Low back pain (LBP) in older adults is one of the most common and costly health issues – but also one of the most misunderstood. A new review paper, Ten myths of back pain in older adults that can lead to ineffective and harmful care, by Carlo Ammendolia, published in Chiropractic & Manual Therapies, highlights ten persistent myths that can lead to ineffective and even harmful treatment of older patients.
Myths That Cost – Both financially and in Quality of Life
According to Carlo Ammendolia, misinformation and outdated beliefs about back pain are major drivers of overtreatment, unnecessary surgeries, and excessive medication use – all of which can worsen outcomes and reduce quality of life. Many of these myths are perpetuated by media, industry, and even healthcare professionals.
Here are some key takeaways:
- Back pain is not inevitable with aging. While common, its prevalence peaks before retirement age and then declines.
- Most back pain in older adults is not caused by serious disease. Less than 5% of cases are due to conditions like cancer or fractures.
- Routine imaging is rarely necessary. MRI and X-ray findings often don’t correlate with symptoms and can lead to overtreatment.
- Movement is medicine. Activity promotes healing, while inactivity worsens pain and function.
- Medication should not be the first line of treatment. Non-pharmacological approaches like exercise and manual therapy are often more effective and safer.
The Chiropractor’s Role: From Myth-Buster to Change Agent
The paper urges chiropractors to actively challenge these myths and promote evidence-based care. This includes:
- Educating patients about what’s normal in aging – and what’s not.
- Avoiding unnecessary imaging and invasive procedures.
- Encouraging physical activity and function over fear and avoidance.
- Collaborating across disciplines and using biopsychosocial approaches, especially for chronic pain.
A Call to Combat Age Bias and Overmedicalization
Carlo Ammendolia points out that these myths also reflect ageist tendencies in healthcare. Older adults are often offered more medication and fewer conservative treatments – despite evidence suggesting the opposite approach is more effective.
What Can Chiropractors Do?
- Update your knowledge on back pain in older adults – using WHO guidelines and recent research.
- Talk to your patients about their concerns and beliefs – and help them understand their pain.
- Be critical of habitual practices and overtreatment – and advocate what works.
Carlo Ammendolia. Ten myths of back pain in older adults that can lead to ineffective and harmful care. Chiropractic & Manual Therapies 2025.
Read the research paper here