My 36-year old grandson seems to have as much back pain as I do. At 89, I have spinal stenosis that hurts like a son-of-a-gun. If he’s this bad off now, what’s he going to be like at my age?

You ask a very interesting question. Understanding the cause of back pain helps predict future events. Some (but not all) spinal disorders can follow us from young adulthood into our older years.

For example, spondylolysis can become spondylolisthesis and cause many problems. Spondylolysis is a condition in which the pars articularis, a supporting structure of the vertebral body gets a tiny crack or fracture. By itself, this may not be a problem. But if the fracture is enough that the body of the vertebra pulls forward (spondylolisthesis), then back pain and neurologic problems can occur.

There’s something else to consider with low back pain (LBP). Studies show that younger people are more likely to have severe LBP. They have less energy and more fatigue. LBP has a bigger impact on their social lives. They are more likely to report the back pain has a negative effect on their overall physical health.

Your grandson’s current LBP may not have any bearing on his future back condition. On the other hand, all aging adults are at risk for spinal stenosis. This is a narrowing of the spinal canal. It’s caused by age-related changes in the spine. Previous back injuries or back pain is not clearly linked with spinal stenosis.