Most of the time, X-rays or other imaging appears normal or within normal limits for the person with mechanical LBP. Treatment is usually conservative with an emphasis on keeping active.

In older adults, low back pain with pain into the buttocks and/or down the legs is often a sign of disc degeneration. Arthritic changes of the facet (spinal) joints can also contribute to painful symptoms.

You may want to ask your uncle a few more questions about his symptoms. For example, watch for pain at night that wakes him up. This may be a signal of something more serious. Pain that stays the same no matter what position or activity he is engaged in may also be a warning flag.

Even true mechanical LBP raises concern for an older adult. He may become unsteady on his feet or even suffer frequent falls. If there are aging changes in the spine causing stenosis (narrowing of the spinal canal), then pressure on the nerves can cause bowel and/or bladder problems.

Even if your uncle is absolutely certain he has mechanical LBP, it may be a good idea to suggest a physical exam. A medical doctor is really the one to rule out more serious pathology.

And there's treatment for LBP that doesn't necessarily involve surgery. Maintaining motion, strength, and function are very important as we get older. A physical therapist can provide your uncle with some practical ways to prevent loss of balance, falls, and fractures that can be very disabling.