If you’re over 50 with chronic back pain, the chances are you’re missing the one thing that can actually make a difference: resistance training.
First, a couple of analogies to help the point I’m about to make stick:
What would you say to a person who was struggling with their weight but survived on take-away food for much of the week?
Start preparing your own meals perhaps?
Or how about a person who was smoking 20 cigarettes a day and was complaining about a persistent cough?
Stop smoking?
Right. More easily said than done obviously, but you get my point.
So what do you think a Doctor should say to a 55 year old man who is complaining of episodic back pain?
Just last week I met a gentleman who was in this very position. He’d never resistance trained before and was suffering with episodes of back pain that had slowly got worse over the years. No red flags were reported.
What did his GP do? Refer him on for a scan. And this was on the cash-strapped National Health Service.
Whilst I’m not privy to the GP’s thought process, I can tell you this particular gentleman was convinced that an injection would solve all of his problems.
The evidence for this is not well established.
Resistance training is the elephant in the room
If you’re over 50 and you’ve been suffering with back pain on and off over the years, and these episodes are getting worse, what’s changed?
My apologies if this comes as a surprise, you’re getting older.
And what happens as you get older? You begin to lose muscle. Up to 3-8% per decade after 30, accelerating after 60.
So that back pain you had in your 30s or 40s was an indication your back wasn’t tolerating the demands of your life particularly well.
Now you’re in your 50s, do you think that situation has improved or worsened over time?
Exactly.
No amount of injections, massage, manipulation, or whatever else you can think of, will close that gap for you.
A well designed and executed resistance training programme will however.
Summary
The evidence suggests that further medical investigations for uncomplicated lower back pain can lead to worse outcomes.
Providing there are no red flags, then the elephant in the room is often a lack of resistance training for people over 50.
Prioritise this above all else, not just for your back pain, but for your general health as well.