If you are older yourself or you have a family member who is getting on a bit then this is for you.
Low back pain stands as one of the most disabling conditions affecting older adults throughout Brighton and the wider UK, contributing to substantial healthcare costs and reduced quality of life. Whilst effective treatments exist, misinformation continues to spread through well-meaning family members, social media and even some healthcare providers. Here at Sundial, we’ve witnessed firsthand how these myths prevent older adults from accessing appropriate care and achieving better outcomes.
This article aims to debunk ten persistent myths about back pain in those aged 65 and over, helping Brighton residents make informed decisions about their spinal health.
Why Back Pain in Older Adults Deserves Special Attention
Back pain in older adults is fundamentally more complex than in younger people. Age-related changes, multiple health conditions and decades of accumulated misinformation creates a perfect storm for misconception. When seeking a chiropractor in Brighton, older adults often arrive with deeply ingrained beliefs that can actually impede their recovery.
Research shows that unhelpful attitudes and behaviours—perpetuated by pharmaceutical companies, media outlets and sometimes healthcare practitioners themselves—represent one of the most preventable contributors to disability and high treatment costs. By addressing these myths head-on, we can transform clinical outcomes whilst reducing unnecessary healthcare expenditure.
The Ten Myths Debunked
Myth 1: Back Pain Is Inevitable as We Age and Part of Normal Ageing
The Reality: whilst back pain is common as we age, it’s certainly not inevitable. Research reveals that non-specific back pain actually increases until around age 60, then levels off and can even slightly decrease. Working-age adults face the highest risk for low back pain, which often lessens in post-retirement groups. However, the severity and risk of chronic pain does increase with age, largely due to specific conditions like osteoarthritis, spinal stenosis and osteoporosis.
What This Means for You: Sundial chiropractors encourage older patients to challenge the notion that back pain is simply “part of getting older.” Early identification and treatment of specific causes can make a substantial difference to your quality of life.
Myth 2: Back Pain in Older Adults Usually Indicates a Serious Medical Problem
The Reality: although serious diseases such as cancer, fracture and infection are more common in older adults, they represent less than 5% of all back pain causes in this age group. Primary (non-specific) low back pain remains the most common type, accounting for approximately 90% of cases across all ages, including older adults.
What This Means for You: whilst it’s sensible to rule out serious conditions, most back pain in Brighton’s older residents is non-specific and responds well to conservative care from our chiropractors in Brighton.
Myth 3: People Over 50 with Back Pain Should Always Have Imaging to Rule Out Serious Disease
The Reality: without red flags suggesting serious disease, imaging isn’t recommended. Age over 50 is sometimes listed as a red flag, but it shouldn’t be used in isolation. Routine imaging rarely identifies the pain source in primary back pain and abnormal findings are incredibly common in pain-free older adults—degenerative changes, bulging discs and narrowed spinal canals often appear on scans yet may cause no symptoms whatsoever.
What This Means for You: Unnecessary imaging can lead to unwarranted testing, specialist referrals and psychological stress that may actually worsen outcomes. A thorough clinical assessment by a chiropractor is often more valuable than an MRI scan.
Myth 4: Older Adults with Back Pain Should Avoid Lifting, Twisting or Bending—”Let the Pain Be Your Guide”
The Reality: without red flags, older adults with back-dominant primary pain should continue normal activities despite discomfort. There’s no evidence that pain during activity causes damage to the lower back. In fact, pain avoidance behaviours delay recovery. For degenerative or osteoarthritic back pain, “motion is lotion”—activity reduces pain without worsening the condition. Lifting, twisting and bending are beneficial for maintaining a healthy back. An older spine isn’t at greater injury risk compared to a younger one.
What This Means for You: when you visit us at Sundial, you’re likely to receive advice that encourages movement rather than restriction. Graduated lifting and progressive physical demands build structural resilience, whilst fear and avoidance increase disability risk. We can give you specific exercises to do at home and advise on the best exercises to do in the gym.
Myth 5: Bed Rest Is Recommended for Back Pain in Older Adults
The Reality: bed rest is particularly discouraged for older adults with back pain. Beyond prolonging recovery, older adults face higher risks of negative consequences including increased joint stiffness, muscle wasting, bone mineral density loss, pressure ulcers and blocked blood vessels. Staying physically active helps prevent the progressive loss of the body’s ability to respond to stress with ageing.
What This Means for You: maintaining an active lifestyle despite back pain, including regular aerobic and strength training exercises, helps preserve the muscle reserves needed to maintain function as we age. Your Sundial chiropractor will support you in staying active and not confined to bed.
Myth 6: Medication Should Be First-Line Treatment for Older Adults with Back Pain
The Reality: first-line treatment for primary back pain should be drug free. Paracetamol has proven no better than placebo in high-quality trials. Anti-inflammatory drugs like ibuprofen and other NSAIDs offer only small benefits and should be avoided in older adults on blood thinners, with high blood pressure or those at risk of gastric bleeding. Muscle relaxants can cause light-headedness in those with balance issues. Antiseizure drugs like pregabalin and gabapentin show no benefit over placebo and are associated with dizziness and cognitive impairment, increasing fall risk. Antidepressants may offer minimal relief but carry risks including cardiotoxicity, dizziness, weight gain, decreased bone density and dangerous drug interactions.
What This Means for You: evidence-based chiropractic care and exercise education should form the foundation of treatment. Here at Sundial, you’ll receive a comprehensive treatment plan that doesn’t rely primarily on medication.
Myth 7: Surgery Is Effective for Back-Dominant Pain in Older Adults
The Reality: surgery for primary back-dominant pain (without leg symptoms) isn’t supported by current evidence and can potentially cause more harm than good in older adults. Complication rates for spinal surgeries range from 3% to 29%, with higher risks at advanced ages. Despite this, there’s been a substantial rise in spine surgery for older adults, often driven by degenerative imaging findings that correlate poorly with actual pain. Whilst surgery may help leg-dominant radicular symptoms from herniated discs or lumbar spinal stenosis, back pain itself often doesn’t improve post-operatively.
What This Means for You: before considering surgery, explore conservative options with a chiropractor. Surgery should be reserved for specific conditions with leg symptoms, not general back pain.
Myth 8: Chronic Back Pain in Older Adults Is Always Due to Structural Damage
The Reality: almost all older adults have degenerative changes in their lumbar spine, yet only a small fraction experience chronic back pain even fewer are disabled by it. Primary chronic back pain is a biopsychosocial condition—it may begin with a physical issue, but pain persists beyond normal healing time without significant physical findings. The strongest predictors of chronic pain in older adults are psychosocial factors: fear avoidance behaviour, poor self-efficacy, low motivation and low mood.
What This Means for You: successful care requires a multimodal approach addressing psychological factors and maladaptive beliefs. Sundial chiropractors are trained in modern, evidence-based care that will address both physical and psychological aspects of your pain.
Myth 9: Interventional Procedures Like Injections Are Effective for Chronic Back Pain in Older Adults
The Reality: recent evidence suggests that epidural injections, joint injections, nerve blocks and radiofrequency ablations are no better than sham procedures for back or radicular pain lasting more than three months. Despite lack of evidence beyond placebo effect, use of these procedures continues to grow alongside high costs. Older adults face increased risks of adverse events including hyperglycaemia and bone mineral loss with steroid injections and temporary motor weakness with nerve blocks—all increasing fall and fracture risk.
What This Means for You: before pursuing ineffective procedures, explore evidence-based conservative care, like the Sundial approach here in Brighton.
Myth 10: Disc Herniations Causing Back-Related Leg Pain Are Very Common in Older Adults
The Reality: the peak age for symptomatic disc herniations is between 30-50 years; they become less likely to cause nerve compression with advancing age due to gradual disc drying , fluid loss and eventual stiffening or calcification. Whilst imaging may show herniated or bulging discs in older adults, these typically represent old, asymptomatic herniations that have calcified and become rigid. Clinical signs of nerve tension and neurological deficits are more reliable indicators of genuine radiculopathy than imaging findings alone.
What This Means for You: don’t let imaging findings alone drive your treatment decisions. A thorough clinical examination by a Sundial chiropractor here in Brighton will better determine whether disc issues are genuinely contributing to your symptoms.
How Evidence-Based Chiropractic Care Helps Brighton’s Older Adults
Chiropractic care for older adults focuses on gentle, tailored approaches that address the unique complexities of age-related back pain. When you come to Sundial, you’ll see a chiropractor who understands evidence-based practice, so you can expect a comprehensive assessment that considers your overall health, medications and individual circumstances.
Rather than perpetuating myths, we work to help you understand your condition, empower you with appropriate exercises and lifestyle modifications, and coordinate care with other healthcare providers when necessary. Treatment focuses on maintaining and improving function, building confidence in movement and addressing any fear-avoidance behaviours that may be limiting your activities.
Taking Action: What Brighton Residents Can Do
Understanding these myths represents the first step towards better back health. If you’re experiencing low back pain and you’re over 65, consider consulting a Sundial chiropractor – we prioritise evidence-based care. Come prepared to discuss your concerns openly, challenge any preconceived notions and work collaboratively towards your recovery.
Key actions you can take include:
Stay Active: continue with normal activities despite discomfort, incorporating regular aerobic and strength training exercises to maintain muscle reserves and bone health.
Challenge Your Beliefs: question assumptions about ageing and back pain. Pain doesn’t always mean damage and activity is typically helpful rather than harmful.
Seek Evidence-Based Care: Sundial practitioners emphasise movement, education and gradual progression rather than passive treatments, excessive imaging, or immediate referral for injections or surgery.
Address the Whole Picture: recognise that chronic back pain involves physical, psycholosocial factors. Effective treatment addresses all these elements.
Moving Beyond Myths to Better Outcomes
The persistence of back pain myths in older adults creates unnecessary barriers to effective treatment, inflates healthcare costs and diminishes quality of life for thousands across Brighton and beyond. By dispelling these misconceptions through advice, improved clinical practice and better public health messaging, we can help older adults access the care they truly need.
Whether you’re seeking a chiropractor for the first time or reconsidering previous advice you’ve received, remember that evidence-based care rooted in current research offers the best pathway to managing back pain effectively at any age. Don’t let outdated beliefs about ageing and back pain limit your potential for recovery and an active, fulfilling life.
Frequently Asked Questions About Back Pain in Older Adults
Is back pain normal as you get older?
No, back pain is not an inevitable part of ageing. Whilst it’s common, research shows that non-specific back pain increases until around age 60, then levels off and can even decrease. Working-age adults actually face the highest risk. When you consult a chiropractor in Brighton, you should receive care that treats your pain as a manageable condition, not an unavoidable consequence of getting older.
What percentage of back pain in older adults is serious?
Less than 5% of back pain in older adults is caused by serious diseases such as cancer, fracture, or infection. Approximately 90% of cases are primary (non-specific) low back pain, which responds well to conservative treatment. A Sundial chiropractor can help determine whether your symptoms require further investigation or can be managed with evidence-based care.
Should I get an MRI if I’m over 50 and have back pain?
Not necessarily. Without red flags suggesting serious disease, imaging isn’t recommended. Age over 50 alone isn’t sufficient reason for imaging. Abnormal findings like degenerative changes and bulging discs are incredibly common in pain-free older adults and don’t correlate well with symptoms. A thorough clinical assessment from a chiropractor in Brighton is often more valuable than an MRI scan.
Should older adults with back pain avoid bending and lifting?
No. Older adults without red flags should continue normal activities, including lifting, twisting bending, despite discomfort. There’s no evidence that pain during activity causes damage. In fact, “motion is lotion”—activity reduces pain and builds resilience. Pain avoidance behaviours actually delay recovery. A chiropractor in Brighton should encourage graduated movement rather than restriction.
Is bed rest good for back pain in older people?
Bed rest is particularly discouraged for older adults with back pain. It prolongs recovery and increases risks of joint stiffness, muscle wasting, bone mineral density loss, pressure ulcers blood clots. Staying physically active with regular aerobic and strength training exercises helps preserve muscle reserves needed for healthy ageing.
What should be the first treatment for back pain in older adults?
First-line treatment should be non-pharmacological. Evidence shows that common medications like paracetamol are no better than placebo, whilst NSAIDs, muscle relaxants nerve pain medications carry significant risks for older adults, including falls, cognitive impairment drug interactions. A chiropractor in Brighton should offer exercise, education manual therapy as primary treatments.
Is surgery effective for back pain in older adults?
Surgery for back-dominant pain (without leg symptoms) isn’t supported by current evidence and can cause more harm than good in older adults, with complication rates of 3-29%. Surgery may help leg-dominant symptoms from specific conditions like herniated discs or spinal stenosis, but back pain itself often doesn’t improve post-operatively. Conservative care from a chiropractor in Brighton should be explored first.
Does chronic back pain always mean structural damage?
No. Almost all older adults have degenerative spinal changes on imaging, yet only a small fraction experience chronic back pain. Primary chronic back pain is a biopsychosocial condition where pain persists beyond normal healing time. The strongest predictors are psychosocial factors like fear avoidance, poor self-efficacy low mood—not structural damage seen on scans.
Are spinal injections effective for chronic back pain?
Recent evidence shows that epidural injections, joint injections, nerve blocks radiofrequency ablations are no better than sham procedures for back or leg pain lasting more than three months. They also carry risks for older adults including hyperglycaemia, bone mineral loss temporary weakness that can increase fall risk. A chiropractor in Brighton can offer evidence-based alternatives.
Are disc herniations common in older adults?
Symptomatic disc herniations peak between ages 30-50 and become less likely with advancing age due to disc desiccation and calcification. Whilst imaging may show herniated discs in older adults, these typically represent old, asymptomatic herniations that have become rigid. Clinical examination by a chiropractor in Brighton is more reliable than imaging alone for determining whether disc issues are causing your symptoms.
What causes most back pain in people over 65?
Approximately 90% of back pain in older adults is primary (non-specific) low back pain, not caused by serious disease or specific structural problems. Whilst conditions like osteoarthritis and spinal stenosis are more common with age and can increase pain severity, the strongest predictors of chronic pain are actually psychosocial factors rather than physical findings.
Can exercise make back pain worse in older adults?
No. Evidence shows that exercise and activity help reduce back pain in older adults without causing damage or worsening conditions like osteoarthritis. Graduated lifting and progressive physical demands build structural resilience. Avoiding movement leads to deconditioning, increased pain disability. Your chiropractor in Brighton should prescribe appropriate exercises tailored to your abilities.
How long should back pain last in older adults?
Most acute back pain episodes improve within a few weeks to months, regardless of age. However, the risk of chronic pain (lasting beyond three months) does increase with age. The key to preventing chronicity is staying active, maintaining normal activities despite discomfort addressing unhelpful beliefs about pain and ageing early in treatment.
When should older adults with back pain see a specialist?
Most older adults with back pain don’t require specialist referral. Primary care providers and chiropractors in Brighton can manage non-specific back pain effectively. Specialist referral is appropriate only when red flags suggest serious disease (cancer, infection, fracture), when there are significant neurological deficits, or when conservative treatment has been properly attempted without improvement.
What are red flags for back pain in older adults?
Red flags include unexplained weight loss, fever, history of cancer, severe neurological deficits (such as loss of bowel or bladder control, progressive leg weakness), significant trauma, or pain that worsens when lying down. Age over 50 alone is not a red flag. If you have concerning symptoms, a chiropractor in Brighton can assess whether further investigation is needed.
About Matthew Bennett, Chiropractor Brighton
Matthew Bennett is the founder and principal chiropractor at Sundial Clinics Brighton, established in 1991. With over 35 years of clinical experience, Matthew qualified from the Anglo-European College of Chiropractic in 1987 and served as President of the British Chiropractic Association for four years. As a Fellow of the Royal College of Chiropractors and former team chiropractor for Brighton and Hove Albion FC and the British Alpine Ski Team, Matthew combines evidence-based chiropractic treatment with sports performance expertise. His authority in musculoskeletal health has been recognised through national media appearances, expert witness roles and contributions to professional publications. Matthew’s commitment to clinical excellence ensures patients receive the most effective chiropractic care in Brighton.