Lower Back Pain In The Over 60s

The aim of this blog is to shed light on some of the most likely reasons why people over 60 — whether yourself, a parent, or a friend — may struggle with back pain.

Lower back pain in the over 60s is one of my favourite age demographics and conditions to treat. Mainly because of the huge difference you can make to someone's daily life but also because of the complexities involved.

The average read time is 3–4 minutes.

This is not a complete list of possible causes, but it highlights the most common conditions that I see in practice: degenerative disc disease, facet joint osteoarthritis, spinal stenosis, and sciatica (which is a symptom not a cause... read on to learn more!).

Degenerative Disc Disease

As we age, the discs between our vertebrae lose hydration and shrink. Interestingly, this reduces the risk of disc herniation (“slipped disc”), but the loss of disc height increases the load on spinal joints, accelerating wear and tear.

Symptoms:

• Lower back pain and stiffness

• Reduced flexibility

• Leg weakness

• Nerve pain (sciatica), numbness, tingling

Long-term smoking can worsen degeneration by damaging the tiny blood vessels that supply discs with nutrients and removes waste.

Facet Joint Osteoarthritis

Facet joints sit just behind the discs and are the bony structures you feel when lying on a hard surface. As discs degenerate, these joints take on more load, often leading to osteoarthritis.

Symptoms:

• Pain when leaning back or twisting

• Morning stiffness that improves with movement

• Radiating pain into the buttocks (similar to sciatica)

• Tenderness when pressing over the joints

Spinal Stenosis

“Stenosis” means narrowing. In the spine, it refers to narrowing of the spinal canal, which houses and protects the spinal cord. This can result from disc degeneration, osteoarthritis, or vertebral slippage (spondylolisthesis).

Symptoms:

• Lower back pain

• Numbness, tingling, sciatica

• Pain that worsens when standing (e.g., in a supermarket queue) and eases when leaning forward on a trolley

  
  

Sciatica

It is important to state that sciatica is a symptom, not a diagnoses. As an Osteopath I am interested in the underlying cause of sciatica which is likely to be one (or more!) of the conditions that I have listed above, and 2 further conditions, that I list below.

The sciatic nerve originates in the lower spine and runs through the hamstrings before branching into nerves that supply the calf and lower leg. Sciatica can be caused by issues in three main areas:

1. Lower back — conditions like disc degeneration or spondylolisthesis

2. Sacroiliac joint — pelvic torsion, leg length differences, or inflammation after a fall

3. Glutes — especially tightness in the piriformis muscle (piriformis syndrome)

Symptoms:

• Sharp, shooting pain down the leg

• Pins and needles, numbness, weakness

• Pain worsened by twisting, coughing, or sneezing; sometimes eased or aggravated by walking

Treatment of the conditions highlighted

Management varies depending on the condition, but the key is personalised care. No two people are the same, and treatment should always be tailored to the individual.

I appreciate that this may seem like a boring answer to treatment but this is the reality and I think it is important that we, as Osteopaths, have an open mind to treatment and do not fall into set protocols for certain conditions.

I hope this overview helps you better understand common causes of back pain in older adults. If you’d like to discuss further, feel free to email me at info@hughmackayosteo.com or send a message via Facebook or Instagram.