How I Kept My Back Pain-Free Into My Seventies

Back pain is so common that most people accept it as normal, almost like gray hair or wrinkles. After spending much of my adult life in sedentary work and after having serious back problems in my thirties and forties, I came to a very different conclusion: most back pain is the cumulative result of specific habits and actions that can be prevented, reduced, or, at the very least, slowed down.

In the end, your back responds to years of abuse and neglect the same way the rest of the body does. And if that is true, then the reverse is also true: you can protect your back far better than you think.

This guide is a practical summary of the choices, actions, and observations that allowed me to avoid the chronic pain, stiffness, weakness, and decline that so many people of all ages come to see as inevitable.

Here is an overview of the most common conditions that precede sporadic or chronic back pain and what to do about them:

1. Weak core, gluteal, and back muscles that fail to support the spine well.

For the past 30 years, I have avoided repetitive gym workouts and high-strain exercise because I believe the risk of injury is too high, especially for people who start later in life.

From what I have seen in the research, a history of athletic training does not guarantee freedom from back pain later on. Rates vary widely by sport and by study, and some groups of former athletes still show a prevalence of back pain ranging from 33% to 84% [link].

Here is what I do to keep my muscles strong and flexible, not only for my age but also for someone 30 to 40 years younger:

• Daily walking. I stick to regular walking in the summer and the treadmill at home in the colder months. Not 10,000 steps, but about half of that, or two miles. I simply don't have time for more than that and need to retain my energy for work.

• Practical physical work at home. I do household chores that are fairly physical, such as replacing a kitchen faucet under the crammed cabinet, cleaning the evaporator coil, replacing the blower fan motor in the hot attic, replacing the garage door opener, and so on.

• Seasonal outdoor physical work. I mow the lawn in the summer and remove snow in the winter. For me, this provides a real workout without the same level of trauma risk as more aggressive exercise.

• Caution with sporadic stretching. I have mixed feelings about sporadic stretching. When it is done regularly and with proper control, it can be very helpful. When it is done irregularly or too aggressively, it can lead to ligament strain or nerve impingement.

• I avoid high-load or repetitive training because in later years, especially when combined with heavily developed muscles, it can overload the ligaments, discs, and other structures that support the spine. Such injuries and resulting pain are very difficult to heal and may remain chronic for life.

• No interest in muscle supplements. I do not take, and never did take, any supplements intended to build muscle because I did not find them effective without lifting weights, and I do not like the dehydration and constant thirst they cause, especially at night.

• Guided relaxation. I have practiced meditative relaxation for most of my adult life, usually before sleep. Tense muscles tend to become even tenser and are more likely to strain or pull surrounding tissues. So intentional daily relaxation is a good preventative measure for keeping the body relaxed after physical and emotional stress.

• Self-massage. I keep two electric massagers, one wired and one cordless, as well as one manual massager in my bed. On most nights, I massage my feet, the muscles above and below my knees, my glutes, and any upper body muscles that feel tense.

• Applying heat when I sense muscular tension or pain. I have two electric heating pads, one in my bed and another in my recliner. I use them on a medium setting on any area that feels tense, sometimes for hours at a time while working. Don't buy the fancy one with the timer — they shut off too fast and tend to break after a year or so of use. Get the cheapest one you can get on Amazon or Walmart with zero electronics, similar to this one [link].

Gravitation, a balanced moderate diet, and good circulation do the rest to keep my muscles, ligaments, and bones in good shape. These steps are not rocket science in any way. They reflect the low-damage lifestyle of many middle-class people in Western Europe and Japan, who tend to enjoy better health than many American men of the same age.

2. Repetitive strain from prolonged sitting, poor lifting mechanics, frequent bending, twisting, or sudden overload.

Prolonged sitting is a professional risk for me because I worked as a programmer from 1984 to 1998 and as a medical writer from 1999 to the present. I have enjoyed both occupations, and my work tends to be at the center of my life. Naturally, my workday often lasts 10 to 14 hours, much of it spent sitting in front of the monitor, and that would badly hurt my back.

To prevent this problem, I work almost exclusively in a recliner, with the laptop on my lap. This approach has allowed me to continue working crazy hours without damaging my back, neck, or wrists.

Occasionally, I need to work in front of a monitor when using layout programs or editing videos because this kind of work requires a large screen and the precision of a regular mouse.

I have done long, multi-week stints of this kind of work and, luckily, it did not cause any harm. I do use a mid-priced ergonomic office chair, a footrest, and a gel seat cushion from Wondergel. Less expensive versions are available on Amazon, but I have never tried them and cannot recommend one. Mine is over 15 years old and still looks like new, so the investment was worth it. I am not affiliated with that company in any way.

Poor lifting mechanics are a risk for everyone, regardless of physical conditioning or age, except for people who do this professionally day in and day out, because they can easily lead to muscle and ligament strain.

I am still able to lift significant weight, but I do it carefully and, so far, have avoided injury. Frequent bending, twisting, and sudden overload are not part of my life, and I am careful to avoid them as well.

3. Degenerative or structural problems such as spinal disc injury, facet joint arthritis, and spinal stenosis.

A spinal disc injury, also called a herniated or slipped disc, occurs when the soft center of a spinal disc pushes through a tear in its outer layer and causes pain, numbness, or weakness in the back, legs, or arms. Most cases improve on their own with rest, but chronic symptoms may require surgery.

Some clinical sources refer to disc herniation as a degenerative cause of back pain because it often arises from discs that have already weakened over time. But it can also occur at any age as a result of mechanical injury.

Facet joint arthritis, also called facet arthropathy, is a degenerative condition affecting the small joints in the spine that provide stability and allow movement. It typically causes pain and stiffness in the neck or lower back, often worsening with activity or after periods of inactivity.

Spinal stenosis is a degenerative condition that affects the spinal column, also called the vertebral column or backbone. It results from the narrowing of spaces within the spinal column, which puts pressure on the spinal cord and nerves. This can lead to pain, numbness, and weakness in the arms or legs. The condition is most common after age 50 and can occur in the lower back (lumbar spine) or neck (cervical spine).

I have never developed any of these degenerative conditions and do not expect to develop them for the rest of my life because my back is not degenerating the way it does in so many people as they age.

4. Nerve-related disorders and chronic pain conditions, such as lumbar radiculopathy or fibromyalgia, that can cause or intensify back pain through nerve irritation or increased pain sensitivity, even without major structural damage to the spine.

Fibromyalgia is a chronic pain condition that causes widespread muscle pain, tenderness, fatigue, and often sleep or concentration problems. It is thought to involve abnormal pain sensitivity rather than a clear injury to muscles, joints, or nerves.

Lumbar radiculopathy is a condition in which a nerve root in the lower back becomes irritated or compressed. It can cause pain, numbness, tingling, or weakness that travels from the lower back into the buttock, leg, or foot. You may be familiar with the term radiculitis, which is technically a subset of this broader condition.

Lumbar radiculopathy often has an inflammatory component because the affected nerve root may be irritated or compressed. Fibromyalgia is not generally classified as an autoimmune disease, although some researchers believe immune and neuroinflammatory mechanisms may contribute to it.

The pathogenesis of carpal tunnel syndrome is broadly similar to lumbar radiculopathy in that both involve nerve compression and inflammation, but carpal tunnel syndrome (CTS) is a peripheral entrapment neuropathy, whereas lumbar radiculopathy involves compression or irritation of a spinal nerve root.

I am well familiar with carpal tunnel syndrome because, back in 1996 to 1998, it destroyed my programming career and was brought on by late-stage undiagnosed type 2 diabetes that nearly killed me.

Today, it is well understood that type 2 diabetes is a precursor to many inflammatory conditions.

In my own case, recovery from type 2 diabetes led to full recovery from CTS, and I have been typing and using a mouse like crazy for almost three decades with no damage at all.

How does this relate to the recovery and prevention of lumbar radiculopathy? In my view, anything that relieves inflammation is also likely to relieve the symptoms of lumbar radiculopathy, just as it freed me from CTS.

My recovery from diabetes was completely self-guided and based on a simple observation: if this condition is caused by excessive carbohydrates in the diet, then reducing them to a minimum and eliminating sweetness, a trigger for insulin, should gradually lead to recovery from type 2 diabetes.

That observation turned out to be correct, and I was able to fully recover from both conditions.

The second equally important factor in my recovery, and in not experiencing a relapse of either diabetes or carpal tunnel syndrome, was supplementation. And this also brings us to fibromyalgia.

It has long been established that micronutrients found in vitamins, minerals, and trace elements play a major role in the pathogenesis, prevention, and recovery of neurological disorders, particularly those involving nerve metabolism, nerve conduction, tissue repair, and abnormal pain sensitivity. This is especially true of peripheral neuropathies and related nerve disorders, in which deficiencies or imbalances in nutrients such as vitamin B12, vitamin B6, thiamin, and other micronutrients can directly impair nerve function.

I believe that my continuous use of supplements over the past thirty years, along with a moderate, balanced diet, has been the primary factor behind my unusual resistance to aging in general and to back pain and neurological disorders in particular.

I describe my supplementation regimen here: How to Prevent and Reverse Low Back Pain.

5. Sciatica, meaning pain radiating along the sciatic nerve, usually comes from a herniated disc, spinal stenosis, muscle and ligament strain, or other forms of nerve root irritation or compression in the lower back.

Sciatica may also overlap with lumbar radiculopathy and be amplified by chronic pain disorders that increase pain sensitivity.

Strictly speaking, sciatica is more a syndrome or manifestation than a root cause category because it describes the pain pattern, not the underlying cause. For this reason, I am not going to dwell on this common condition further.

6. Inflammatory disorders, such as ankylosing spondylitis or other arthritic conditions affecting the spine, that cause pain and stiffness through chronic inflammation rather than simple wear and tear.

This kind of back pain often behaves differently from ordinary mechanical pain: it is commonly worse after rest, especially in the morning or at night, and may ease with movement or exercise.

I have never experienced the kind of back pain associated with inflammation because my diet and lifestyle are focused on preventing inflammatory conditions of all kinds and protecting me against digestive disorders, heart disease and stroke, kidney and liver damage, and non-genetic cancers.

7. Lower back pain may come from vertebral fractures caused either by major trauma or by weakened bone, especially osteoporosis.

Compression fractures are a common example and may occur with surprisingly little force in older adults or others with fragile bones. On the contrary, my height has remained unchanged, my back has remained structurally stable, and I have been able to continue working, walking, lifting, and handling physical tasks without any sign that my vertebrae have become weak or brittle. If my vertebrae were fragile, I would not be living and working this way at my age.

This completes my overview of what I do to prevent back pain, although, in many ways, it sounds more like a list of what I do not do. That is not accidental. In my experience, preventing back pain has far less to do with heroic exercise, complicated routines, or expensive interventions than with avoiding the kinds of habits, excesses, and injuries that slowly damage the spine over time.

Much of what protected my back was not dramatic at all. It was a matter of moderation, restraint, and refusing to treat physical wear and tear as a normal or necessary part of my aging.

Summary

There may well be other rare conditions behind back pain that are outside my area of expertise. However, those seven cover the majority of them. So, let's summarize what made me largely impervious to back pain in my senior years:

• Most back pain in later life comes from a limited number of causes, including weak support muscles, repetitive strain, degenerative spinal changes, nerve-related disorders, inflammation, and vertebral fragility.

• In my case, I believe I avoided these problems through moderate physical activity, careful lifting, ergonomic work habits, weight control, an anti-inflammatory lifestyle, and long-term supplementation.

• I do not believe the good condition of my back is a matter of luck. I see it in my unchanged height, preserved mobility, ability to work long hours, and the absence of the chronic pain, stiffness, weakness, and physical decline that so many people accept as normal aging.

• I believe that if you follow the same steps and start early enough, before degenerative conditions take hold, you can prevent back pain for the rest of your life, excluding an accident.

• If you are already experiencing some of these conditions, I do not know to what extent they can be reversed, but I do believe that their severity can be reduced and their progression slowed.

In the end, this guide is not about perfection, genetics, smarts, or luck, but about the cumulative effect of daily choices made consistently over many years before serious damage takes hold.

I cannot promise that every person reading this essay will get the same outcome, but I am convinced that most people can protect their backs far more than they think, reduce unnecessary suffering, and remain active and independent much longer than they were led to believe by the stories they read and by observing the aging of their older friends and relatives.

Author's note

I would like to retell the story from my Why Should You Trust Me essay in case you haven't read it yet:

People of all ages get into unfortunate accidents - winter falls, car crashes, slips in the bathtub, and so on. 

The number of deaths after bone fractures in the United States is staggering. According to the CDC, accidental falls lead to nearly 319,000 hip-fracture hospitalizations each year among older adults, and about 1 in 5 die within a year, which puts the death toll in the approximate range of 60,000. 

Vertebral compression fractures are also serious. In older adults, about 10% to 30% die within a year after a low-energy spine fracture, depending on the population studied. Many of those who survive are left with chronic pain and lasting physical limitations.

Don't become one of them.

Additional Reading

I wrote two detailed guides on this topic last year, but they were less focused on my own actions and experience. If you found this material useful, these guides provide additional background and perspective:

• How to Prevent and Reverse Low Back Pain.  Although this earlier guide covers a similar subject and includes my own experience with low back pain, it is neither the same material nor repetitive.

• Why Taking Calcium Doesn’t Prevent Osteoporosis. This title is not clickbait, and reading the guide may spare your body serious damage in later years.

The first guide focuses on the causes and practical management of low back pain, while the second explains why bone health and fracture prevention involve much more than simply taking calcium. Together, they provide a wider context for the concepts summarized in this guide.