Back pain occurs in 80% of us. And if you have ever experienced back pain, you know that it isn’t very comfortable.
What we now know is the common source of back pain lives deep within the structures of the spine – the intervertebral discs. One of the ways we understand the discs (and how gravity influences them) is by studying the effects of microgravity on an astronauts’s spine.
An astronaut’s spine swells when they go to space. And you would think that this is a good thing–alleviating the compressive forces on the discs–but this isn’t so. The number one complaint they have is their back hurts. Research has shown that they gain as much as 6 cm in height and have to do compressive exercises to squeeze the water out of the discs so they do not over swell.
On Earth, the spine undergoes a diurnal height variation. That is, the spine is like an accordion — stretched out in the morning and compressed in the evening hours after a day of being vertical. It is a natural experience for the discs to have this sinusoidal wave of decompression and compression. But if the discs are internally damaged, this sinusoidal curve is not so smooth and the spine can undergo quick changes in decompression and/or compression.
One of the key problems with back pain has to do with the outer walls of the discs and the damage they endure. These are called annular fissures. Think of the discs like a very thick car tire with cracks in the sidewalls. These cracks develop as a result of over stress and are often innervated, with nerves, that cause back pain. The fissures often cause changes in the sinusoidal diurnal height changes leading to instability.
The key to healing back pain is to first identify the postures or movements that are making it worse. It comes back to the first Hippocratic Oath which states, ‘do no harm‘. This is an important first approach for not only the doctor but also for the patient and their own back. It is very difficult to heal a tissue if it continually being irritated and stressed.
The healing of annular fissures comes from deliberate and targetted nutrient supply systems through mechanical means. What this entails is first making sure the patient is extracting the behaviours that are eliciting internal injury and secondly, developing a treatment plan to facilitate a healing environment for the cells that repair the disc.