An explanation of how the ageing process affects the spine
As people age, they may experience various changes in their spine, including:
- a loss of bone density, known as osteoporosis, or
- degenerative changes in the spinal discs, referred to as degenerative disc disease.
While these changes are commonly observed in older individuals, they are not necessarily caused solely by ageing.
I believe that in many cases, these changes are more closely tied to what a person’s spine has been exposed to and its history of injury, rather than age being the primary factor.
For instance, while osteoporosis may have a genetic component, a person’s lifestyle notably influences their bone density. Regular engagement in weight-bearing activities and maintaining a healthy diet are two key lifestyle choices that promote strong bones.
Similarly, degenerative disc changes are frequently localized to one or a few levels rather than the entire spine. If these changes were solely due to ageing, we would expect degenerative changes to be rather uniform. However, this usually isn’t the case, suggesting that degenerative changes are more likely influenced by how individuals have used their spine over the years, rather than only how old a person’s spine is.
Common degenerative changes in the spine
The most common degenerative changes in the spine include the following:
- Disc degeneration. Disc degeneration refers to the various changes that can occur to spinal discs following a spinal injury.
- Facet hypertrophy and arthritis. Facet hypertrophy refers to the thickening/bony growth of the joints at the back of the spine. Arthritis typically refers to damage to the cartilage of the spinal joints and is usually seen in conjunction with facet hypertrophy.
- Ligamentum flavum hypertrophy. Ligamentum flavum hypertrophy refers to the thickening of the ligament that runs vertically between two adjacent vertebrae and is part of what makes up the back of the spinal canal.
These degenerative changes often follow a predictable course after injury. Typically, the sequence unfolds as follows: an individual sustains a spinal injury, which damages a disc, vertebra, ligament, or another structure. This injury compromises the spine’s natural stiffness or stability, known as joint laxity or instability, at a specific functional segment—a unit composed of a disc and the two adjacent vertebrae. This joint laxity then initiates a progressive deterioration of the disc, ultimately resulting in degenerative disc disease.
To compensate for the instability or joint laxity, the spine initiates the growth of bony projections known as osteophytes, along with hypertrophy of the facet joints. These arthritic changes play a crucial role in restoring stability to the spine. Additionally, the ligamentum flavum, a spinal ligament, thickens as part of this stabilizing response.
These changes, on their own or in combination with each other, have the potential to cause narrowing of the spinal canal, a condition referred to as spinal stenosis.
This narrowing of the spine can lead to compression of the spinal cord and spinal nerve roots, potentially causing symptoms such as leg pain, muscle weakness, altered sensation, and difficulties with walking and standing.
This process typically develops over several years, and as a result, these changes are most commonly observed in older individuals.
Strategies for managing age-related back pain and maintaining spinal health
“An ounce of prevention is often worth a pound of cure,” a saying that holds especially true for back pain. Taking care of your spine from a young age is the best strategy to minimize the likelihood of experiencing back pain as you grow older.
However, if you do experience back pain as you age, there are steps you can take to overcome it. As a McGill Method chiropractor, I have seen this occur in many situations.
Like any type of back pain, the first step is identifying your specific pain trigger. Once identified, avoiding this trigger can help reduce your pain. Finally, it’s important to enhance the resilience and strength of your spine to ensure you can engage in daily activities without experiencing back pain.
General guidelines that help manage most cases of age-related back pain and maintain spinal health include the following:
- Walk daily, starting at a pain-free level and gradually increasing your activity.
- Focus on developing a strong core. The McGill Big 3 exercises are a great way to start.
- Keep your hips as loose and mobile as possible. The more you rely on your hips to move, the less strain you put on your spine.