The possibility of herniated discs in the elderly is always a concern raised by geriatric specialists when dealing with the ravages of senior citizen back pain. Statistically, elders are less likely to suffer chronic back pain than adults in the ages of responsibility; mainly from 26 to 55.
This detail flies in the face of accepted medical theory which states that most cases of chronic back pain are the results of degenerative structural issues in the spinal anatomy. After all, degeneration continues for life and the spines of the elderly are worse off structurally than in most younger patients. However, research shows that chronic disc pain is not nearly as likely to occur in seniors compared to the incidence in younger adults.
This essay investigates the truth of intervertebral herniations in the older population.
Being that degeneration does indeed contribute to herniations, the incidence of bulging and ruptured discs in elderly patients is very high. However, the occurrence of symptoms is quite low, despite the presence of universal disc desiccation and often multiple herniations. Additionally, the presence of spinal arthritis is also universal and often blamed for sourcing symptoms in younger patients, but is not commonly cited as a serious concern in elder patients.
These facts are all very telling when it comes to the misconception of structural back pain theory, also known as the Cartesian approach to dorsalgia treatment. Of course, in some cases, structural issues do cause elder patients to experience pain and may even require drastic medical intervention in extreme circumstances. However, when studying the universality of degeneration and the low incidence of chronic pain, it is difficult to subscribe to the Cartesian model in any age demographic, particularly when it comes to senior citizens.
One of the major dangers of central herniated discs in seniors is their possible contribution towards problematic central spinal stenosis concerns. Being that canal narrowing is normal in the elderly, a severe bulging disc may be all that is required to virtually close up the spinal canal completely.
In elderly back pain sufferers with symptomatic herniations and other disc issues, treatment should always be conservative when at all possible. The risks of surgery are multiplied in senior citizens, particularly if they have any other problematic health issues. Luckily, most doctors abide by this rule and are able to successfully manage disc symptoms in the elderly without surgery. In some cases, operative intervention may be required, but at least the minimally invasive disc surgery procedures, which are so common in today’s medical system, reduce trauma and risk as low as feasibly possible.
I always advise elder patients to seek treatment using more than one care provider. The best combination is often a neurologist and a geriatric specialist or an orthopedist and a geriatric specialist.
Herniated discs are incredibly common and become more so as we age. The spinal anatomy normally suffers degeneration year by year and the structural changes to the bones and discs in the spine facilitate bulges and ruptures as part of the normal lifecycle. Finding an elderly patient without marked degenerative disc disease and at least 1 herniated disc is rare.
Some enlightened doctors, like Dr. John E. Sarno, speculate that the reason for the lower incidence of back pain associated with identical structural issues in elder patients, compared to younger adults, represents an expected pattern when using the mindbody model of pain. Remember that psychosomatic disc pain is often a result of repressed and suppressed life stresses which are at their pinnacle in the younger pressure-filled years of 26 to 55.
Many elders have the benefit of a different stage of life, and the enlightenment that only age can bring, to protect them from the ravages of pain which attacks younger victims. This is an interesting perspective to be sure...