Maintaining a healthy spine with chiropractic evaluations and adjustments in addition to regular exercise and strength training will help keep your spine and spinal discs healthy as you age.
What are the different components of the spine?
Dr. Luke Stringer: Yeah, absolutely. Great question. So, the spine is essentially made up of the cervical spine, that’s your neck, the seven bones, C for cervical, 1 all the way through to 7. It then goes into the upper to mid-back, which we call the thoracic spine. We have 12 bones in the thoracic spine, T for thoracic, 1 through 12. Then we have the lumbopelvic spine, which is the low back, the tailbone and the pelvis. We have five bones in the lumbar spine. We have the sacrum, which is made up of four or five bones. Then we have the pelvis, which is made up of two pelvises.
And when you’re looking at the spine from the front, you want to see a spine that’s in alignment. So, you’re going to drop a plumb line from the dens, which is kind of how you give someone a thumbs up, that’s the second bone in your neck. Your atlas is the bone that sits on top of it, and your skull sits on top of the atlas. The dens, if you look at an x-ray, literally looks like someone’s giving you the thumbs up. That should go all the way down into your pubic symphysis, which is where your pelvis links together right at the base of your pelvis.
Then from the side you want to see the spine in alignment. So, our neck should have a lordotic curve to look like the front of the letter D, the top bone of your neck should meet the bottom bone. Then your thoracic spine at the mid-back should be the opposite shape. We call that kyphosis. The kyphotic spine should be 37 degrees from the 3rd through the 10th bone. When you evaluate the lumbopelvic spine, it should look like the neck. The top bone of your lower back should meet the top bone in your pelvis and that should measure 40 degrees. So essentially when you are upright and in alignment and gravitational forces are applied to the spine, the weight of the head is distributed evenly throughout the back of the spine into the neck, keeping pressure off the joint complex.
In the joint complex, you’re going to have two vertebrae bones separated by discs. This is like the shock absorber of your spine. Then through the middle of that spine you’ve got your spinal cord. Out of those, you’ve got spinal nerve roots that come out to innovate the body, everything from feeling to function. Again, the thoracic spine should carry the weight of all those vital organs, and the cardiovascular system. Your lumbar spine should carry the weight of everything that sits in your abdomen so the GI system, renal system, and again, that keeps pressure off the joint complex.
You supplement that with balance strength in those deep neck flexors that sit in your neck, in front of the neck, and deep muscles that sit deep between your shoulder blades and your diaphragm and your core. That adds stability so then when you’re upright, you should be able to move freely and stably and function as intended without pain or dysfunction.
How do you know if spinal discs are healthy or not?
Dr. Luke Stringer: Yeah, great question. There are two images that are essentially the gold standard for evaluating the health of the spine. So, X-rays are the gold standard for bone and you always want to be looking at is the bone healthy. And then MRIs are the gold standard for soft tissue, so muscles linked to tendons and discs. As a chiropractor, you are typically using on the initial kind of analysis, X-ray analysis. So, when you evaluate the X-rays, you should be able to see clean spaces between the vertebrae throughout the spine. So, you’re going to see an even space from the front of the disc to the back of the disc. The bones above and below it should be block like and essentially be smooth in their edges. And then you should see a nice space for the intervertebral foramen which is where the nerves come out.
However, if you’re on X-ray and you’re seeing that joint space decrease, well we know if they’ve got dysfunction on the X-ray that would show up on MRI and show some form of disc pathology. Then once you start seeing that degenerative change to those bones, those edges start to get rough, the bones start to change shape and we start to see those bone spurs, then that’s obviously a degenerative change. So, we call it in the neck, cervical disc degeneration and/or in the lower back the lumbar disc degeneration or degenerative disc disease. You can pick that up on X-ray. You don’t necessarily need an MRI to confirm that. However, MRIs are the gold standard for discs. If you get an MRI, the MRI is going to be showing if you’ve got disc degeneration from X-ray, you’re going to see pathology within the disc. It could be anywhere from a bulge to a herniation to a dissection to a prolapse. They’re basically just degree severity of changes to health within the disc.
If spinal disc health is neglected over time, what kind of long-term issues can arise and how might these impact daily activities or quality of life?
Dr. Luke Stringer: Yeah, great question. So, the discs within our spine are the shock absorbers of the spine. So, if you’re physically upright, you want a healthy disc because that’s going to cushion gravity throughout the spine, which is then going to allow us to be able to exercise and perform activity without creating dysfunction particularly high-impact activities, skiing, playing sports. However, if we are subluxated and we’re out of alignment, there is increased pressure within the disc, the increased disc pressure is over time going to break that disc down.
View your disc like a jelly doughnut. If you and I want to go to jelly doughnut, the bread of the doughnut is the collagenous tissue around the disc that keeps all the disc fluid in the central part of the disc. And then the jelly of the doughnut is the fluid within the disc. We want those discs to be nice and healthy. Again, it’s going to allow us to move well, it’s going to allow us to function as we should without pain or restriction.
Once those discs start becoming damaged and/or degenerative, that’s when we start leading into pain and dysfunction. Now, if you’ve got degenerative disc disease and/or we’ve got disc pathology, that doesn’t necessarily mean you’re going to have pain or dysfunction. However, it can absolutely lead to that. On the mild end, we’re going to see limited range of motion. We’re going to see increased stress and tension within the muscles and joints, which over time is going to create compensation and pain. Then as we progress into degenerative disc disease, then you’re going to start seeing symptoms. So, pain or when the disc fluid starts to shift into the nerve canal, that’s when we get those referral symptoms. So pain that goes down into the hands and fingers, numbness and tingling. Typically, it’s called carpal tunnel syndrome although research states numbness and tingling in the hand, 82% of the time is actually coming from nerve root impingement in the neck, which is coming from disc pathology.
In the low back we can have low back pain and that pain that starts referring into the leg, which commonly can be sciatica. However, it’s not always sciatica. It can be more coming from the disc within the low back. And then if we’re not on top of those symptoms, the next progression of referral pain is numbness, then it’s weakness, and then it’s foot drop and then it’s atrophy. Then you’re looking at surgical outcomes, laminectomies, discectomies, and unfortunately surgical outcomes of the spine just aren’t great. So, the health of your disc is paramount in how we feel, how we function, and essentially how we age or how quickly we age.
How does chiropractic care help maintain the health of the spinal discs?
Dr. Luke Stringer: Yeah, great question. Motion is lotion, literally. We have two legs and we have eyes in the front of our head. Why? We’re bipedal, to be upright. Thousands of years ago we were walking around hunting animals and kind of catching food and things of that nature. Fast-forward several thousand years, we’re now pined behind a desk. We’re not built to be sedentary. We’re built to be upright and moving. So, what happens is as we become sedentary, we see those postural misalignments, increased disc pressure, and all of a sudden we’re degenerating at a quicker rate than we should. We all degenerate over time, however, how quickly is up to us. And how quickly is up to us, when I say that I mean, what’s your alignment like and how is that playing a role in increasing disc pressure because that’s going to degenerate us faster.
So how does chiropractic play a role in preserving disc health and/or slowing down the degeneration process, aka the aging process? Well, movement is essentially how we keep discs healthy. 80% of stimulation in the brain comes from movement of the spine. Someone won a Nobel Peace Prize for that. So essentially when your spine moves, it literally stimulates your brain and we obviously all want our brains to be stimulated. Also, when the joint moves through an adjustment specifically, it creates movement within the disc which creates osmosis where the disc gets full of fluid and obviously that keeps the joint moving well, as we discussed on previous podcasts, our last one around sports performance.
Limited joint function can increase stress and tension in the joint complex which breaks down the disc. And then spinal alignment is critically important. For example, if you are looking at someone, their ear should be on top of their shoulder. But if they’ve got that anterior head carriage, you know that kind of corporate posture where the head jutted forward, the chin is out in front of the chest, well that top bone is in front of the bottom bone. So, it’s like you and I going bowling, Liz. If we’ve got a 10-pound ball snug to our chest, it’s 10 pounds, hold it a foot away from our arm, all of a sudden it’s a lot heavier. Essentially the further away the head gets from the spine, the more pressure you put on the disc, which breaks the disc down, which leads to pain and dysfunction.
So, chiropractors can do what? They can evaluate the subluxations, misalignments in the spine, they can adjust them. They are going to get the joint moving in alignment. It’s going to stimulate the nervous system, the brain and the disc, literally hydrate it, keep it hydrated. We can evaluate postural misalignments via X-ray or postural analysis and we can objectively change the shape of your spine through technical chiropractic biophysics, the most researched form of chiropractic. It’s all evidence-based, it takes engineering and mathematical principles applied to the spine and we can objectively change the shape of your spine. We can evaluate muscle imbalance. You are pinned behind a desk, you’re not moving, those posture muscles pick up on movement. Your neck flexors are going to get weak and lazy. Your shoulder muscles are going to round. Next thing you know, you’ve got that kind of corporate posture that’s going to increase stress and tension. So, through a rehab program supplemented with adjustments and traction, you can objectively improve and change the shape of your posture. And by doing that, you’re going to improve the health of the disc and then improve the integrity of the disc over time.
How can people protect their spinal discs from damage as they age? Are there daily habits or routines that can help prevent disc problems?
Dr. Luke Stringer: Absolutely. So as a chiropractor, I’m obviously biased, but everybody on the planet should be getting chiropractic care and getting adjusted. Adjustments are going to keep the disc hydrated, which are going to slow down the aging process, which is going to allow you to live a longer, more fulfilled life. It’s also going to de-stress the nervous system. It’s going to allow you to feel and function better.
But things you can do at home. One, basic spinal mobility. So just get that joint moving through its intended range of motion, bending forwards, backwards, side to side and rotating. We should be focusing on mobility, so doing some active range of motion like we just discussed. And then some static isometric stretching of all the muscles that are going to create stress and tension within the joint complex. And then we should be moving and do some form of exercise because as we just discussed, when we’re moving, it’s stimulating the disc and stimulating the nervous system in the brain, it’s going to slow down that degeneration process.
We should be doing some strengthening work too. When you are actively doing strengthening work, it increases pressure within the joint complex so the disc and the bone has increased osteoblastic activity, which keeps the bone and the disc and the joint healthy, all that. You’ll see your primary care physician, “Oh, you’re aging, get off your feet, do some chair yoga and water aerobics.” No, absolutely not.
You should be loading the joint, including the disc through movement and exercise, and by having good range of motion, balanced muscle strength, and then actively stressing the joint, your discs and joints are going to age much slower at a healthier rate than someone who’s inactive and sedentary and not doing those things.
If you are interested in speaking with Dr. Luke Stringer visit www.southloopchiropractor.com or call (312) 987-4878 to schedule an appointment.
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