You may not be aware of it, but your spine starts to age in your 20s and 30s, and that continues throughout the rest of your life.
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“We all experience degenerative changes, but the good news is that these changes don’t always cause serious problems,” says spine specialist Kush Goyal, MD.
There is no actual disease called degenerative disk disease (DDD), Dr. Goyal says. He believes DDD is not a diagnosis, but more representative of natural aging in the spine that we all eventually experience.
Dr. Goyal adds that natural degenerative changes lead to pain in the back and/or legs. However, more often than not, these changes do not cause any symptoms.
One of the problems spine specialists see frequently is arthritis. “You can potentially see the similar degenerative changes on MRI of the spine in any two 50-year-old patients, one with symptoms, and one without symptoms,” he explains.
So that’s the importance of a good clinical exam to correlate the imaging with the history and physical exam. If your physician says after an examination that you have degenerative changes, it’s typically some form of arthritis of the spine, he says.
Arthritis is common in the aging spine
“If you took 100 patients who are 30 years old, about 30 percent will have some form of arthritis in their spine,” Dr. Goyal says.
The percentage of patients with a significant amount of degenerative changes increases as people age, he says. “In the average 80-year-old, more than 80 percent will have a significant amount of arthritis in their spine.”
Another common degenerative change is that the disc or cushions between the major bones in the spine become smaller. They may appear to have less height and bulge. The color of the discs on MRI or the water content of the discs may decrease with time as well.
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Signs of larger problems worth another look
According to Dr. Goyal, the following are several red flags that mean you should consult with a physician or spine specialist:
- Progressive weakness
- Clumsiness or poor balance
- Pain that persists or worsens beyond a couple of months
- Bowel or bladder changes that may be caused by spinal cord or nerve roots being compressed
How to maintain spine health
As you age, there are a number of steps you can take to maintain your spine health, including the following:
- Avoid or quit smoking, which has a significant negative effect on healing of the spine: “Patients tend to heal faster when they don’t smoke,” Dr. Goyal says. “The effect of the medications we use, the therapy, the injections, and the surgery are all impacted by smoking.”
- Eat a nutritious diet. Focus on vegetables, fruits, lean meats and whole-grains.
- Exercise and include activities like yoga to achieve core strength (abdominal wall and muscles in your back and neck) to support your spine.
- Maintain an ideal body weight to relieve pressure of extra weight on your spine.
The bed rest myth
If you do have back pain, Dr. Goyal advises, you want to stay as active as possible and not just stay in bed for several days. The weaker your muscles get, the more back pain and problems you’ll have.
“You want to stay active. Continue walking, doing your normal activities, etc.,” he says. “Then do other activities such as exercising as tolerated.”
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