Nestled between most of the vertebra of our spine lie intervertebral discs. These are
fibrocartilagenous rings that make our spine an excellent shock absorber. They can get injured by making a small innocent moves such as bending to pick up something from the floor or turning your torso without pivoting from your feet when carrying something heavy. They can also be injured by more traumatic events like falls, car accidents and playing sports without proper training.
The structure of our intervertebral discs is very unique. They are composed of an annulus fibrosus which is like a multi-layered (lamellae) wicker-basket-like structure that encases a jelly-like structure: the nucleus pulposus.
The annulous fibrosus main function is containing the more fluid nucleus pulposus inside the disc so that together they add “springiness” to the spine so that it absorbs the forces coming from the ground during locomotion. The annular fibers are organized in concentric lamellae (layers) whose fibers run at approximately 30 degrees from each other. This arrangement gives the annulus a lot of strength. The inner layers of the annulus are not richly innervated (do not have a lot of nerves); however, the annulus gradually becomes more innervated towards the outer layers. Remember this last fact for later.
The nucleus pulposus is a remnant from our embrionic development. It is completely surrounded (contained, isolated) by the annulus fibrosus. Its main function is distributing hydraulic pressure in all directions within each disc for even shock absorption throughout the spine. This allows you walk, jump, sit, run and do other physical activities smoothly while protecting the joints of your body.
Unfortunately, the pressure the nucleus pulposus exerts on the annulus fibrosus (the wicker-like layers that encase it) during our daily activities can sometimes tear it (create small cracks). The tears might be caused by fatigue due to age, malnutrition, improper physical activity and many other factors. The fact is that it generally tears from the inside out.
Remember what I wanted you to remember in a previous paragraph?
If the nucleus pulposus increases the pressure on the annular tears, initially the tears will not hurt much since the inner part of the annulus is not richly innervated. As the tears become bigger and grow slowly towards the more innervated outer layers. Low back pain issues will ensue. This process can culminate into a disc bulge, a herniation or worse extrusion of the annulus with sequestration in the most severe cases (which I will cover on a later post). And yes, these conditions could be as painful as they sound and sometimes require surgery. So, the take home is that frequent episodes of low back pain in a belt-like pattern can be an indication that one or more your intervertebral discs might be tearing from the inner layers towards the outside. Make sure you don’t take these warnings lightly. Recurrent low back pain MUST be checked by a professional.
Shouldn’t we make sure we take good care of our discs? HOW?
POSTURE, POSTURE, POSTURE. Should I say it again? I’ve been blessed with being short. I have to make each of my 67 1/2 inches count (previously 68 inches). Unfortunately, most people don’t pay attention to their posture. How difficult is it to think head over your shoulders, shoulders back and down, tighten your stomach and step through your heels? Every time you see your reflexion on a mirror or a store window, check yourself out… I mean, your posture. Correct it!
STRENGTHEN YOUR CORE
Pilates is an excellent way to strengthen your core. Find out about what planks (exercise) are and include them on your exercise routine. Beware of over doing sit-ups, crunches and similar exercises. I will write more about this in the future. In the mean time read about this, consult with fitness trainers and read about functional training.
STRETCH THE USUAL CULPRITS
This one should be easy if you read my series on stretches for your low back that I published at the beginning of the year. Erector spinae, gluteus medius, hamstrings, hip flexors, quadriceps… When spinal movements are modified by tight muscles, your discs longevity will be shortened by deterioration. As tedious as stretching can be, it does not compare to the dull pain from a slowly tearing annulus or the sharp or electric pain of a disc herniation beats. Yoga is great for stretching (and actually strengthening though not building muscle). Stretching before bed is an excellent way to let go of the stresses of the day. Just find time to stretch!
Ensuring correct movement between each segment of your spine is paramount. If the spine does not move correctly, the shock from everyday activities will not be dispersed correctly among its segments fatiguing some areas of your discs more than others. Cracks may develop in those areas and the possibility for disc degeneration and herniation increases. The likelyhood that a chiropractic adjustment performed by a trained chiropractor injures a patient is almost nonexistent. Most injuries due to a chiropractic-like manipulation are performed by medical practitioners who have not had years of chiropractic training.
A well balanced nutrition is great way to keep your spine and your discs in excellent shape. Maintain a stable and reasonable weight. Reduce the amount of sweets, red meats and processed foods in your diet. Eat your veggies. As far as supplementation: Vitamin C is very important for the formation of collagen. Collagen and chondroitin sulfate are components of your discs. The benefits of supplementation are controversial; however, people with moderate and severe arthritis can get excellent benefit from supplementation with glucosamine and chondroitin sulfate.
So, implement these changes in your life and you’ll be grateful you read this article when you did.