You’re getting older. But how much of what you’re experiencing is inevitable and how much can you still influence?
Stiff mornings, slower recovery, less strength, the same ache returning, shakier balance. Too often, changes like these get filed under age and left there. For each of the seven questions below: what may be going on, what you can do about it, and when to have it looked at. Some changes are part of aging. Some deserve medical attention. And there may be more opportunities for improvement than you realize — at 45, at 65, at 85.
When do we start getting old?
At 40, when we notice we don’t recover quite as quickly? At 55, when getting out of bed takes a little longer? At 70, when someone tells us, “well, you’re not getting any younger”?
Or does something else happen along the way — do we gradually begin accepting limitations without ever asking whether we can do anything about them?
Some version of this walks into my office most weeks. Someone in her late sixties says her right hip has been bothering her for about a year. She stopped her Tuesday walking group. Getting out of the car takes a plan now. She had it looked at: ten minutes, an X-ray, and a sentence. Must be arthritis.
She’s 68. Her right hip hurts. Her left hip is the same age, and it doesn’t.
Could arthritis be part of the explanation? Absolutely. But is it the whole explanation? That is what I want to find out.
She is not unusual in having the question. In a national poll of adults aged 50 to 80, 70% reported current joint pain and 60% had been told at some point that they have arthritis. Among those with joint pain, about half said it limited their usual activities.
After forty years in practice, here is what I have learned. The number of birthdays we have celebrated does not tell the whole story. Some changes are inevitable. Others deserve a closer look. And a great deal of how we move and function remains open to improvement.
And let me say one thing before the list. If you are reading this at 70 or 80, you have almost certainly already tried things. You have been given advice, some of it contradictory. You have started programs and had them interrupted by a flare, an illness, a surgery or a winter. None of what follows assumes you have not thought about any of this.
What follows also isn’t a prescription. Where you start depends on your health, your history and what you are currently able to do — which is exactly what an examination is for.
So whether you are 45, 65, 75 or 85, here are seven questions worth asking. These are the questions patients bring me, not a ranking of what people search for online.
1. Why Am I So Stiff When I Wake Up?
What may be going on. Stiffness after a night of stillness is ordinary, and in mechanical and age-related joint problems it usually eases within a few minutes of moving. Joints need input, and sleep provides none. What matters is how long it takes to loosen up and whether movement helps.
What you can do. Time it for a week. Five minutes, twenty, forty-five, more than an hour. Then notice whether moving improves it or makes it worse.
When to have it looked at. Stiffness lasting substantially longer, involving several joints, appearing on both sides, or arriving with swelling is a different pattern. Prolonged morning stiffness is one of the features clinicians look for in inflammatory conditions, and it deserves medical evaluation rather than patience.
2. Why Does Everything Take Longer to Recover From?
What may be going on. Some of this is real and physiological: tissue repair and the muscle-building response to exercise do change with age. But a great deal of it is capacity. If the demand stayed the same while strength and endurance quietly declined, the same Saturday in the garden now sits closer to your limit than it used to.
What you can do. Rather than doing less, build more headroom. Raise the capacity so that an ordinary week stops landing at the edge of it, and spread demanding work across days instead of stacking it into one.
When to have it looked at. Soreness that lasts well beyond a few days, or recovery that keeps getting worse rather than holding steady, is worth examining.
3. Why Am I Losing Strength When Nothing Has Changed?
What may be going on. Muscle mass declines with age — by some estimates in the range of a few percent per decade from midlife, and faster after 60 — and strength tends to go with it. The important part is that this is not a one-way street. Older adults gain strength when they train, and that has been demonstrated repeatedly.
What you can do. Resistance work on two or more days a week is the general recommendation for every adult, with no upper age limit attached. Hard for you is what counts, not heavy by anyone else’s measure.
When to have it looked at. Strength that is clearly worse on one side, or weakness that comes with numbness, tingling or changes in sensation, is a neurological question and should be examined.
4. Why Do I Keep Getting the Same Ache in the Same Place?
What may be going on. A problem that resolves and returns to the same spot may be telling you that something about the demand, the load or the movement has not changed. There can be other explanations, which is why the pattern is worth examining rather than assuming. Pain tends to settle before capacity does, so people often return to the same week that produced the problem with slightly less to meet it.
This is also where imaging gets complicated. In a review of 33 studies of more than 3,000 people with no back pain at all, disc degeneration was present in 37% of 20-year-olds and 96% of 80-year-olds. In pooled studies of adults over 40 with no knee symptoms, 43% had cartilage defects and 37% had osteophytes. Findings like these are common in people who feel fine, which is why a finding needs your history and your examination beside it before anyone can say it is the reason you hurt.
What you can do. Count the pattern rather than the pain. How many episodes, how far apart, and what you have stopped doing since the first one.
When to have it looked at. Recurrence that is arriving more often, lasting longer, or spreading is worth examining rather than waiting out.
5. Why Is My Balance Different?
What may be going on. Balance is built from three streams of information — your eyes, your inner ear, and the sensors in your joints and feet — and your brain compares all three. It is also a skill, and it is kept by use. Most people were never given a balance program at any point in their lives, so it is often the capacity with the least in reserve.
What you can do. Practice balance where it is safe to practice it: on a firm floor, in a corner or beside a counter or sturdy rail you can hold, and start at the level you can hold comfortably. For many people that is standing with the feet close together while holding on, then with lighter support, and only later on one leg. Progress by ability rather than by calendar, and if you are unsteady or have fallen, have someone guide the progression rather than working it out alone. Have your vision and hearing checked. Vary the surfaces you walk on as your confidence allows.
When to have it looked at. Sudden loss of balance together with slurred speech, facial drooping, weakness or numbness on one side, double vision or a severe sudden headache may be a stroke. Call 911 immediately — do not wait, and do not drive yourself. Sudden severe vertigo with vomiting or an inability to walk is also an emergency.
Short of that: balance that has changed noticeably, unsteadiness that comes with numbness or weakness, and any fall or near-fall should be assessed promptly rather than practiced around. The ability to stand on one leg for ten seconds has been studied as a marker of health in middle-aged and older adults, and exercise programmes built around balance and functional movement reduce the rate of falls by roughly a quarter.
6. How Do I Know What’s Normal Aging and What Needs Attention?
What may be going on. Some changes are related to aging, some to how we use our bodies, and some to medical conditions that deserve attention. The pattern matters, but it doesn’t tell the whole story.
What you can do. Notice the pattern and bring it with you. Problems that vary with position, load and time of day, and that respond to movement, are often mechanical — but that is a clue, not a way to rule anything out on your own. Problems that progress steadily regardless of what you do deserve attention sooner.
When to have it looked at. Do not file these under aging: new or progressive weakness, numbness that does not resolve, unexplained weight loss, fever, or night pain that consistently wakes you. Those warrant prompt medical evaluation.
And one is more urgent than the rest. New loss of bladder or bowel control, or numbness around the groin or inner thighs, particularly alongside back pain or leg symptoms, should be treated as an emergency — go to an emergency department rather than waiting for an appointment.
7. What Can I Do Now to Keep Doing What I Love in Ten Years?
What may be going on. This is the question underneath the other six, and it is the one most worth answering while nothing is urgent.
What you can do. Three things carry most of the weight: strengthening work on two or more days a week, something that challenges balance on three or more days, and continuing to do the things you want to keep — because abilities we stop using can become harder to maintain.
And notice the advice you have been given. If everything you were told was something to stop doing — stop running, don’t lift that, give up the garden — then half the plan is missing. Avoidance has a place, especially early. Nothing is built by subtraction alone.
One assignment, if you take nothing else from this article: write down one activity you want to still be doing ten years from now. Then name one thing you can begin this week that helps preserve that ability.
When to have it looked at. If something has been limited for more than a few weeks, that is the moment to have it examined, while there is less to undo.
What Age Does Explain
And here is the part worth knowing: structure does not have to change for symptoms and function to change. In knee arthritis the X-ray and the symptoms line up poorly — across studies, somewhere between 15% and 81% of people with arthritis visible on film actually had pain. Which means that “the X-ray shows arthritis” and “this is why you hurt, and nothing can be done” are two different statements.
I don’t want to oversell this. Tissues change. Recovery slows. Some conditions become more likely with each decade, and sometimes an examination confirms exactly what you were told — that part of this cannot be restored, only managed and worked around.
The difference is that you will know. An examination may confirm that aging-related changes are contributing. But the explanation should come from what we find, not simply from the number of birthdays you have celebrated.
Getting older may explain some of what changes. It doesn’t mean we should stop asking why.
Where Chiropractic Fits in This
I’m a chiropractor, so here is the part of this that is mine. Several of these questions involve how your joints move and how your nervous system is controlling that movement: the stiffness that eases once you start moving, the ache that keeps coming back to the same place, strength that has changed on one side, balance that depends in part on what your joints and feet are reporting.
Imaging and lab work are very good at finding what I would call hard lesions — a fracture, a tumor, an infection, a tear. Those have to be found, and when one of them is what you have, that is where you belong. What I am examining for is the soft lesion: joints that aren’t moving the way they should, muscles that fatigue early, patterns that load one area over and over, and what all of that does to the nervous system controlling it. It usually doesn’t appear on an image. It appears in how you function — and it is often what is still there after the hard lesions have been ruled out.
It is not a fringe position. The American College of Physicians’ guideline on low back pain lists spinal manipulation among the non-drug treatments to try first, for acute and for chronic pain alike, before medication.
One more thing, and it matters more than people expect. The body heals on its own timeline, not on ours. I can restore motion where it is restricted, examine how the joints and the nerves serving them are working, and help you change the demands you keep putting on them. I cannot decide when your tissue will respond, and neither can you — wanting the headache gone by Thursday has never once set the schedule. Most of the disappointment I see comes from stopping at the point where something felt better rather than at the point where something had actually changed.
Your capacity to repair is also finite and shared. If you are sleeping badly, fighting something, recovering from surgery or carrying an untreated condition, less is available for the hip. And if you are not responding the way the findings predicted, that is information too — sometimes it means the plan needs to change, and sometimes it means something else is going on that we haven’t found yet. Either way it is a reason to look again, not a reason to wait longer.
And some of what turns up isn’t ours. Being examined is how you find out which it is.
An Invitation
Whether you live in Santa Monica or are reading this from somewhere else, you are welcome at Ptak Family Chiropractic.
We’ll look at how you move, how your joints function, and what your strength, balance and neurological findings show us. What we find determines what we do — and if what you need belongs with your physician or another specialist, we’ll tell you that too.
If you have been told to live with something, bring us the question you’ve been asking yourself. We never charge you to sit down and talk about your needs. Call Ptak Family Chiropractic at 310.473.7991 and make an appointment.
Or visit ptakfamilychiropractic.com.
Getting older is inevitable. Giving up the things you love doing shouldn’t be automatic.
Your age tells us how long you’ve lived. It doesn’t tell us everything about how well you can live from here.
Selected References
University of Michigan National Poll on Healthy Aging. Arthritis and joint pain. January–February 2022 survey; published September 2022.
Bedson J, Croft PR. The discordance between clinical and radiographic knee osteoarthritis: a systematic search and summary of the literature. BMC Musculoskeletal Disorders. 2008;9:116.
Qaseem A, Wilt TJ, McLean RM, Forciea MA. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Annals of Internal Medicine. 2017;166(7):514–530.
Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. American Journal of Neuroradiology. 2015;36(4):811–816.
Culvenor AG, Øiestad BE, Hart HF, Stefanik JJ, Guermazi A, Crossley KM. Prevalence of knee osteoarthritis features on magnetic resonance imaging in asymptomatic uninjured adults: a systematic review and meta-analysis. British Journal of Sports Medicine. 2019;53(20):1268–1278.
Volpi E, Nazemi R, Fujita S. Muscle tissue changes with aging. Current Opinion in Clinical Nutrition and Metabolic Care. 2004;7(4):405–410.
Araujo CG, de Souza e Silva CG, Laukkanen JA, et al. Successful 10-second one-legged stance performance predicts survival in middle-aged and older individuals. British Journal of Sports Medicine. 2022;56(17):975–980.
Sherrington C, Fairhall NJ, Wallbank GK, et al. Exercise for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews. 2019;1:CD012424.
World Health Organization. WHO Guidelines on Physical Activity and Sedentary Behaviour. Geneva: World Health Organization; 2020.
About the author. Dr. Jeffrey Ptak, DC, DSS, MSS, MA, founded Ptak Family Chiropractic in Santa Monica and has practiced since 1986. He is the author of the forthcoming book It’s Like You Never Left, to be published by Indigo River Publishing.
Educational information only; not a diagnosis or a substitute for individualized care. This article does not suggest that imaging is unnecessary or that a clinician’s explanation is incorrect; it describes questions worth asking. Begin new physical activity at a level appropriate to your current health and ability, and practice balance only with stable support and, where appropriate, supervision. Seek prompt medical evaluation for new or progressive weakness, persistent numbness, unexplained weight loss, fever, or night pain that consistently wakes you. Seek emergency care immediately for new loss of bladder or bowel control or numbness around the groin or inner thighs, and for sudden balance loss, slurred speech, facial drooping, one-sided weakness, double vision, severe sudden headache, or severe vertigo with an inability to walk.
Ptak Family Chiropractic
We listen… We care… We get results…
Chiropractic for Adults and Children
3122 Santa Monica Blvd., Suite 102 · Santa Monica, CA 90404
310.473.7991 · ptakfamilychiropractic.com
Mon / Wed / Thurs 8:00–12:15 and 2:00–6:00 · Tues / Fri 8:00–12:00 · Sat 10:00–12:00