Menopause and Lower Back Pain --Causes and Treatments
So many people suffer back pain as they get older, we’ve come to think of it as a “normal” result of aging. Perimenopause aches and pains are nothing new, so it follows that they could be even worse in full fledged meno. Right?
Well, pain may be common, but it’s not “normal.” It’s the body’s signal that something is wrong, and – spoiler alert – quite often, things that are wrong can be fixed.
As with many things going wonky at this time in our lives, the estrogen depletion of menopause may be playing a role in your back pain. A study done in China in 2017 looked at the spines of 1,566 women and 1,382 men of the same age.
Results? In the 15 years after menopause, women’s lumbar discs degenerated much more quickly. So if you’re feeling back pain, it’s important to act right away to protect your spine and your active future.
When it comes to bodies and dealing with pain, we turn, as we often do, to our fabulous physical therapists, Meagan and Brianna.
Menopause and lower back pain: causes and countermeasures
According to Meagan and Bri, there are lots of possible causes, including muscular pain or strain, herniated disc, problems with the SI joint (stay tuned for more on that in an upcoming blog), kidney stones, and issues with your bones.
For women in midlife and menopause, additional common issues might be postural changes resulting from pregnancy, changes in exercise form and technique, poor stability, poor activation of your core, and poor breathing. Menopause and joint pain are often spoken in the same sentence, but many of the above factors can be mitigated through intention.
Also, a surprisingly big culprit? “Doing YouTube exercises that are inappropriate for their ability are a huge problem,” Brianna says. “Please don’t do that.”
If you really want to watch something on YouTube, check out our painful sex webinar.
So, first thing to do is figure out what’s causing the pain.
Best way to do that? See a doctor or a physical therapist and talk about what you might be doing (or not doing) that’s causing the hurt. Here’s a handy list to help you zero in on causes and fixes to help you have that conversation.
Is it your exercise program?
“There are lots of pieces of information you need to tell your doctor or PT,” says Bri. “How long does the pain last? Is it days or hours? Is it just muscle soreness from exercise, and is it triggered by a particular exercise? If it’s specific to an exercise, it may be as simple as changing position or modifying a little: tweak, rotate, breathe, and you may solve the problem.”
Meagan adds, “If you have other joint or muscular pain that’s dull, that happens during exercise, your doc or PT needs to know that. If it warms up and goes away or comes on at the end and is gone soon, that’s probably diffuse muscular pain, that’s just the discomfort of getting in shape. But if it’s localized or increases or is sharp – you need to respect that. The body is designed to use pain as a signal that there’s a problem. But our brains can sometimes override those pain signals, if we really want to get fit or lose weight.
“More often than not, pain should not be pushed through.”
Is it your mattress?
It might be time to update or replace your mattress, Bri says. They’re a pain to replace and they can be expensive, but the wrong mattress or a too-old mattress can set you up for a great deal more pain and expense down the road.
Is it your job?
Most of us just aren’t aware enough of our body position when we’re working, says Meagan. We hunch, we lean, we curl forward, all of which can put more strain on your back. A better option is just don’t sit all day, nor stand all day. “Every 5 – 10 minutes, just stand up,” she tells us. “That’s it. Just stand up, then sit down again. Stretch a little, walk around the office if you can. This allows your body to use its natural lubrication on those joints. It’s just unreasonable to sit for 8 hours and assume it won’t have an impact.”
Their thoughts on adjustable desks? If you or your office can afford it, go for it, Bri and Meagan agree. Varying posture during the day is a great way to reduce the load on any one part of your body.
Is it your commute?
Car seats are designed to be able to fold forward, so the place where we need the most support – the lower back – tends to be a hole instead. If your car seat situates you so your hips are lower than your knees, get a lumbar roll or just roll up a towel to stick behind you to get your butt and hips level with or slightly above your knees.
A lumbar roll that’s easily removed can do double duty with your office chair.
Is it something more serious?
Back pain can have more serious causes that require medical intervention: visceral pain could be from a kidney infection. Pain that’s up high, between the shoulder blades (what Bri calls the “bra strap area”), could indicate a compression fracture. So if you feel pain there – especially if you have osteoporosis, osteopenia, or a family history of either – you need to get to the doc for some x-rays.
Sudden back pain can also, rarely, be an indication of certain kinds of cancer, so if the pain is sudden or worsens at night, or you have a personal or family history of cancer, take it seriously and make an appointment.
Exercise and back pain
When we hit midlife and suddenly have some extra pounds (particularly in menopause, when many of us start to put on belly fat), there’s a tendency to go all-out to get back to our younger bodies.
There’s nothing wrong with wanting to get stronger and fitter, and exercise can be very helpful in relieving back pain or avoiding it altogether. But you have to do it right, with good form, while breathing correctly, and after making sure you have the basics in place before you move on to more challenging workouts.
So what are we doing wrong?
Back pain from exercising incorrectly is often the result of poor stabilization, says Meagan. When pelvic floor muscles and the bottom of your core are weak, you don’t have the structural integrity to hold your pelvis, SI joints, and lumbar spine (lower back pain) in good alignment. Then, when you bend or twist, things can shift out of alignment and cause sudden pain. This can be exacerbated in menopause and perimenopause, when aches and pains due to these factors can be triggered more easily and be worse in terms of pain.
This often happens in an exercise classes where moves are difficult and unfamiliar, and you may not have the form, strength, or stability to do the move you’re being asked to do, Bri adds.
If you want to exercise or continue to exercise while still protecting your back, there are ways to do it safely.
One: focus on the basics first
Avoid hurting your back by first mastering the basics. A really great way to do this is to see a physical therapist (PT) who can help you identify weaknesses and design a plan to get stronger, wisely.
Most people benefit from a three-dimensional program, Meagan tells us: stabilization to address the central core; flexibility, to address restrictions in your range of motion that you might be compensating for; and cardio, to build up your aerobic capacity. A good PT or coach can help you design a plan that covers all three.
According to Meagan, ramping up slowly is key, especially for those who already experience back pain. “I’d start with breathing, breathing Kegels, getting the pelvic floor and breath working together. You need to get into functional positions right away. Squats, lunges, getting rotation in there, developing movement strategies with appropriate stability and activation of core musculature to allow you to increase difficulty.”
If you don’t have access to a PT, and you’re taking a fitness class, Brianna advises you opt for classes with as few students as possible. If you can, take an individual lesson or attend a class with no more than 3 students per instructor, she says, so you get more personal attention. Learn to do the moves safely before moving on to harder exercises or bigger classes.
Don’t have a PT of your own? We have two, but we’ll share. Here’s what a PT might tell you NOT to do.
Two: have realistic goals
When you’re getting ready to launch your new “I’m going to get fit, and this time, I mean it” program (just me?), have actionable, reasonable goals in mind.
What are you hoping to achieve, asks Bri. Do you want to be able to walk longer, are you trying to build strength, are you focusing on cardio or core? There’s no one-size-fits-all exercise program, she warns, because, “We’re all good at hiding our dysfunctions, and we need to tease them out. A gradual, progressive program will address those areas of weakness and allow you to build endurance and stability as you work towards your goals.”
But but but, you say, I feel fine! Nothing hurts!
That may be true, Meagan says, but chances are it just means you aren’t experiencing symptoms yet. “Few of us are perfect,” she says, “and most of us are just getting away with bad habits that will likely catch up to us later. Posture, breathing, proper warm ups and cool downs – because we ignore these, it’s just a matter of time before something is going to hurt or break or get inflamed. The answer is to interrupt the problem now before it becomes apparent.”
“Apparent,” by the way, is PT-speak for “painful.”
Three: not keeping up ≠ wimping out
When you take a class, you focus entirely on the instructor, following her steps, mimicking her form, and never everchecking out the person next to you who, 45 minutes in, hasn’t yet broken a sweat. Right?
“One of the issues we see with taking classes,” Bri says, “is you might be standing next to someone who’s been doing this for years. They look great, they make it look easy, and you try to keep up. But they may have core strength you don’t have yet, and you could end up hurting yourself.”
Be OK with modifying some of the moves or simply sitting out portions of the program if you’re not ready. Sure, the gal next to you is 10 years older, but that may just mean she’s been developing her skills and strengthening her core for 10 years longer.
Regular exercise can be enormously beneficial for your body, brain, and mood, but no one benefits from a slipped disc or strained muscle. If you plan to add or increase exercise, consider getting some expert help to do it safely.
If you’ve experienced back pain, what did you do about it? (You did something, right?) We’d love to hear how you managed the pain, so please share what you’ve learned with the class. Tell us your experience in the comments below, or on Gennev's Facebook page or Midlife & Menopause Solutions, our closed Facebook group.
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