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Sunday April 28, 2013
By Dr NG SWEE SOON
Spinal degeneration can lead to pain in the back or neck, so get it properly diagnosed and managed to avoid unnecessary complications.
OUT of the 206 bones in the body, 33 are found in the spine, and it stretches all the way from the skull down to the pelvis.
These bones are known as vertebrae, and together they form the spine or backbone. The spine does not only give your body the form, strength, support and flexibility it requires, it also houses and protects the very significant spinal cord.
The spinal cord can be considered the super highway that connects all the nerves in your body to your brain. In essence, it serves as the primary communication conduit by which all important chemical messages travel uninterrupted from your brain to your body and vice versa.
The vertebrae of the spine are stacked one on top of the other like a chain of concrete hollow blocks. There are two types of vertebrae: the articulating and the fused vertebrae. They include:
*24 articulating vertebrae in the cervical (neck), thoracic (mid-back) and lumbar (lower back) regions.
*9 fused vertebrae in the sacrum (pelvis) and the coccyx (tailbone).
The articulating vertebrae are connected at the spongy intervertebral discs (in front) and at the bony facet joints (at the back). The intervertebral discs are soft, flat cushion paddings in between the vertebrae that act as shock absorbers.
The facet joints are specialised joints that give the vertebrae the flexibility to help your body perform movements like twisting, bending, stretching, rolling, arching, etc.
There is a large opening in the middle of the vertebrae known as the spinal canal, where the spinal cord resides. As with all other bones in the body, your spine is held together by soft tissues (tendons link your muscles to bones; ligaments link bones together).
Like your eyesight and hearing, the ageing of your spine is more noticeable. Most people enter their golden years without much physical discomfort, but some may experience painful symptoms related to the ageing spine.
Here are some of the common symptoms:
*Lower back pain
*Pain in the buttocks (sometimes)
When the condition becomes serious, nerves may get pinched, and this will result in pain radiating down the hands or legs. Sometimes, you may experience numbness or even weakness in these extremities.
Osteoporosis also comes with ageing as the bones start to lose their density and become more porous. The elderly with osteoporosis may gradually stoop ,with the head and shoulders bending forward. As years pass, he/she may develop a “hunchback”. Some may simply complain that they have become shorter.
When osteoporosis sets in, you are at a higher risk of spinal fracture.
Spinal degeneration comes as part of the ageing process but the rate and degree of deterioration vary according to individuals. This condition is greatly influenced by lifestyle choices.
You can slow down spinal degeneration by observing the following activities:
*Maintain an ideal weight.
*Avoid neck and back injury.
*Observe proper ergonomics and postures.
*Refrain from strenuous sports.
*Go for annual health screening.
Most people seldom go for a spine check-up until they experience pain there. If you think your spine is giving you problems, you should consult a doctor, preferably an orthopaedic surgeon, the earlier the better. An orthopaedic surgeon is a medical doctor who specialises in the surgical treatment of muscoskeletal (bones and joints) conditions.
Before going to see your doctor, it is important for you to write down a detailed history of your ailment. This will be useful when the doctor is diagnosing your condition. Your doctor will also ask about your occupation, lifestyle, habits, previous injury, diet, etc. He/she may send you for a clinical examination and certain medical investigations that will confirm the diagnosis and help with the treatment plan.
Physiotherapy is the mainstay of treatment for spinal degeneration. Its main focus is to improve flexibility and regain muscle strength. Sometimes, you will be given short-term pain medications to take care of the inflammation and aid in the recovery.
Depending on your condition, your doctor may perform minimally invasive procedures such as facet joint/nerve root injection and epidurolysis to reduce inflammation and pain.
There are various other modalities such as transcutaneous electrical nerve stimulation (TENS), ultrasound, shockwave therapy and radiofrequency.
If your nerve tissues are impinged, your doctor may carry out surgery. This procedure is to remove the offending structures (decompression) such as the disc, bone spur or thickened tissues.
When instability of the vertebrae is detected, he/she will perform fusion surgeries to join (fuse) two or more adjacent vertebrae together.
You do not need to live with painful age-related degenerative diseases.
If you have pain in the back or neck, get it properly diagnosed by an orthopaedic surgeon or neurosurgeon. With a proper diagnosis, your doctor can customise a treatment plan to either treat or delay the deterioration rate.
Your physiotherapist can also show you different types of rehabilitative exercises to recover or improve your physical abilities. Make sure you follow your doctor’s advice so you can age gracefully, minus the pain!
For more information, visit www.quillorthopaedic.com.
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