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Another important consideration is the age of the patient. Some conditions such as arthritis and chronic degenerative disc problems are more common in older people. Osteoporosis, with thinning of the bones, may cause a collapsed vertebra and severe back pain. Elderly patients may also have back pain caused by secondary cancer deposits in the spine, for instance in older men with cancer of the prostate. There are features of back pain which suggest there could be a more serious cause; back pain that persists for weeks, or keeps the person awake at night, should always be checked in case further investigation is required. With chronic or recurrent back pain, a program of exercises can help to improve posture and take pressure off the lower intervertebral discs. The main emphasis these days is to get the person with the back problem very involved in the treatment plan. Activities such as high-impact aerobics and jogging may cause further back symptoms and should be avoided in people with back problems. In contrast, a swimming program may be very beneficial. |