Latest Issue

UPMC Surgeon: How Aging Affects the Spine

Almost everyone experiences back pain at some point. According to the National Institutes of Health, back pain is one of the most common reasons Americans go to the doctor, second only to colds and the flu.

Our bodies are incredibly designed and can withstand a lot of stress, but as we age, the normal wear and tear of life can increase the risk of spine-related problems and the likelihood of neck and back pain.

The most common age-related spine conditions are degenerative changes in disks and joints, spinal stenosis, and frail vertebrae.
– Discs and cartilage help hold the spine together providing movement to the spine as well as absorbing impact between bones. Degenerative changes in the discs in the spine can cause the bones to rub against one another and degenerative joint problems, such as osteoarthritis, cause the cartilage between the bones to break down. Degenerative issues are usually associated with symptoms such as stiffness, tenderness, numbness or tingling, and intermittent back pain, especially when active.
– Spinal stenosis is the result of the degeneration of the cushioning discs in the spine which causes the spinal canal to narrow. This can lead to pressure on the spinal cord and pinch your nerves. Most often spinal stenosis causes low back pain, but it can also cause pain, numbness, or weakness in the legs.
– Our bones are constantly breaking down and regenerating. Osteoporosis occurs when the body’s natural ability to create new bone does not keep up with the loss of old bone. Bone production decreases with age and the older you become, the more likely you are to experience a form of osteoporosis. Women are also more likely to develop osteoporosis than men. The condition causes the bones to become weak and brittle, which can lead to fractures and other structural issues in the spine.

There are several ways to treat age-related back pain, depending on the extent and severity of your condition and pain. Spine care specialists approach spine pain by opting for conservative treatment options and exhausting these measures before recommending surgery. Conservative treatment takes time but can have great results.

Conservative treatments include:
– A healthy and nutritious diet: Focusing on a healthy, well-balanced diet, helps maintain a healthy weight and ensures you’re fueling your body properly for an active lifestyle and enriching your body with essential vitamins and minerals.
– Quitting smoking: Smoking increases the risks for other health issues and can have negative effects on bone development and health.
– Getting active: Our bodies are made to be in motion and a physically active lifestyle helps promote joint health.
– Support with physical therapy: Therapists can help identify and correct muscle weaknesses, posture problems, or other body mechanics issues that are contributing to your pain. A physical therapist will teach you specific exercises to strengthen your back, abs, and hips, as well as stretches that can help with mobility. By increasing strength, endurance, and flexibility, you often can reduce pain and improve function.
– Incorporating medicine with other treatments: Nonsteroidal anti-inflammatory (NSAID) medications can help reduce inflammation and relieve pain. Your provider may also offer a pain-relieving injection targeting specific areas of the spine. Common injections include cortisone for inflammation, trigger point injections targeting muscle spasms, and nerve blocks. Consult with your specialist before taking any medications.

The hope is these conservative treatment actions will not only help improve your pain over time but also make you the healthiest you can be. If conservative treatment is not enough for your pain and condition, surgery may be considered, and the healthier you are at the time of surgery, the better the potential outcome.

Although surgical intervention remains the last resort, advances in surgical techniques are making spinal surgery less frightening for patients. Newer technology enables surgeons to operate with more precision through smaller incisions, which has improved the outcomes of surgeries for certain people. This lends itself to patients returning to their day-to-day lives more quickly.

Although not everyone is a good candidate for certain procedures, a specialist will walk patients through all the options, and that is where patients can benefit from a team approach to spine surgery like what is available through UPMC Spine Care.

At UPMC, a care team comprised of surgeons from neurosurgery and orthopaedics and specialists from pain management and physical medicine all work together with their expertise to look at your case to develop multiple options and creative solutions for your pain management and treatment. You will be presented with a package of treatments together that is tailored to your specific needs, and you will play an active role in your entire treatment journey.

While some minor aches and pains may be par for the course of our lives, back pain that affects your quality of life is concerning and should be evaluated. If you experience back pain, listen to your inner voice. If you feel that you need to see a doctor, especially after a fall, go and get evaluated right away.

By Ronald DiSimone, M.D., F.A.C.S.
UPMC Spine Care

Ronald DiSimone, M.D., F.A.C.S., is an orthopaedic surgeon with UPMC Spine Care, 2330 St. Mary St. W., 1st Floor, Lewisburg, and UPMC Orthopaedic Care, 1705 Warren Ave., Suite 101, Williamsport. To schedule an appointment with Dr. Disimone, call 570-321-2020. To learn more about the comprehensive services available at UPMC Spine Care in northcentral Pennsylvania, visit