Spine Health in Older Adults

Spinal health is critical to maintaining mobility, postural stability, and independence in older adults. Aging affects vertebral bodies, intervertebral discs, ligaments, muscles, and the spinal cord itself.

• Disc degeneration: reduced hydration and height → loss of flexibility.
• Facet joint arthritis: cartilage loss and osteophyte formation → stiffness, pain.
• Vertebral compression: due to osteoporosis or trauma.
• Kyphosis: exaggerated thoracic curvature, often from compression fractures or muscle weakness.
• Ligamentous calcification: reduced elasticity of spinal ligaments.
• Spinal canal narrowing (stenosis): from disc bulging, facet hypertrophy, or ligamentum flavum thickening.

• Osteoporotic vertebral fractures.
• Lumbar spinal stenosis → neurogenic claudication.
• Degenerative disc disease (DDD).
• Cervical spondylotic myelopathy.
• Chronic low back pain and axial spine pain.

• Age >65 years.
• Sedentary lifestyle.
• Vitamin D / calcium deficiency.
• Smoking and alcohol abuse.
• Poor posture and ergonomics.
• History of osteoporosis or spinal trauma.

• Weight-bearing exercise: walking, Tai Chi, resistance training.
• Postural correction: stretching, yoga, physiotherapy.
• Core strengthening: improves lumbar spine support.
• Adequate intake of calcium and vitamin D.
• Avoid tobacco and excessive alcohol.
• Fall prevention: home safety, balance training.

• DEXA scan: for bone mineral density.
• MRI / CT: to evaluate stenosis, disc herniation, or fractures.
• X-ray: alignment, vertebral collapse, scoliosis or kyphosis.

• Pharmacologic:
  • Bisphosphonates for osteoporosis.
  • NSAIDs or acetaminophen for pain control.
  • Muscle relaxants cautiously.
• Non-pharmacologic:
  • Physical therapy and posture training.
  • Heat/cold therapy, TENS units.
  • Bracing for vertebral compression fractures (short term).
• Surgical (selected cases):
  • Decompression (e.g., laminectomy) for stenosis.
  • Kyphoplasty or vertebroplasty for fractures.
  • Instrumented fusion for instability or deformity.

• Promote self-efficacy in pain management.
• Encourage regular physical activity and safe movement.
• Provide resources for assistive devices and home modifications.
• Address fear of falling and educate on spine-sparing techniques.