Exercise and Low Back Pain in the Older Adult: Current Recommendations

Low back pain (LBP) is a condition that is commonly experienced in people regardless of age and is prevalent in the older adult (individuals >65 yrs). Unfortunately, LBP research frequently excludes the older adult population due to age related co-morbidities. Clinical decision-making for this patient population is thus affected. As such, exercise prescription must be extrapolated from the available literature focused on chronic LBP, older adults without LBP, and younger adults with LBP. The aim of this paper is to review common exercise paradigms including strength, aerobic, and motor control training for treating LBP while discussing potential considerations in exercise prescription for the older adult population. Aside from previous episodes of LBP, predictive factors for development of LBP include poor back muscle endurance, perceived disability, depression/anxiety, fear avoidance, catastrophizing, and illness perception. Exercise is often considered unsafe in the older adult; however, there have been no reported serious cardiovascular incidents with exercise in the older adult from ages 80-100. While there is no clear superior exercise paradigm for the older adult with LBP, there is evidence that the older adult benefits from exercise in general. In addition, these benefits do not decrease with age.