Back pain is just a natural part of getting older
She was 64 and had been in pain for four years. Her son had told her this was just what happened when you got older. She'd accepted it. She only came to me because her daughter-in-law insisted. 'I assumed nothing could be done,' she said. A lot could be done.
What Patients SayI'm 58 and I've had back pain for a few years now. My son says I should just accept it — he says back pain is just what happens when you get older. Is he right?
Where Did This Come From?
The "ageing equals pain" equation is deeply embedded in cultural understanding of getting older. Your body wears out. Your joints ache. Your back hurts. It's what happens. Accept it. Move on.
There's a kernel of truth in here — age-related changes in the spine are real and universal. But the leap from "structural changes increase with age" to "pain is inevitable and should be accepted" is a significant and harmful overreach that leads many older adults to under-report symptoms, under-seek treatment, and under-engage with effective management strategies.
I see this in clinic constantly. Patients who've been in significant pain for years who come in almost apologetic — "I know it's just my age." It's not.
What the Science Actually Says
While it's true that spinal structures change with age — discs dehydrate, facet joints develop osteoarthritic changes, bone density decreases — these changes don't automatically cause pain. Many 70-year-olds with significant degenerative findings on MRI have no meaningful back pain. Many have modest pain well-managed with simple interventions.
What the research consistently shows is that chronic disabling back pain in older adults is not an inevitable consequence of ageing, and it is not untreatable. Exercise therapy, cognitive behavioural approaches, appropriate pain management, and targeted interventions (including surgery for specific indications) all have evidence in older populations. Importantly, deconditioning — the physical weakness and reduced fitness that comes from inactivity — is a major driver of back pain in older adults, and it's a modifiable factor.
Older adults who remain physically active have significantly lower rates of chronic disabling back pain than their sedentary peers.
Ageing is not destiny. Frailty is not inevitable. And accepting severe, limiting pain as "just your age" when it might respond to treatment is not wisdom — it's the mythology of low expectations.
The Verdict
Back pain is not a normal, unavoidable part of ageing. Age-related structural changes are universal, but disabling pain is not inevitable and is often treatable at any age.
What To Do Instead
- Get a proper assessment — don't assume your age makes symptoms inevitable
- Engage with exercise — even gentle, modified exercise has evidence for pain reduction in older adults
- Ask about targeted treatments: physiotherapy, injections, and surgery all have appropriate roles in older patients
- Don't underreport pain to healthcare providers — you deserve proper attention
Yellow Flags — Worth Monitoring
- Back pain in an older adult that has changed in character — new type, new severity, new location — don't attribute to "just ageing", get it checked
- Progressive mobility loss — this is a serious quality-of-life and independence issue that should be actively managed, not accepted
Red Flags — Get Checked Immediately
- New severe back pain in an older adult after a trivial injury or no injury — possible vertebral compression fracture, common in osteoporosis
- Back pain with night pain unrelieved by position changes in older adults — possible malignancy, infection
- Dionne CE et al., "Standardized measurement of back pain in older populations," Clinical Journal of Pain, 2008. Cecchi F et al., "Epidemiology of back pain in a representative cohort of Italian persons 65 years of age and older," Spine, 2006.