Wear and tear of the spine - what is that?

Our spine is made up by vertebral bodies, vertebral arches, vertebral joints, spine and transverse processes, intervertebral discs, ligaments, and so on. The spine includes also the spinal canal and the nerve exit site (Neural Foramen). Wear or tear represent the processes of degradation of these structures and their function.

In terms of wear and tear on the intervertebral disc we are talking about degeneration. There is impairment and reduction in the number of cells with a consequently functional dysfunction which at the same time leads to the loss of water content and to a reduction of the disc elasticity. The disc height is also reduced causing cracks which later will lead to herniated discs and other wear disorders.

As a consequence of worn bone structures (spondylosis, osteochondrosis), the margins of the bones (osteophytes) accumulate ossifications (bone attachments that in turn limit the mobility of the affected segment. Ossification around the spinal canal, accompanied by thickening and hardening of the ligaments and capsules, leads to spinal canal stenosis, and/or neural foramen stenosis. Wear on the disc and vertebrae often lead to bone edema. Osteoarthritis of the vertebral joints is called vertebral joint arthrosis or facet arthrosis.

The wear often sums up several structures and almost always begins in the intervertebral disc. In addition to the patient's age, there are also other external factors that can cause severe changes in our spine, such as a long exposure to jobs that put pressure on the back. Furthermore wear is influenced also by the individual predisposition of humans, the amount of physical activity as well as smoking and obesity. So it is only too logical that the symptoms usually develop slowly.

Basically, we should all internalize: If we only realized how few people pay attention to their back health, we wouldn't be surprised to see the consequences…in the form of complaints that may not be able to be trained or massaged away.

The lumbar spine is the most affected part of our spine

Three quarters of the population, from the end of their twenty years, can notice the formation of cracks in individual intervertebral discs. By the middle of the thirties, 4 out of 10 people have worn spinal joints, and by the age of seventy, almost everyone has them. 

How much does normal wear and tear progress, is determined by two factors: our genes and our lifestyle. According to statistics, 60-80% of the population had back pain at least once in their lives. About 40% struggle with it often or even permanently. At 62%, most back problems occur in the lumbar spine. The cervical spine is represented by 36% and the thoracic spine only by 2%.

Causes of wear? Spinal discs need movement

If we wonder what leads to spinal wear, the answer will be: There is not a SINGLE cause – but several causes! And if we are unlucky enough, as consequences of genes, it will begin the day after our birth! Of course this is not normality because normality lays in the complexity! The first signs of aging usually appear on the intervertebral discs. This is because the cartilage tissue is not nourished by blood vessels and has a slowed metabolism. Therefore, discs become thinner, sometimes tearing, they do not play their buffer function well anymore and as a consequence they lose elasticity and resilience. Because of the volume loss and the distance between the individual vertebrae shrinks, loosen up the holding ligaments.

However, one of the main causes depends on us: discs need movement - they stay young and elastic only when they are kneaded to boost their metabolism. Spine wear can affect all parts of the spine - the cervical, thoracic and lumbar spine but the weakest points of our spine are the upper and lower one. The points of transition most affected are: between the lumbar spine and the sacrum and between the lower cervical and the thoracic spine.

The range of symptoms is wide

Can I feel the symptoms of a degenerative spine? Oh, yes … you can! Pain can cause a dreary everyday life even bad nights. Who wants pain? Nobody! And yet, pain is a blessing! It is a wake-up call when something wrong is going on our body, and usually it says: GO TO THE DOCTOR!

When the creeping process of the degenerative spine has begun in your back, the situation manifests itself in spreading or acute pain, AND it may lead to restrictions on the mobility of the back – all over again inflammatory reactions in the vertebral joints will be detected. Sensitivity and/or motor skills can be disturbed - the highest time for a visit to the doctor is in case of abnormal sensations and paralysis. This is an alarm that signals that nerve strands are being pressed. Over time the spinal canal becomes narrower due to years of wear and the joints thicken, consequently creating pain that radiates into the buttocks and legs.

In the area of ​​the thoracic spine, facet joint arthrosis can also trigger pain that radiates into the heart. Even the small rib joints may be affected by osteoarthritis. The extreme wear of the joints can cause us pain that radiate in the chest and back.

As you can see for yourself, the range of possible symptoms that indicate spinal cord wear is wide and this lead us to one more reason to make an appointment with the doctor.

Diagnosis of spinal wear

Is your spine worn out? This is a question that can be answered only by a specialist that will take the problem and study it professionally. Of course, you play your important role during the so called anamnesis that will lead you to a prescription of imaging examinations. Diagnostic methods play the most important role in determining what is going wrong in our body, without them, specialist cannot be 100% sure. That is why the Avicenna Clinic disposes of state-of-the-art technical equipment in the field of diagnostic imaging:

Open magnetic resonance imaging (MRI): An MRI - also known as magnetic resonance imaging - is completely radiation-free - unlike computed tomography (CT) - and is therefore well-suited for children.
 
Digital X-ray: Despite modern developments in diagnostic imaging, X-ray technology is still considered necessary for certain basic examinations. Digital X-rays allow us to accurately examine the lungs and bones in order to detect fractures, degenerative changes, osteoporosis, tumors and joint diseases.

Treatment options of spinal wear

Back pain is curable but targeted individual treatments take place only once an accurate diagnosis has been made. Early diagnosis and therapy, interdisciplinary work, application of several methods, aftercare and the development of future prophylactic programs are important components of our spinal therapy. Unfortunately, there is no panacea for back pain.

Since the causes of the general diagnosis, “spinal column wear” are extensive, the consequences are also complex. They range from muscle tension and restrictions of movement with possible nerve irritation and it is important to break the vicious circle in which the patient is located. In order to achieve this purpose and to create a better quality of life, the range of therapy is extensive. Our therapies include conservative therapies (such as physiotherapy), CT-guided infiltrations and self-evident surgical therapies. In microsurgical technology, we manage with particular care - and therefore with the utmost security for the patient. In the drug treatment predominantly anti-inflammatory drugs are used.

It is also part of our therapy to encourage the patient not only to passively rely on our help, but to actively participate in it which means: do physical exercises and - if obesity is the cause of your problems – change your diet. In other words, you are RESPONSIBLE for your health. In addition to conservative therapy, we have other therapeutic approaches (depending on the strength and extent of the wear) available. In microsurgery, the compressive attachments are removed to create more space for the nerves.

Prognosis - strong muscles stabilize the spine

Increased strain on the spine, a lot of physical work, sedentary lifestyle, stress or congenital malpractice - either the whole range or individual components have put you in the situation in which the doctor speaks of degenerative spine. And how does it continue? Are you going to give up? Despair? No, of course not! When it comes to signs of wear, the medical treatment is important: strong and well-trained muscles stabilize the spine and can compensate for wear and tear to a certain extent. So if you move a lot and behave back-friendly you can often live with a normally worn spine, but in principle an unscathed spine is largely painless.

Dr. med. Munther Sabarini

Author
Dr. med. Munther Sabarini
Specialist in Neurosurgery

Hans-Heinrich Reichelt

Co-author
Hans-Heinrich Reichelt
Chief Editor of Medizin für Menschen

The Avicenna Clinic in Berlin is always willing to help you

Since the year 2001, the Avicenna Clinic is based in Berlin. Our doctors have at least 25 years of international experience in their respective fields (neurosurgery, spinal surgery, anesthesia, and orthopedics).

If you have severe back pain, a herniated disc or a suspected herniation, please contact us using the following information:

Avicenna Clinic
Paulsborner Str. 2
10709 Berlin

Telephone: +49 30 236 08 30
Fax: +49 30 236 08 33 11
E-Mail: info@avicenna-klinik.de

You can call anytime, write an e-mail or fill out a callback form. Each patient then gets an appointment with a doctor of our clinic, who is a spine specialist (neurosurgeon). Based on MRI images (brought or made in our clinic) and on an in-depth examination, the doctor will discuss with you all the different therapy options or possibly surgery. You can also use our specialists only to obtain a (second) opinion.

If you decide to undertake your therapy and/or surgery in Berlin, we would want to make your stay as pleasant as possible. In our clinic, you are at the center of our attention! You can expect state-of-the-art equipment in all areas - from the operating room to the patient bedroom.

The latest, gentle, minimally invasive treatment procedures are the focus of our clinic. Together we try to find a suitable treatment for your complaints. The actual therapy takes place only after a detailed discussion with the patient, examinations and the diagnostics.

For us, as important as medical care, it is the commitment we take to guarantee our patients a high level of personal care that can, in turn, ensure them a comfortable stay.

During the period of inpatient stay our team of nurses will take care of you 24 hours a day. They also offer services in several foreign languages, including English, Russian, Polish, Turkish, Spanish, Italian, Arabic, Bulgarian and French. We care not only about your safety but also your needs, respecting traditions and religions.

Our team is made up of a group of highly qualified specialists who work together to guarantee you a quick recovery.