Dr Margaret MacGregor at Pinnacle Surgical Partners looks at how back and spine problems develop and how we can help avoid them.
As we age, degenerative changes occur throughout the body, with spondylosis (a painful condition of the spine resulting from the degeneration of the discs) being the fundamental process that leads to the majority of clinical problems for which one seeks treatment. Spondylosis is seen in approximately ten percent of humans at age twenty-five, and 95% of those aged 65. The degeneration begins in the disc itself—the disc begins to desiccate, leading to its loss of height, and then transfer of the load bearing to the adjacent joints and supporting soft tissues. The stress causes enlargement of the joints and ligaments, resulting eventually in narrowing, or stenosis, of the spinal canal and foramina (or apertures through which the nerve roots exit). As the discs tend to degenerate more to the front, it causes us to tend to flex forward as we age. This, in turn, causes the ligaments at the back to stretch and weaken, making them more likely to be injured. As these degenerative changes progress, it increases the likelihood of injury. Known risk factors for progressive spondylosis include smoking, repetitive trauma, and genetics..
Types of problems which occur as a result of spondylosis, or normal aging include axial pain (meaning located just within the spinal column, not into arms or legs), radicular pain (meaning pain along a nerve root), and myelopathy (symptoms which result from chronic spinal cord compression).
As low back pain is one of the most common types of pain reported, and it affects over eighty percent of us at some point during our lifetime, and accounts for over two out of every hundred visits to the doctor’s office, it represents a significant cause of pain and disability. Treatments, both invasive and non-invasive are best directed toward the root cause of the problem.
What tactics can one employ to prevent or lessen the severity of any of this pain? The answer is often to listen to the advice our mothers may have given us long (or even not so long) ago.
Eat less! The correlation between obesity and (especially) low back and joint pain is well established. The forces exerted on the spine by a large belly cause additional strain on the low back. Obesity increases the risk for any surgical procedure, and correlates with an increased risk
Exercise more! Purposeful activity is important at any age. Exercise builds muscle mass, (which aids in osteoporosis prevention), improves flexibility and balance, helps with weight loss and overall health. Do what is suitable for your age and overall physical condition. Water therapy is often helpful, as it offers resistance, and by immersing the body, the joints and spine are carry less load than when on the ground. Yoga is an excellent form of exercise—it is adaptable for any age group and physical condition, focuses on core strength, stretching, and flexibility, as well as balance, breathing, and mind-body awareness. Pilates, especially with equipment is another favored form of exercise.
Sit up straight! It is important to have correct posture when standing and sitting. Poor or incorrect posture will, over time, lead to elongated, weakened, and inactive upper back muscles, weakened and elongated back muscles, shortened hamstrings and pectoralis muscles. If spending long hours at a computer for work or home office, consider using a standing desk. Also, make sure that all screens and keyboards are ergonomically correctly positioned. Take frequent breaks from sitting. Use a telephone headset to avoid continuous lateral bending Consider your choice of seating—a large therapy ball changes passive sitting to active sitting, improves core strengthening, balance, and can be used for stretching.
Take your vitamins! A good multivitamin, but in particular Vitamin D, in the form of D3 (as it is most easily absorbed) is paramount. A high percentage of today’s population is deficient in Vitamin D—the vitamin which obtained naturally from the sun, is blocked by sunscreen. Vitamin D is paramount in calcium metabolism. Calcium, in turn, is needed not only by the bones, but by every cell in the body for proper metabolism. Vitamin D facilitates normal immune system function, and aids in the prevention of some diseases, as well as depression. Darker skin tends not to absorb Vitamin D as well (due to the increased melanin content). Symptoms of Vitamin D deficiency include: joint and muscle ache, fatigue, stress fractures, and difficulty thinking clearly.
Don’t smoke! In addition to the myriad of other problems related to tobacco, cigarette smoking is known to accelerate disc degeneration, lead to softer bones, delay wound healing after surgery, and impair bony fusion after surgery or fracture.
Although we cannot prevent aging, there are concrete steps we can take to improve our overall health and well-being, and, in turn, the health of our spine, thus decreasing the incidence of back and neck complaints throughout our lives.
To schedule an appointment, please call Pinnacle Surgical Partners at 615.885.2778 or visit us online at www.pinnacleneurosurgery.com