Wear and tear of the spine

Wear and tear, or deterioration of the spine, refers to the degradation of the body's structures and their function. Our spine consists of vertebrae, vertebral arches, vertebral joints, spinous and transverse processes, intervertebral discs, ligaments, ligaments and more. The spinal column also includes the spinal canal and the nerve exit site (neuroforamen).

Wear and tear of the intervertebral disc

In the case of wear and tear of the intervertebral disc we talk about degeneration. There is a reduction in the number of cells with functional impairment of these cells. This leads to loss of water content and elasticity. The height of the intervertebral disc is reduced. Cracks appear in the intervertebral disc, which later leads to herniated discs and other wear disorders.

Wear and tear of the bone structures (spondylosis)

When bone structures wear out, ossifications (bone attachments) collect at the edge of the bones (osteophytes). The technical term for this is spondylosis, osteochondrosis or spondylosis. This limits the mobility of the affected segment. Ossification in the area of the spinal canal, together with thickening and hardening of the ligaments, ligaments and capsules, leads to spinal canal stenosis or neuroforaminal stenosis if this occurs in the area of the nerve exit point (neuroforamen). Wear of the intervertebral disc and vertebrae often leads to bone edema. Arthrosis of the vertebral joints we call vertebral joint arthrosis or facet arthrosis.

What are the causes of wear of the spine?

Wear and tear often summarizes several structures and almost always begins in the intervertebral disc. In addition to age, we know of other, external reasons for wear and tear. For example, years of heavy physical work can lead to wear-related changes in the spine and spondylosis. Furthermore, a person's individual predisposition, types of sport and their intensity, as well as smoking and being overweight, all influence wear and tear. So it is only too logical that the symptoms surrounding the disease usually develop gradually.

Basically, we should all internalize: If we realize how little many people take care of their backs, then it is no surprise that one day it will bring the bill. This can happen in the form of discomfort that may no longer be able to be exercised or massaged away. Sufferers then need real treatment for spondylosis or osteochondrosis.

The structure of the human spine

Even at a young age, changes in the spine, vertebrae and vertebral bodies can be seen in many people. In three quarters of all people in their late twenties, cracks appear in individual intervertebral discs. By their mid-thirties, four out of ten people have worn spinal joints.

By the age of seventy, virtually everyone has significant signs of wear and tear on the spine. How much normal wear and tear progresses is determined by two factors: our genes and our lifestyle.

It is estimated that 60 to 80 percent of the population has experienced back pain at least once in their lives. About 40 percent struggle with it often or even permanently. At 62 percent, most back problems occur in the lumbar spine (LS). This is "low back pain" in the classic sense. The cervical spine (HWS) is affected by 36 percent and the thoracic spine (BWS) by only two percent.

Causes of wear and tear of the spine

If we ask about possible causes of spinal wear and tear, the answer is: There is not one cause - there are several causes! If we are unlucky, the wear and tear starts after birth because we have the corresponding genes. Of course, this is not the norm. Rather, the norm lies in the complexity of the specific causes of spondylosis and osteochondrosis.

The first signs of aging usually show up in the intervertebral discs. This is due to the fact that the cartilage tissue is not nourished by blood vessels and has a slowed metabolism. Therefore, the intervertebral discs become thinner, sometimes tear, no longer buffer as strongly and lose elasticity and resilience. Because the loss of volume also shrinks the distance between the individual vertebrae of the spine, the ligaments that hold them in place loosen.

Lack of movement as the main cause

One of the main causes of this, however, lies within ourselves: Intervertebral discs need movement. They only stay young and elastic if they are kneaded so that their metabolism is stimulated. Wear and tear on the spine can affect all parts of the spine: The cervical spine (C-spine), the thoracic spine (thoracic spine) and the lumbar spine (lumbar spine). Like everywhere else, there are weak points in the spine. These are located in the area of the transition from the lumbar spine to the sacrum and in the area of the lower cervical spine in the transition to the thoracic spine.

Do I feel the symptoms of a degenerative spine? Oh yes, and how! A general word about the symptoms: pain, wherever in the body, causes a dreary daily life and often bad nights. Who wants pain? No one! And yet pain is a blessing! Because they are an indication that something is wrong in the body and that you should go to the doctor.

Acute pain and limited mobility

If the insidious process of degenerative spine has started in your back, the situation manifests itself in spreading or acute pain, as already emphasized. But that is not all: there may be restrictions in the mobility of the back. Again and again, inflammatory reactions in the vertebral joints are also observed.

Abnormal sensations, disturbed motor function, paralysis as an alarm signal

Sensitivity and motor function can be disturbed by spondylosis. It is high time to see a doctor if there are sensory disturbances and signs of paralysis. This is an alarm signal that nerve cords are being pressed. With radiating pain in the buttocks and legs, you are obviously paying the price for the fact that with increasing age the spinal canal is narrowed due to years of wear and tear and due to the thickening of the joints.

Pain in the heart as a symptom of wear and tear of the thoracic spine

In the thoracic spine, facet joint arthritis can also cause pain around the heart. The small rib joints can also be affected by osteoarthritis. The extreme wear and tear of the joints can cause us pain that radiates to the chest and back.

You can see for yourself: The range of possible symptoms that indicate wear and tear of the spine is wide. All the more reason to make an appointment with your doctor. Because insidious processes can only be stopped, if at all, if they are taken seriously and treated!

Diagnosis wear of the spine

The doctor decides whether there is wear and tear of the spine, because only he can judge it professionally as a diagnosis. Beforehand, he has conducted an intensive anamnesis interview with the patient and then may have prescribed imaging procedures to determine the findings. Every disease or injury inside the body presents itself in different ways and special equipment is essential for accurate diagnoses. For this reason, Avicenna Clinic has state-of-the-art technical equipment in the area of diagnostic imaging: 

Open Magnetic Resonance Imaging (MRI): an MRI, also known as magnetic resonance imaging, uses no radiation at all (unlike a computer tomography/CT) and is therefore well suited for examining children.

Digital X-ray: Despite modern developments in diagnostic imaging, X-ray technology is still considered necessary for certain basic examinations. Digital X-ray allows us to accurately examine the lungs and bones to detect fractures, degenerative changes, osteoporosis, tumors, as well as joint disease.

As varied as back pain is, so are the ways to help and ideally heal. Only after we have determined the cause of your complaints do we begin with targeted individual treatment. Early diagnosis and therapy, interdisciplinary work, the use of several methods, support even after treatment, and the development of future prophylaxis programs are important components of our spinal therapy. Unfortunately, there is no panacea for back pain.

Since the causes of the general diagnosis of wear and tear of the spine are extensive, the consequences are also complex.They range from muscle tension and restricted movement with possible nerve irritation (pain) in sufferers. The aim is to break this vicious circle in which the patient finds himself. 

In order to achieve this and restore quality of life, the range of therapies is also extensive. Our therapies include conservative therapies (for example physiotherapy), CT-guided infiltrations and, of course, surgical therapies. We use microsurgical techniques to operate in a particularly gentle manner - and therefore with the greatest possible safety for the patient. Medicinal procedures mainly involve the use of anti-inflammatory drugs.

Part of our therapy is also to encourage the patient not only to passively rely on our help, but to actively participate in it. For the treatment of wear and tear on the spine, this means exercise and, if obesity is a cause of the problems, a change in diet. In other words, taking personal responsibility for one's own health and contributing to change.

In addition to conservative therapy, we have other therapeutic approaches depending on the severity and extent of the wear and tear. Microsurgery involves removing the compressive attachments to create more space for the nerves.

Increased stress on the spine, a lot of physical work, sedentary activities without compensation, incorrect loads or congenital poor posture: Either the whole gamut or individual building blocks have put you in the situation where the doctor speaks of a degenerative spine. So where do you go from here? Give up? Despair?

No, of course not! When it comes to wear and tear, after medical treatment, strong and trained muscles stabilize the spine and can compensate for wear and tear to some degree. Create a routine of exercises to strengthen your back. Take advantage of physical therapy! So if you move a lot and are back-friendly, you can often live largely pain-free even with an aging but basically intact spine.

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.