Degeneration....The Ugly Truth

How many of you have been told you have osteoarthritis or joint degeneration? During my lectures, I like to ask the attendees to raise their hand if they have arthritis. I am never surprised to see the numerous amounts of hands that are raised. This is something that many of us in the health field experience daily. One question that patients typically ask is WHY? Why do I have osteoarthritis and degeneration?

Degeneration of the spine is seen commonly in our population. Many of my patient's X-rays show degeneration in very common locations, the mid neck, middle back and low back. There are two big reasons why these specific locations are present in many of my patients: Hypomobility and Hypermobility.

Hypomobility is a smaller range of motion than expected. Hypermobility is movement beyond the expected normal range of motion. These two things can occur due to bad posture and improper motion. There are three things to concentrate on for proper posture: Neck Stability, Shoulder Stability, and Core Stability. These are overlooked in today's society.

The cervical region, or neck, is a common location of pain and degeneration. The head weighs eight to ten pounds. In a neutral position, the head is well balanced and puts zero pounds of pressure on the spine. For every inch the head hangs forward, it feels as if the weight of the head has doubled. This places a great deal of stress on the neck. When you hang your head forward, it causes the bottom of your neck to become hypomobile over time. To look straight ahead and not at the ground you then have to look up. This causes the upper neck to become stiff or hypomobile. If you cannot move as well through these areas, you have to make up for it in other areas. This cause the mid neck to become hypermobile. Hypermobility can lead to bone spurring.

Bone spurs are formed at the front of the spin in the mid neck to try to fuse the vertebra together. This is a way of protecting the spinal cord and nerves that are located at the spinal canal toward the back of the vertebra. Bone spurs show that there is a problem in that area that needs to be addressed. This degeneration can lead to pain and numbness in the arms and hands. The following is the progression of degeneration. Another instability that can lead to degeneration of the spine is shoulder instability. Shoulder instability is very prevalent in our population. Many people walk around with their shoulders rolled forward in a slumped forward posture. This is due to having weak mid back muscles and strong chest muscles. The shoulder is in a stable position when the shoulder blades are down and back. Bad Posture is when someone is slumped forward. THis posture causes an increase in the curve of the back. An increased pressure is then applied to the disc leading to degeneration of the spine. Also, when the shoulders are rolled forward, it pus an increased pressure on the rotator cuff muscles due to the tightness in the muscles. This can increase the likelihood of a rotator cuff tear. Shoulder blade stability allows stress to be taken off the front of the shoulder. It also helps take pain away from the area between the shoulder blades.

For the low back, the importance of core stability cannot be stressed enough. Core Stability helps prevent degeneration of the lower spine. It protects the spine from improper motion and decreases the likelihood of a disc bulge or herniation. Disc bulges are seen commonly in the low back because of improper lifting and weakness in the core muscles. Postural exercises are very important to prevent degeneration of the spine.

While sitting at the Oak Ridge football games, I cannot help but notice the posture of the high school students sitting in the stands. Their whole body is slumped forward. I read x-rays on a daily basis and I know what this is leading to. Many people blame age as the sole reason for degeneration. If this were the case, why do I see patients in their twenties with degenerative disc disease? What could possibly cause this to be so prevalent?

How many of you remember purchasing your first computer? Many of us had the luxury of not sitting at a computer since the age of two. Children and teenagers now sit at a computer for several hours a day. Also, they sit there and text message their friends or play video games. The common denominator here is SITTING. We are not equipped to sit. OUr hunter-gatherer ancestors did not have time to sit. They were up hunting and gathering up necessary food and water for energy needed to hunt and gather the next day. We have the luxury of gathering up all we can fit in a cart at the grocery store that somebody else has hunted and gathered for us. We are a nation that sits and a lot of time our eight-hour a day jobs require it. We must become aware of our poor posture in order to avoid further complications down the road. Aging is not the sole reason for the occurrence of degeneration. It is improper posture and improper motion over a period of time.

Dr. Clark Eckert, D.C.