Low Back Pain; Cold Weather Increasing Causes, Diagnosis, Treatment

Low back pain
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Low back pain (LBP) is a common disorder involving the muscles, nerves, and bones of the back. Pain can vary from a dull constant ache to a sudden sharp feeling. Low back pain may be classified by duration as acute (pain lasting less than 6 weeks), sub-chronic (6 to 12 weeks), or chronic (more than 12 weeks). The condition may be further classified by the underlying cause as either mechanical, non-mechanical, or referred pain. The symptoms of low back pain usually improve within a few weeks from the time they start, with 40-90% of people completely better by six weeks

Low back pain is a symptom, not a specific disease. Low back pain is discomfort in the lumbosacral area of the back that may or may not radiate to the legs, hips, and buttocks. It is a symptom that can have many causes. As many as 90% of all individuals may never have a clear diagnosis for the cause of the pain. A small percentage may have a more serious disease not related to the back.

Types of Low Back Pain

The duration of back pain is considered in three categories, following the expected pattern of healing of connective tissue.

According to the severity

  • Acute pain – lasts up to 12 weeks, subacute pain refers to the second half of the acute period (6 to 12 weeks), and
  • Chronic pain – is pain which persists beyond 12 weeks.

According to the pain category

Low back pain can be broadly classified into four main categories

  • Musculoskeletal – mechanical (including muscle strain, muscle spasm, or osteoarthritis); herniated nucleus pulposus, herniated disk; spinal stenosis; or compression fracture
  • Inflammatory – HLA-B27 associated arthritis including ankylosing spondylitis, reactive arthritis, psoriatic arthritis, and inflammatory bowel disease
  • Malignancy – bone metastasis from lung, breast, prostate, thyroid, among others
  • Infectious – osteomyelitis; abscess

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Any one could predict an approaching storm when her joints ached, and she might have been onto something. Similarly, people with chronic back pain may notice a change in how they feel as the seasons change or weather shifts. But the connection between weather and spine pain isn’t well defined, and several reasons play into why a person might feel pain based on where they live or the season.

While some spinal conditions have a clear link to weather, the weather’s effect on pain may be more complex.“I don’t see a lot of research about how weather affects specific spinal conditions because it is so multi-factorial,” “But I’ve advised patients semi-jokingly after they’ve broken an ankle that they will be able to predict weather and amaze friends.”

While some spinal conditions have a clear link to weather (for instance, cold weather has been found to irritate sciatica), weather’s effect on pain may be more complex.

Types of low back pain associated with physical findings of no clear pathoanatomical significance
SyndromeFindingsAssessment/Plan
Facet syndromeHistory and physical examination:

  • local and pseudoradicular symptoms and signs
  • pain on movement
  • facet tenderness
  • pain on reclination
  • positive injection test
  • joint dysfunction on manual diagnosis

Radiological findings (not indicated on intial evaluation):

  • differentiation from high-grade or activated spondylarthrosis (possibly, juxtaforaminal cyst) or
  • axial spondylarthritis
Differential diagnosis:

  • major joint dysfunction (blockage)
  • activated spondylarthrosis

Treatment:
analgesics (1–3 days), muscle stabilization,
manual medicine, facet injection if indicated

Sacro-iliac joint syndromeHistory and physical examination:

  • sactro-iliac joint symptoms, positive provocation test
  • functional leg length discrepancy
  • injection test

Radiological findings (not indicated on intial evaluation):

  • differential diagnosis: inflammation (sacro-iliitis in seronegative spondylarthritis)
Functional disturbance:
muscular imbalance
Treatment:
stabilizing exercises, analgesics (1–3 days) if needed, manual medicine, sacro-iliac joint injection if indicated
Myofascial pain syndromeHistory and physical examination:

  • muscle trigger points: local pain with peripheral radiation
  • peripheral and central sensitization

Radiological and histological findings:

  • not indicated
  • no clear evidence from MRI or biopsy
  • pathogenesis and definitive diagnosis still unclear
  • (low intra- and interrater reliability)

Local treatment:
active physiotherapy, manual therapy, infiltration, acupuncture

Functional instabilityHistory and physical examination:

  • “snapping” feeling
  • generalized deconditioning
  • pain on movement, possibly accompanied by ‧sensory and motor deficits (reversible)
  • impaired proprioception

Radiological findings:

  • no direct evidence
  • unclear pathogenesis and definition
  • treatment with manual medicine
  • physiotherapeutic stabilization program
  • caveat: surgery, differential diagnosis, structural instability

Low back pain is often caused by non-pathological functional disturbances that are best detected by physical examination and cannot be adequately demonstrated by imaging studies, especially the following:

  • segmental dysfunction (e.g., “blockages” []),
  • sacroiliac joint syndrome,
  • altered spinal statics (e.g., hyperlordosis or straightening of the normal lumbar lordosis),
  • muscle dysfunction (e.g., Janda’s crossed syndromes, shortened muscles, trigger points),
  • connective-tissue changes (e.g., swelling, fascial hypomobility), and
  • systemic conditions (e.g., incoordination, inadequate deep stabilization, or constant hypermobility).

A Look at One Study Linking Weather and Low Back Pain

Rx medical team said a 2014 European study examined differences in perceived joint pain between older people with osteoarthritis (OA) who said they were weather-sensitive versus those who did not. The study participants came from 6 European countries with different climates.

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“More than two-thirds of the participants said weather affected their OA pain,” Dr. Hayden said. “The researchers found that people from warmer climates—the Southern Europeans—were more weather sensitive than those from Northern Europe, and weather sensitivity was also more prevalent among woman and people with anxiety conditions.”

Weather and seasonal changes can alter how we feel mentally and emotionally—and there’s a definite link between depression and back pain.

Dr. Hayden specifically noted the shift from warmer months into colder ones as a time when depression and other health problems peak.

Winter brings cloudier weather, which increases secretion of melatonin from the brain’s pineal gland, Dr. Hayden said. Melatonin makes people drowsier and less energetic. On the other hand, Dr. Hayden said sunlight increases serotonin, which makes you happy. And, when the weather is gloomy and their energy is zapped, people don’t spend much time outside.

“Outdoor activity and exercise help with joint pain,” Dr. Hayden said. “But when seasonal changes keep you inside, you will hurt more.” Dr. Hayden also said the seasonal change to winter means the holiday season is upon us, which may bring its own set of challenges.

“The holidays are very stressful to a lot of people,” he said. “It seems like there is a rash of heart attacks during the holidays. Lots of people have lost loved ones during the holiday season—and the changes in weather are reminders of that.”

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More Theories on Weather and Low Back Pain

While the literature on weather and back pain is limited, Dr. Hayden said some evidence suggests that seasonal drops in temperature may affect the viscosity of synovial fluid in joints. This could be one explanation why people with spinal joint pain experience a flare-up during cold weather. “Synovial fluid is the joint’s lubricant,” Dr. Hayden said. “Just like with a car, you want to warm it up when the weather is cold because the oil is thick and doesn’t lubricate as well—it’s the same thing with synovial fluid.”

Dr. Hayden said that the structures within your joints—tendons, ligaments, muscle, and other connective tissues—each have different densities and react differently to temperature changes. “When it’s cold, some of those connective tissues may be looser than others,” he said. “Those that are tighter may take longer to warm up, and they may produce joint dysfunction.”

Another thought is that barometric pressure changes could be the culprit. It’s this theory that supports the notion that people with joint pain can predict when it’s going to rain. “One rheumatologist said to think of the joint capsule and surrounding tissues in the joint as being a balloon,” Dr. Hayden said. “Barometric pressure squeezes on that balloon, so if the pressure drops—which happens when a cold front moves in—then the balloon in your joints expands. That inflammation can cause pain.”

One final theory that Dr. Hayden shared anecdotally but has not been confirmed in research is the idea that mold from rain can contribute to back pain. “I’m in the southeastern United States, and some of my patients tell me that their pain gets worse not only when it’s getting colder, but after it rains,” he said. Dr. Hayden hypothesized that rain gets trapped beneath the carpet of dead leaves under trees, causing mold to rise into the air.

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“I wonder if mold spores that fill the air a few days after a rain produce widespread allergies and an inflammatory response, heightening pain perception,” he said. “I think that’s possible, particularly down here in the south.”

Should You Move to a Warmer Climate for Back Pain Relief?

Several mental, emotional, and physical factors play into pain perception, and moving to a sunny locale may not be the answer. However, Dr. Hayden said warmer climates have been long thought to be healthier for several conditions. “You are more likely to be in the sun, so you’re more likely to be sucking up vitamin D, which is good for bones and joints,” he said. “You’re more likely to be in a better mood and stay physically active.”

But, if moving to a year-round warm climate isn’t an option, lifestyle changes (like the tips noted below) are typically enough to do the trick, Dr. Hayden said. He also said certain clinical treatments, like an infrared sauna, help capture the benefits of the sun even during the darkest winter days.

“Many of my patients in chronic pain feel relatively pain-free and relaxed after sitting in an infrared sauna,” he said. Unlike harmful ultraviolet rays, infrared light is healthy light from the sun. “This light penetrates deeply into your tissues, warms you, makes your connective tissue stretchier,” he said. “Connective tissue that moves better, hurts less.”

Symptoms of Low Back Pain

Weakness in the Legs – The weakness is often times asymmetric.

Loss of Sensation – Those affected may experience numbness or tingling in their perineum

Loss of Reflexes – A person’s knee and ankle reflexes might be diminished, along with anal and bulbocavernosus abilities.

Sensory Loss – Sensory loss may range from, ‘pins and needles,‘ to complete numbness. It might affect the person’s bowel, bladder and genitalia Bladder, Bowel and

corda equina syndrome/spinal nerve & pheripheral nerve harniation too

The associate clinical feature is..

Approximate area of “saddle anesthesia” seen from behind (yellow highlight)

Diagnosis of Low Back Pain

The first step in the rule is to exclude a neuropathic pain source by use of the IASP criteria [] and NeuPSIG guidelines []. The next step is to make sure that the following criterion 1 is satisfied in combination with either criterion 2 or 3

Criterion 1. Pain experience disproportionate to the nature and extent of injury or pathology, i.e. not sufficient evidence of injury, pathology, or objective dysfunctions capable of generating nociceptive input consistent with the patient’s severity of pain and disability. Criterion 2. At least one of the following patterns present

  • bilateral pain/mirror pain (i.e., symmetrical pain pattern)
  • pain varying in (anatomical) location/ traveling pain to anatomical locations unrelated to the presumed source of nociception e.g., hemilateral pain, large pain areas with non-segmental (i.e., neuroanatomically illogical) distribution
  • widespread pain (defined as pain located axially, on the left and right side of the body and both above and below the waist)
  • allodynia/hyperalgesia outside the segmental area of (presumed] nociception. These findings are based on testing of light touch by means of a swap or cold items (allodynia) as well as testing by pinprick or pressure (hyperalgesia).
  • Criterion 3. Hypersensitivity of senses unrelated to the muscular system. These findings are based on a score of at least 40 on the Central Sensitization Inventory [].

A doctor can diagnose cauda low back pain. Here’s what you may need to confirm a diagnosis

corda equina syndrome/mri-harniation disc-too

  • A computed tomography (CT) scan.
  • Urodynamic studies – may be required to monitor recovery of bladder function following decompression surgery.
  • In most cases of low back pain, medical consensus advises not seeking an exact diagnosis but instead beginning to treat the pain. This assumes that there is no reason to expect that the person has an underlying problem. In most cases, the pain goes away naturally after a few weeks. Typically, people who do seek diagnosis through imaging are not likely to have a better outcome than those who wait for the condition to resolve.

Treatment of Low Back Pain

Non-surgical 

Rest – It is important that patient take proper rest and sleep and avoid any activities which will further aggravate the disc bulge and its symptoms. Many minor disc bulges can heal on their own with rest and other conservative treatment.

Cervical Pillow – It is important to use the right pillow to give your neck the right type of support for healing from a cervical disc bulge and also to improve the quality of sleep.

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Specific treatment for lumbar disk disease will be determined by your health care provider based on

  • Your age, overall health, and medical history
  • The extent of the condition
  • Type of condition
  • Your tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the condition
  • Your opinion or preference

Typically, conservative therapy is the first line of treatment to manage lumbar disk disease. Approach for Treating and Reversing a Disc Bulge about half of the disc bulges heal within six months and only about 10% of the disc bulges require surgery. So, the good news is that conservative treatment for a disc bulge helps in treating as well as reversing the disc bulges.

Ice & Moist Heat Application

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Ice application where the ice is wrapped in a towel or an ice pack for about 20 minutes to the affected region, thrice a day, helps in relieving the symptoms of a disc bulge. Heat application in the later stages of treatment also provides the same benefit.

Hot Bath

Taking a hot bath or shower also helps in dulling the pain from a disc bulge. Epsom salts or essential oils can be added to a hot bath. They will help in soothing the inflamed region.

Traction

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  • Massage therapy may give short-term pain relief, but not a functional improvement, for those with acute lower back pain. It may also give short-term pain relief and functional improvement for those with long-term (chronic) and sub-acute lower back pain, but this benefit does not appear to be sustained after 6 months of treatment. There does not appear to be any serious adverse effects associated with massage.
  • Acupuncture – may provide some relief for back pain. However, further research with stronger evidence needs to be done.
  • Spinal manipulation – is a widely-used method of treating back pain, although there is no evidence of long-term benefits.
  • “Back school” –  is an intervention that consists of both education and physical exercises. A 2016 Cochrane review found the evidence concerning back school to be very low quality and was not able to make generalizations as to whether the back school is effective or not.
  • Patient education on proper body mechanics (to help decrease the chance of worsening pain or damage to the disk)
  • Physical therapy – which may include ultrasound, massage, conditioning, and exercise
  • Weight control
  • Use of a lumbosacral back support

Medications for Low Back Pain

  • Analgesics – Prescription-strength drugs that relieve pain but not inflammation.
  • Antidepressants – A Drugs that block pain messages from your brain and boost the effects of endorphins (your body’s natural painkillers).
  • Medication – Common pain remedies such as aspirinacetaminophen, ibuprofen, and naproxen can offer short-term relief. All are available in low doses without a prescription. Other medications, including muscle relaxants and anti-seizure medications, treat aspects of spinal stenoses, such as muscle spasms and damaged nerves.
  • Corticosteroid injections – Your doctor will inject a steroid such as prednisone into your back or neck. Steroids make inflammation go down. However, because of side effects, they are used sparingly.
  • Anesthetics – Used with precision, an injection of a “nerve block” can stop the pain for a time.
  • Muscle Relaxants – These medications provide relief from spinal muscle spasms.
  • Skeletal muscle relaxers –  may also be used. Their short-term use has been shown to be effective in the relief of acute back pain. However, the evidence of this effect has been disputed, and these medications do have negative side-effects.
  • Neuropathic Agents: Drugs(pregabalin & gabapentin) that address neuropathic—or nerve-related—pain. This includes burning, numbness, and tingling.
  • Antibiotic –  to the management of bowel & bladders control and protect further infection. Infection causes should be treated with appropriate antibiotic therapy
  • Topical Medications – These prescription-strength creams, gels, ointments, patches, and sprays help relieve pain and inflammation through the skin.
  • Calcium & vitamin D3 – to improve bones health and healing fracture.
  • Glucosamine & diacerine – can be used to tightening the loose tension and regenerate cartilage or inhabit the further degeneration of cartilage.
  • Corticosteroid – to healing the nerve inflammation and clotted blood in the joints.
  • Dietary supplement -to remove the general weakness & improved the health.
  • Lesion debulking –  is required for space-occupying lesions – eg, tumors, abscess.
  • If surgery cannot be performed – radiotherapy may relieve cord compression caused by malignant disease.
  • Radiation therapy and Chemotherapy – may have a role in treatment if the cauda equina syndrome is caused by the tumor.
  • Support or brace – A pelvic belt can be used to stabilize a joint that is too loose until the inflammation and pain subside.
  • Joint injections – Numbing injections into the sacroiliac joint are used diagnostically to help identify the cause of them but are also useful in providing immediate pain relief. Typically, an anesthetic is injected along with an anti-inflammatory medication.
  • Recommended—Cognitive behavior therapy, supervised exercise therapy, brief educational interventions, and multidisciplinary (biopsychosocial) treatment, short-term use of non-steroidal anti-inflammatory drugs and weak opioids.

    To be considered—Back schools and short courses of manipulation and mobilization, noradrenergic or noradrenergic-serotoninergic antidepressants, muscle relaxants, and capsicum plasters. Not recommended—Passive treatments (for example, ultrasound and shortwave) and gabapentin. Invasive treatments are in general not recommended in chronic non-specific low back pain.

Other treatment options

  • Other treatment options –  may be useful in certain patients, depending on the underlying cause of the CES
  • Weakness – Physiotherapy may be helpful if there is no inflammatory component such as that found in arachnoiditis where exercise might exacerbate the condition and cause flare-ups.
  • Sensory Loss – Little conventional treatment exists for sensory loss in cauda equina syndrome, although in conditions such as Multiple Sclerosis use of vitamin B complex is considered to have potential beneficial effects.
  • Sore Feet – Loss of muscle tone and control over the movement of the foot may lead to foot pain. If foot drop is a notable issue, a brace to hold it in position may help. It is important; however, to attempt to maintain as much muscle tone as possible as well as the range of movement (ROM). Exercises might help.
  • Sexual Dysfunction – Sexual dysfunction is very hard for people to talk about at times. It might be best to pursue advice from specialists. If no physical treatment is feasible for improving function, the person and their sexual partner might pursue counseling which might help to lessen the impact of this disability on not only the person affected but their partner.
  • Depression – Depression is an understandable reaction to a form of debilitating illness. Antidepressant medication should be reserved for severe depression. Counseling and support are the preferred methods of managing depression. Sharing experiences may help people with cauda equina syndrome to come to terms with the disabilities associated with cauda equina syndrome.
  • Poor Circulation – Poor circulation is a common issue in cauda equina syndrome. The person’s feet may be cold and turn white, then red when re-warmed (also known as, ‘Raynaud’s syndrome,) as well as chilblains. Some medications exist that can be taken, yet it is most likely best to use general measures such as avoiding getting cold feet and foot massage with warm oil to help improve the person’s circulation. Avoid extremely hot baths after the feet have been cold because it will most likely cause chilblains.
  • Postoperative care – includes addressing lifestyle issues (eg, obesity), and also physiotherapy and occupational therapy, depending on residual lower limb dysfunction.
  • Prolotherapy – the practice of injecting solutions into joints (or other areas) to cause inflammation and thereby stimulate the body’s healing response – has not been found to be effective by itself, although it may be helpful when added to another therapy.
  • Herbal medicines – as a whole, are poorly supported by evidence. The herbal treatments Devil’s claw and white willow may reduce the number of individuals reporting high levels of pain; however, for those taking pain relievers, this difference is not significant. Capsicum, in the form of either a gel or a plaster cast, has been found to reduce pain and increase function.
  • Behavioral therapy may be useful for chronic pain. There are several types available, including operant conditioning, which uses reinforcement to reduce undesirable behaviors and increase desirable behaviors;
  • Cognitive behavioral therapy – which helps people identify and correct negative thinking and behavior; and respondent conditioning, which can modify an individual’s physiological response to pain. Medical providers may develop an integrated program of behavioral therapies. The evidence is inconclusive as to whether mindfulness-based stress reduction reduces chronic back pain intensity or associated disability, although it suggests that it may be useful in improving the acceptance of existing pain.
  • Tentative evidence supports neuroreflexotherapy (NRT) – in which small pieces of metal are placed just under the skin of the ear and back, for non-specific low back pain
  • AcupunctureAcupuncture is needle puncture of the skin at traditional “meridian” acupuncture points. Modern acupuncturists also use non-meridian points and trigger points (tender sites occurring in the most painful areas). The needles may be stimulated manually or electrically. Placebo acupuncture is needling of traditionally unimportant sites or non-stimulation of the needles once placed.
    Back schoolBack school techniques vary widely, but essentially consist of repeated sessions of instruction about anatomy and function of the back and isometric exercises to strengthen the back.
    Beck Depression InventoryStandardised scale to assess depression. This instrument consists of 21 items to assess the intensity of depression. Each item is a list of 4 statements (rated 0, 1, 2, or 3), arranged in increasing severity, about a particular symptom of depression. The range of scores possible are 0 = least severe depression to 63 = most severe depression. It is recommended for people aged 13 to 80 years. Scores of more than 12 or 13 indicate the presence of depression.
    Cognitive behavioural therapyCognitive behavioural therapy aims to identify and modify peoples understanding of their pain and disability using cognitive restructuring techniques (such as imagery and attention diversion) or by modifying maladaptive thoughts, feelings, and beliefs.
    Low-quality evidenceFurther research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
    MassageMassage is manipulation of soft tissues (i.e., muscle and fascia) using the hands or a mechanical device, to promote circulation and relaxation of muscle spasm or tension. Different types of soft tissue massage include Shiatsu, Swedish, friction, trigger point, or neuromuscular massage.
    Moderate-quality evidenceFurther research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
    Multidisciplinary treatmentMultidisciplinary programmes are typically taken to comprise treatments provided by two or more healthcare providers with different professional training to obtain different perspectives and approaches to recovery. The term multidisciplinary does not imply a mandatory roster of specialists and does not dictate the nature of the treatment.
    Operant behavioural treatmentsOperant behavioural treatments include positive reinforcement of healthy behaviours and consequent withdrawal of attention from pain behaviours, time contingent instead of pain contingent pain management, and spouse involvement, while undergoing a programme aimed at increasing exercise tolerance towards a preset goal.
    Oswestry Disability IndexBack-specific, self-reported questionnaire measuring pain and function in completing physical and social activities. The scale score ranges from 0 (no disability) to 100 (maximum disability).
    Respondent behavioural treatmentRespondent behavioural treatment aims to modify physiological responses directly (e.g., reducing muscle tension by explaining the relation between tension and pain, and using relaxation techniques).
    Roland Morris Disability QuestionnaireA 24-item, self-reported, disability scale specific to back pain recommended for use in primary care and community studies. Measures daily function in completing activities affected by back pain. The scale score ranges from 0 (no disability) to 24 (severe disability).
    SciaticaPain that radiates from the back into the buttock or leg and is most commonly caused by prolapse of an intervertebral disk; the term may also be used to describe pain anywhere along the course of the sciatic nerve.
    Transcutaneous electrical nerve stimulation (TENS)Electrodes are placed on the skin and different electrical pulse rates and intensities are used to stimulate the area. Low-frequency TENS (also referred to as acupuncture-like TENS) usually consists of pulses delivered at 1 to 4 Hz at high intensity, so they evoke visible muscle fibre contractions. High-frequency TENS (conventional TENS) usually consists of pulses delivered at 50 to 120 Hz at a low intensity, so there are no muscle contractions.
    Very low-quality evidenceAny estimate of effect is very uncertain.

Surgery of Low Back Pain

Surgery for back pain is typically used as a last resort when the serious neurological deficit is evident. A 2009 systematic review of back surgery studies found that, for certain diagnoses, surgery is moderately better than other common treatments, but the benefits of surgery often decline in the long term.

  • Surgery may sometimes be appropriate for people with severe myelopathy or cauda equina syndrome.
  • When a herniated disc is compressing the nerve roots, hemi- or partial- laminectomy or discectomy may be performed, in which the material compressing on the nerve is removed.
  • A mutli-level laminectomy can be done to widen the spinal canal in the case of spinal stenosis. A foraminotomy or foraminectomy may also be necessary if the vertebrae are causing significant nerve root compression.
  • A discectomy is performed when the intervertebral disc has herniated or torn. It involves removing the protruding disc, either a portion of it or all of it, that is placing pressure on the nerve root.
  • Total disc replacement can also be performed, in which the source of the pain (the damaged disc) is removed and replaced while maintaining spinal mobility. When an entire disc is removed (as in discectomy), or when the vertebrae are unstable, spinal fusion surgery may be performed.
  • Spinal fusion is a procedure in which bone grafts and metal hardware is used to fix together two or more vertebrae, thus preventing the bones of the spinal column from compressing on the spinal cord or nerve roots.

If infection, such as a spinal epidural abscess, is the source of the back pain, surgery may be indicated when a trial of antibiotics is ineffective. Surgical evacuation of spinal hematoma can also be attempted if the blood products fail to break down on their own.

6 Ways to Keep Weather-Related Pain at Bay

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You don’t need to move to a sunny climate for the sake of your back. Dr. Hayden said you can minimize weather’s effects on how you feel with these tips

  • Watch your diet – Dr. Hayden recommended reducing your consumption of inflammation-inducing foods, such as red meats, fried foods, sugars, and processed starches. Also, eliminate tobacco use.
  • Stay hydrated –Alcoholic beverages not only dehydrate you, but they also worsen depression and anxiety. Dr. Hayden said drinking plenty of water is important for your spine, and it’s something often overlooked in seniors. “The thirst center is not nearly as sensitive in an older adult as it is in a younger person, and they can dehydrate in a hurry.”
  • Keep warm  Layer clothing or keep your house warm to shake the winter chill. But, Dr. Hayden also noted that you should keep a humidifier running with heat to help prevent respiratory problems caused by the effect of dry heat on your sinuses.
  • Get out in the sunlight on a regular basis  Natural light helps wards off depression, and it improves productivity in the workplace, Dr. Hayden said.
  • Exercise –“Physical activity is huge, particularly with low back conditions,” Dr. Hayden said. His exercise of choice is walking, which he said engages the postural muscles in the spine.
  • Find a good hobby  A hobby gives you a diversion from your pain—it releases endorphins, your natural painkillers. Dr. Hayden said he’s personally seen the benefits of this tip: “When I’m playing my music, I don’t feel my low back pain. A hobby gives you a focus besides what you’re feeling.”

References

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