes rather than the actual source of pain.⁵
Imaging is generally recommended when:
- Symptoms suggest a serious medical condition
- Significant trauma has occurred
- Progressive neurological weakness develops
- Surgery or injections are being considered
- Symptoms persist despite best efforts with conservative care⁴
Red Flags: When You Should Seek Immediate Medical Care
Although most back pain is not dangerous, seek immediate medical attention if you experience:
- Loss of bowel or bladder control
- Numbness around the groin or saddle region
- Rapidly worsening leg weakness
- Unexplained fever
- Recent major trauma
- Unexplained weight loss
- A history of cancer with new, severe back pain
- Severe pain that is constant and unrelated to movement⁴
What Actually Helps Back Pain?
Keep Moving
One of the strongest conclusions from decades of research is that movement is medicine. Prolonged bed rest generally delays recovery. Walking is often one of the safest and most effective places to begin.²
Exercise
Exercise consistently demonstrates moderate to strong evidence for reducing pain, improving function, decreasing recurrence, and improving confidence with movement.² Helpful exercises often include:
- Walking
- Core endurance
- Hip strengthening
- Mobility exercises
- Balance training
- Flexibility work
The best program is individualized to each person’s needs.
Physical Therapy
Evidence-based physical therapy focuses on restoring movement, improving strength, reducing fear of movement, improving balance, and educating patients about pain. Treatment may include:
- Therapeutic exercise
- Manual therapy
- Movement retraining
- Education
- Progressive strengthening²
Lifestyle Matters
Recovery is influenced by much more than the spine itself. Research increasingly supports the importance of:
- Sleep quality
- Physical activity
- Nutrition
- Stress management
- Smoking cessation
- Maintaining a healthy body weight¹·²·⁶
Advanced Non-Surgical Treatment Options
At Kriz Mobility and Vitality, treatment plans may incorporate advanced technologies when appropriate, based on an individual’s examination findings, diagnosis, and goals. These may include:
- Neuromodulation
- Radial shockwave therapy
- Photobiomodulation (light therapy)
- Manual therapy
- Therapeutic exercise
- Balance and gait training
- Functional movement retraining
Current evidence suggests that these interventions are most effective when integrated into a comprehensive rehabilitation program rather than used in isolation.²
Five Habits That Help Prevent Back Pain
1. Walk Daily
Regular walking improves circulation, endurance, and spinal health.²
2. Build Strength
Strong hips, legs, and trunk muscles reduce mechanical stress placed on the spine.⁷
3. Avoid Staying in One Position Too Long
Changing positions every 30–60 minutes may reduce stiffness and discomfort.
4. Practice Good Lifting Mechanics
Keeping objects close to your body and avoiding twisting while lifting helps reduce unnecessary stress on the spine.
5. Stay Active
Research consistently shows that individuals who remain physically active generally recover faster and experience fewer future episodes of back pain.²
References
1. Hartvigsen J, Hancock MJ, Kongsted A, et al. What Low Back Pain Is and Why We Need to Pay Attention. The Lancet. 2018;391(10137):2356-2367.
2. Qaseem A, Wilt TJ, McLean RM, Forciea MA; Clinical Guidelines Committee of the American College of Physicians. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Annals of Internal Medicine. 2017;166(7):514-530.
3. World Health Organization. Low Back Pain. Fact sheet, 2023.
4. Chou R, Deyo R, Friedly J, et al. Noninvasive Treatments for Low Back Pain. Agency for Healthcare Research and Quality (AHRQ). Comparative Effectiveness Review No. 169. 2016.
5. Brinjikji W, Luetmer PH, Comstock B, et al. Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. American Journal of Neuroradiology. 2015;36(4):811-816.
6. Foster NE, Anema JR, Cherkin D, et al. Prevention and Treatment of Low Back Pain: Evidence, Challenges, and Promising Directions. The Lancet. 2018;391(10137):2368-2383.
7. George SZ, Fritz JM, Silfies SP, et al. Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021. Journal of Orthopaedic & Sports Physical Therapy. 2021;51(11):CPG1-CPG60.
This material is educational in nature and is not a substitute for individualized medical advice, diagnosis, or treatment. Consult a qualified health care provider with any questions regarding a medical condition.
