My back is getting old, and the problems it is causing have become, quite literally, a pain in the backside.

Until pain manifests itself, most people probably don't give much thought to their backs and the role this body part plays in every aspect of our lives.

For months I ignored the lower back aches and severe cramps down my legs whenever I am upright. Only bending over or sitting seem to diminish the pain.

When Ibuprofen and Tylenol, even taken together, failed to provide relief, I knew it was time to do some research and visit a doctor.

The probable source of my pain, I learned, was inflammation or compression of the spinal nerves, especially the sciatic nerve that runs from the lower back through the buttocks and all the way down the back of each leg.

Several medical conditions can cause this malady, and the most common, unfortunately, are age related.

Spinal stenosis occurs when the spinal canal narrows and puts pressure on nerve roots that run through it. This narrowing can be caused by degeneration of bones in the vertebral column.

Another common cause of sciatic nerve pain is a herniated disk. As we age, the cushions (disks) between our vertebrae can flatten and bulge. Eventually a disk may start leaking the jelly-like substance inside, and as this substance oozes, it presses on the spinal cord and nerves.

Arthritis can be another cause of severe back pain, and what person over 60 hasn't experienced arthritis in some part of the body!

In the spine, arthritis causes the spaces between the vertebrae to narrow, resulting in disk bulges or bony growths that put pressure on nerve roots.

To accurately diagnose the cause of back pain, a doctor may order one or more tests that show what is happening with the spine.

Spinal X-rays primarily show bones, bone spurs and fractures. An X-ray of the back also is useful for spotting age-related vertebrae changes.

MRI (magnetic resonance imaging) tests seem to be the first choice of most physicians. These images can show disk changes and pressure on the spinal cord and nerves.

CT (computerized tomography) tests combine X-ray images from many different angles. When a contrast dye is injected into the spinal column, the dye highlights the spinal cord and nerves.

Nonsurgical options usually are the first line of treatment.

Over-the-counter medications for pain and inflammation work for some folks. If that treatment does not work, the doctor may prescribe stronger drugs that contain narcotics. These drugs, however, can become habit-forming, so they should be used for only a short time.

Some doctors may recommend treatment options such as acupuncture, massage or spinal manipulation by an experienced chiropractor.

A physician may suggest physical therapy and moderate exercises, including in water, to strengthen back and abdominal muscles, build strength and maintain flexibility of the spine.

Heat and ice may be useful to ease pain and allow greater activity levels.

Another therapy I have tried is TENS, transcutaneous electric nerve stimulation, in which electrodes taped to the back deliver painless electrical currents to numb the area temporarily.

When all else fails, doctors often recommend corticosteroid injections into the space that surrounds the spinal cord. This injection usually relieves inflammation, but it must be used sparingly, because steroids can weaken nearby bones and tissues.

Only in rare cases is surgery the recommended treatment to create more space in the spinal canal so the nerves are not pinched.

In hoping to avoid narcotics, the injection and surgery, I am exhausting all the conservative options first. So far I have not had much success, but I plan to keep trying. Perhaps eventually something will work.

Like many other folks with chronic back pain, I will learn to manage the discomfort.

I simply refuse to let pain change my life.