Hi Doctors,
Apologies if I don’t have enough information to give you, but I wanted to ask for your advice about my mother. She’s 73 and has been suffering from lower back pain for the last few years. She has had an MRI recently and was told that she has degenerative discs causing the problem.
The pain is such that she spends most of the time sitting or lying. She can walk a little, but after a while (20-30 mins) her back pain will flare up. She can swim though without pain (she has been a swimmer for many years).
She also has osteoarthritis, which I think has particularly affected her hands and knees (I’m not sure if it’s in her back too). She had a knee replacement a couple of years ago, but hasn’t regained full range of motion in that knee since.
Last time I saw her I asked if she’d considered trying to strengthen her back (with resistance training), but she couldn’t see how she could get into the positions to perform a deadlift or a squat, even without any additional weight, due to her back pain. She’s had no exposure to the weightroom before, and is of the generation that fears lifting weights will probably cause back problems, rather than sure them. I’m hoping to convince her otherwise…
I’d like to ask if you think I’m right to suggest strengthening her back with resistance training in this instance? I know that the advice you generally give for people with back pain is to get stronger using the barbell. But because of my mum’s age, the results of her scan and her arthritis, I’m worried about suggesting the wrong thing.
I realise that you might not have much info to go on, but I appreciate you thoughts.
Thanks.
This is a very common and unfortunate situation.
I agree with exercise in general, and of course recommending strength training would be my bias. But there needs to be a lot more to this than the training alone.
I can tell from your history that she’s had various ideas about and explanations for back pain “given” to her by various healthcare professionals. She has fear of pain and cannot imagine herself performing certain movements. Her recent MRI “confirms” the problem. This is the hard part in managing chronic back pain – all these ideas need to be modified. Wholesale conceptual change is difficult, and requires a lot of education, patience, and skill.
I’ll point you in the direction of a few resources:
First, you might find a recent thread here helpful, as it contains a number of linked resources: Radiofrequency denervation - Medical Q/A with Drs. Feigenbaum & Baraki - Barbell Medicine Forum
An article I wrote: https://startingstrength.com/article/aches-and-pains
And this video: https://www.youtube.com/watch?v=oji2mfcjisk
Good luck.
Hi Austin,
Thanks a lot for your kind reply. Your summary is very accurate; she’s been told by her Dr and a couple of PTs that what’s happening to her is a part of aging and that she should essentially just try to manage the pain with medication or a TENS machine.
I’m seeing her this weekend, so I’ll gently suggest some exercise, and maybe see if I can assist her getting into perhaps a deadlift position. Or, at least, see how far she can get.
Thanks for the links. I’m about to watch the video, and I just read your “Aches and Pains” article. Fascinating how powerful the brain is with regards how we perceive pain.
P.S. I just watched the Joe Rogan podcast with Dave Goggins, where he described his first endurance event, which was a 100 mile ultramarathon. After 70 miles he had to stop, almost passing out with what he said was the worst pain he has ever experienced. He was urinating blood and his whole body was in agony, but, after a short rest, he forced himself to start moving again. The pain eased and he was able to run the last 30 miles at a quicker pace than he’d been running the first 70. The relationship between the brain, pain and how we deal with it, seems a fascinating topic.
All the best.