February 03, 2014

Discs

Articles by Dr. Erdman are for informational purposes, and are not to be taken as specific medical advice.

It’s been awhile since I’ve written on a chiropractic specific topic. There is a lot of misinformation about intervertebral discs from many sources. Most doctors believe that once a spinal disc or nerve is damaged, you need surgery or are forced to live with pain, weakness and organ malfunction for the rest of your life.

The truth is that while the spine can and does easily degenerate, it can also regenerate. Conditions once thought to be permanent can many times be stopped, and sometimes reversed. Chiropractic, like medicine, is becoming more specialized all the time. The special training necessary to physically change your condition by fixing your postural problems is not to be found at every office, nor is every patient a candidate to be fixed. The process of rehabilitating a degenerated spine is time consuming and requires significant active participation from the patient. Not everyone is willing to put in the time and effort necessary to achieve a better spine.

Your spinal disc number twenty three from head to sacrum. Discs are about 88% water. A loss of 12% of the water in the disc will reduce its height by 50%. Research shows that a 1 mm loss of disc in the neck and a 1.4 mm loss in the lumbar region will cause the same amount of neurological compression and IVF encroachment as an 8 degree rotation. (It takes 3 degrees of rotation to pinch the nerve and cause pain down an arm or leg or disrupt internal organ function). You can see it doesn’t take much change to alter its function.

Up until puberty, the disc receives nutrition and eliminates waste product like most other soft tissues, through a supply of blood. After puberty, vessels to the disc atrophy and disappear completely by the start of your third decade of life. This is huge! Simply put, your body does not use blood supply to nourish or heal the discs after about the age of 20. So how do they keep living?

The discs must receive their necessary water, nutrients and eliminate waste from osmosis and imbibition. The only way this occurs is through loading/unloading cycles by each and every spinal unit attached to each disc. This is called hysteresis. Hysteresis is essential for correcting the spinal structures; by reducing the tensile strength and rebound elastic energy in the disc prior to adjusting or corrective exercises, you allow for improved outcomes and motion. Consider the disc a sponge. It can hold a significant amount of water. But the only way to exchange the water in the sponge with other water is to squeeze or twist it. This is exactly what must occur for your discs to stay alive. Motion is life; lack of motion is a slow death for discs.

From the time you crawl out of bed in the morning to when you jump back into bed, you lose an average of 20mm of height. The sleep cycle allows the unloaded discs to regain much of the lost water height, but not all of it.  This is another reason sleep is very important.   Since some height is not regained, the spine becomes shorter starting at about age 30. It is common for most adults to lose two inches by age 60.

The multitude of injuries and accidents we put ourselves through along life’s winding path also plays a role in disc damage. If discs need complete motion by surrounding joints to be nourished and eliminate waste properly, what occurs when an area of the spine is damaged or reduced in segmental motion by injury? That’s right, less food to the joint, and the less healthy it becomes.

Therein is the reason posture and function go hand in hand. Your poor posture is acquired over a lifetime of insults. By not correcting the dysfunctions with chiropractic treatment, there remain areas of less function which feed the discs less nutrients as the years go on. Finally, one day, you’ve got enough pain to compel you to seek treatment. If you go to the medical side, they say, “Aha, you have arthritis, there’s nothing we can do. Take these pills for pain and inflammation; see you when it gets bad enough for surgery.”

If you come to this chiropractor, there are many things to be done to try to stop the degenerative changes. These include manipulation, posture specific exercises, posture corrective rehabilitation, and a life style change. Not everyone qualifies for corrective care at the moment, but it is a goal to work toward. If you are a male with a hundred pound beer belly, there’s nothing I can do to correct your posture until that goiter is gone. But in the meantime, there are exercises specific to discs and loading/unloading cycles to feed the discs regularly, and manipulation can help free up areas of dysfunction while you lose that weight.  And pain relief is possible even when correction may not be an achievable goal.

A healthy spine is a choice you must commit to in order to keep. Unfortunately, most doctors have little understanding of the complex biomechanical structures, and have no suggestions for their upkeep or rehabilitation. Most patients only want to be out of pain and only think of their backs when they hurt. You can’t ignore your spine until it hurts, then expect a simple adjustment to “fix” you up. It doesn’t work that way. Although I can usually help people “feel” better rather quickly, “correcting” the spine is a much different process, yet worthy of the outcome; a healthy, pain free spine.