It is happening folks … we are aging. And so are our bodies. Some of you may notice that as this is occurring, stiffness is ensuing and flexibility is harder to maintain in the joints of the body. A good contributor to this problem is something called degenerative disc disease (DDD). It is a natural process that occurs in the spine, specifically with the cartilaginous discs between the vertebrae, and is present in almost all older individuals. Imaging studies (X-ray or MRI) have shown that 80 percent of people at age 50 and 93 percent at age 70 have signs of degenerative discs. Like I said, it is happening. This process has been described as “wrinkles on the inside,” as they are changes occurring to everyone and are natural. In this column, I will talk a little bit about what is happening, and discuss some preventative and lifestyle approaches that can be made to combat this aging process.
The “shock absorbers” of the spine are the intervertebral discs, which provide cushion for the spine with vertical load, as well as twisting and bending motions. They help the back stay flexible and absorb shock as we load the spine in activity. As the body ages, the discs become thinner and more dehydrated, experiencing fluid loss, and the space between the vertebrae gets narrower. Cracks and tears can also happen in the outer ring of the disc. This can lead to back and neck pain in those associated areas, but pain is not always present. In my office, I see patients daily that have degenerative discs and surprisingly experience no pain in the area of disease. A more common complaint is stiffness, loss of range of motion and flexibility. In cases where advanced DDD is present, vulnerability is present in that disc space. This vulnerability is secondary to inflammation and spinal instability, and can be easily aggravated, which can lead to pain in the back and associated nerves, which can manifest as radiating pain down the legs or into the arms. In these advanced scenarios, further intervention may be needed and consult from an orthopedic surgeon is necessary.
Although it sounds like doom and gloom that your spine will shrink no matter what, there are some great tools to keep things flexible and maintain hydration in the discs. I’m going to talk about three specific lifestyle components, including exercise, diet and supplementation, and specific spinal therapies, all of which studies have shown to slow DDD progression.
Exercise is a key component to managing the aging process in a lot of ways. It helps our cardiovascular risk, promotes good mental health and keeps the body moving. One of the things that keeps joints from stiffening over time is keeping them flexible, by bringing them through full range of motion in a balanced and stable way, consistently with exercise. In considering what exercises to do for spinal health, I like to think about three components of exercise — stretching, strengthening and cardio. The stretching piece seems very intuitive and maintaining flexibility is obviously of major importance in the aging process. This could be a regular yoga practice or simply a few dedicated stretches every day that help to loosen the spine and surrounding musculature. The component that is gaining attention and I think is the most important is the strength piece, more specifically, core stability. When the spine is ever so slowly shrinking and the discs are losing height, core strength and stability can provide a “girdle” for you and literally help hold you up and take pressure off the disc spaces. When building a “core,” it is important to understand your body’s specific weaknesses, address alignment and build stability around a good foundation. I would advise seeing a physical therapist, chiropractor or personal trainer initially to address this issue and be sure to be strengthening in a balanced way to avoid further injury.
In addition to exercise, diet and supplementation can help prevent degeneration of the spine and nourish joints in the body. An anti-inflammatory diet, low in sugar, alcohol, dairy and gluten can be a good place to start. Also, foods or supplements rich in omegas are a good option for anti-inflammatory effect as well.
Finally, a good way to work on spinal health is to make sure that the muscles, tendons and vertebrae of the spine are in alignment and moving well. This can be addressed in many ways and a combination of therapies is probably most beneficial. Therapies may include massage, rolfing, myofascial release, to name a few, as well as many other techniques can be a great way to address the soft tissues. Alignment can be evaluated and corrected with chiropractic, physical therapy and Pilates. I find it best to choose a therapy that you are comfortable with and be consistent. Consistency is key! With proper alignment and a good foundation, strength can then be gained to maximize the work you are doing on your own to keep good spinal health.
Basically, there is no pill to prevent the spine from degenerating, but general lifestyle changes can be made to significantly slow the process.
For further information or to schedule an appointment please contact Dr. Jessica Balbo at Alison Palmer Physical Therapy and Wellness Center at 612-384-3529 or firstname.lastname@example.org.