November/December 2024

November/December 2024 Issue

The Last Word: How Lower Back Pain and Balance Are Connected
By George Michalopoulos, DC
Today’s Geriatric Medicine
Vol. 17 No. 6 P. 34

Many adults experience lower back pain on occasion, which can lead to a chronic condition. Others suffer from occasional or frequent problems maintaining balance. Although these concerns may seem to be distinct, they can trigger one another or aggravate an existing condition. While lower back pain and balance issues can be considered a common part of aging, they can also pose significant challenges to a person’s health and mobility. Thus, it’s important for clinicians to be able to understand the connections between balance and lower back pain so they can identify the causes of the problem and provide effective treatments.

Signs of a Balance Problem
Problems maintaining balance increase in likelihood as people age. Roughly one in five people aged 65 to 74 experienced balance issues in the past year, while that number increases to about one in three people aged 85 or older.1 Because balance is a crucial element of mobility and independence for older adults, doctors should highlight the common signs for patients, which include the following:

• dizziness or lightheadedness;
• difficulty walking;
• trouble standing even for short tasks, such as getting a drink of water or performing daily hygiene; and
• issues climbing stairs.

Balance disorders can lead to falls, which are a common cause of lower back pain that can make balancing more difficult.

Causes of Lower Back Pain and Balance Difficulties
Approximately one in four adults reported chronic lower back pain in the past year,2 which often lasts longer than a year. Identifying the cause is key to finding appropriate solutions. These conditions can create balance issues and contribute to lower back pain.

Traumatic Injuries
Injuries, including whiplash, traumatic fractures, and strain, are a common cause of lower back pain. As people age, their bodies may not respond as quickly or deftly as they did in younger years. This can increase the likelihood of injury, particularly straining. Failing to take proper precautions before engaging in physical activity can contribute to lower back pain and worsen balance problems.

Spinal Cord Conditions
The spinal cord transmits signals from the brain to the lower back and legs, a crucial part of the body’s balance apparatus. Spinal cord stenosis involves the compressing the spinal cord, which can disrupt or slow nerve signals. Over time, this can lead to myelopathy, or a failure of the signals to lead to the extremities, making it difficult for people to walk in a straight line or balance while closing their eyes.

Lumbar Spine Degeneration
Degenerative conditions can affect the function of the spinal cord, especially in older people. For example, a herniated disc in the lumbar spine commonly results from strain, such as lifting heavy objects with the back. The strain can lead to tears in the disc, through which soft tissue can bulge, which typically causes back pain near the disc, numbness or tingling, weakness, and difficulty moving the back.

Vestibular Balance Disorders
The vestibular system contains a network of canals and organs in the middle ear that help people to determine their position in relation to their environment, a crucial part of balance and mobility. Vestibular balance disorder is a common cause of dizziness and vertigo, particularly in older adults. It can arise from a variety of conditions, such as the use of certain medications, infections, problems in the inner ear, calcium buildup, or a traumatic brain injury. Vestibular balance disorder can cause patients to walk differently, which can put additional strain on the back.

A Vicious Cycle
Ultimately, unless a patient receives treatment to address the primary cause, they are likely to experience continuing issues. Health concerns affecting balance can increase the likelihood of a fall or other injury, leading to pain. Lower back pain can prompt patients to change their behaviors, which can worsen the problem in some instances. Because certain lower back conditions affect balance, treatment is vital to helping patients maintain balance and mobility in their later years.

By paying close attention to these connections between balance and lower back pain, doctors can help their patients find effective treatments to manage both the lower back pain symptoms and balance concerns.

— George Michalopoulos, DC, is CEO and chiropractic neurologist for The Neurologic Wellness Institute (https://neurologicwellnessinstitute.com)—a clinical facility that restores optimal functioning to the brain and body with a balance of neurology and metabolic lifestyle changes. He has 28 years of experience in the industry and utilizes a multidisciplinary approach including brain-based rehabilitation, physical therapy, diet, and education about patients’ existing problems.

References
1. Mitchell MB, Bhattacharyya N. Balance disorder trends in US adults 2008‐2016: epidemiology and functional impact. OTO Open. 2023;7(2):e58.

2. Casiano VE, Sarwan G, Dydyk AM, Varacallo M. Back Pain. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing; 2024. https://www.ncbi.nlm.nih.gov/books/NBK538173/