Written by Sam Moylan
Ageing…it is an unavoidable fact of life and something that generally comes with the negative connotations of reduced physical capacity and an onset of aches and pains. As a Physiotherapist, I can’t count the number of times people have cited age as the cause for their symptoms, and though it may be a factor, it is definitely not the whole story. While ageing is inevitable and perhaps a slow decline in our physical abilities is something we have to accept, it is not well correlated with an increase in pain.
What is considered normal is some ‘wear’ or age-related change to our tissues over our lifetime. These changes can be likened to wrinkles on our skin, things that are just a part of living life. Often, however, these findings are reported or interpreted in a threatening way and are blamed as the cause of pain. Extensive research has shown that there is a very poor relationship between what are often called ‘degenerative’ findings and a person’s symptoms.
Many of the scary findings on scans are in actual fact just age-related changes that are considered normal and are highly prevalent in pain free populations. Unfortunately, this isn’t always communicated to people receiving medical imaging and this is probably part of the reason why ageing is associated with an increase in pain. Other interesting research has looked at the incidence of some of the most common musculoskeletal pain disorders, low back pain and neck pain, in different age groups. The results challenge our societal beliefs around pain and ageing and highlight that there are other factors that have a much larger influence on our likelihood of developing or experiencing pain.
Studies by Hoy et al., 2012 and Kazeminasab et al., 2022, showed that the incidence of lower back and neck pain appeared to be greatest around mid-life, with a reduction either side of this point. It is clearly not a straight increase in pain as we age and the fact that the likelihood of experiencing musculoskeletal pain is higher in the middle of our lives may point to a closer relationship between stress and pain, rather than age.
Another common issue associated with ageing is osteoarthritis (OA), and this is again something that is commonly thought to worsen with age. A study by Van Berkel et al. 2021, followed 505 individuals with early symptomatic hip OA and completed a 10 year follow up. It was found that only 1 in 9 received a hip replacement over the 10 years. Overall, there were slight increases in the clinical signs of OA, eg. MRI findings, however, symptoms and physical activity levels remained stable or even slightly improved. These results were without any specific intervention for the hip OA. It is very encouraging to see that on average hip OA did not worsen over 10 years, even without any treatment.
As we can see it is not all doom and gloom with ageing. Although we may have reductions in our physical capacity and have some age-related changes to our bodies, this does not have a correlation to pain. The main takeaway from this is that it is safe and highly beneficial to continue to move and exercise as we age, even if there are some degenerative changes on scans. It is well researched that exercise is the best tool we have to delay our physical decline, if we stop moving it is all downhill from there.
At Darch Physio we place a big focus on empowering you to feel confident in your body so that you can continue to move as the years go by!
References
- Brinjikji, W., Luetmer, P. H., Comstock, B., Bresnahan, B. W., Chen, L. E., Deyo, R. A., … & Jarvik, J. G. (2015). Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. American journal of neuroradiology, 36(4), 811-816.
- Hoy, D., Bain, C., Williams, G., March, L., Brooks, P., Blyth, F., … & Buchbinder, R. (2012). A systematic review of the global prevalence of low back pain. Arthritis & Rheumatism, 64(6), 2028-2037.
- Kazeminasab, S., Nejadghaderi, S. A., Amiri, P., Pourfathi, H., Araj-Khodaei, M., Sullman, M. J., … & Safiri, S. (2022). Neck pain: global epidemiology, trends and risk factors. BMC Musculoskeletal Disorders, 23(1), 1-13.
- van Berkel, A. C., Schiphof, D., Waarsing, J. H., Runhaar, J., van Ochten, J. M., Bindels, P. J., & Bierma-Zeinstra, S. M. (2021). 10-Year natural course of early hip osteoarthritis in middle-aged persons with hip pain: a CHECK study. Annals of the rheumatic diseases, 80(4), 487-493.