Many of us suffer from chronic back pain. If that pertains to you, chances are at one point or another you’ve been referred to physical therapy or told to start an exercise program.
I certainly recommend exercise and strengthening to all my patients with spinal-related problems. Patients often ask me why we use exercise as treatment. I wanted to review the basic reasoning for this recommendation and discuss physician expectations when exercise is prescribed.
In a previous article (Feb. 15), I discussed the basics of how our spines gradually degenerate. This leads to chronic pain for many. On some level, we will develop degenerative spinal changes. This process is in part determined by genetics as well as daily wear and tear.
One of the key factors driving this process is a lack of blood flow inside the actual discs of our spine. Discs rely on nutrients from the vertebrae immediately adjacent to them. Nutrients are pulled from the blood supply of the vertebrae to nourish the cells inside the disc. These cells keep our discs healthy and functioning normally. Anything that compromises blood flow inside the vertebrae in turn contributes to premature disc-cell death. As these cells die from a lack of nutrition, our discs are more susceptible to degeneration and injury.
With this knowledge, it would make sense to do anything that would promote blood flow into the vertebrae and nutrition into the discs. At this point, the limits of modern medicine prevent us from growing new blood vessels to serve this purpose. We are left, therefore, with treatment that improves the existing blood supply. Maintaining overall health and fitness is the best way to maintain this blood flow. A healthy heart pumps blood more efficiently. A lean body with good muscle mass maintains blood flow to tissues outside the heart. Healthy diet and exercise maintain lean body mass and lower cholesterol. Not smoking and controlling diseases such as high blood pressure and diabetes are critical as these problems lead to weaker blood flow throughout the body.
Specific spinal exercises often are prescribed. We refer to these programs as “core stabilization.”
They often involve Pilates, yoga, floor/mat exercise, physioball, machines and sometimes free weights.
The goal is to improve spinal flexibility and strengthen the muscles that move and support our spines.
This of course, does not cure degenerative discs. In fact, the exercises have no direct effect on the discs. The way they reduce pain is by preventing weakness, stiffness and muscle spasm/tension that often accompanies internal disc problems.
Preventing or reversing these secondary problems is vital to minimize pain and maintain an active lifestyle.
The Steadman Hawkins Clinic, headquartered in Vail, specializes in sports medicine. For more information, go to www.steadman-hawkins.com.
