Monday, March 10, 2014

Bone Spurs And My Back

        

What are they?
These are the kinds of x-rays we as chiropractors see every day.  Pretty scary, huh?  If you show these x-rays to a person in the medical field, they will say, "Oh, this person has osteoarthritis".  Breaking down that label - osteo = bone, arth = joint, & itis = inflammation - your bone-joint is inflamed.  But as chiropractors, we always ask, "Why?"  Why did THAT joint degenerate but the one nearby - just as old as the other one - not have bone spurs?
Bone spurs or osteophytes, are bony projections that form off of the
bones of the spine, (vertebra) and joints of the extremities, (shoulders,
elbow, wrists, hip, knee, ankle and foot). They are the body's attempt to "shore up" an area of increased biomechanical stress by laying down more calcium.
How about some science?  Okay - this bony response is a demonstration of 
Wolff's law- a theory developed by the German anatomist and surgeon 
Julius Wolff (1836 – 1902) in the 19th century.  His theory states that bone in a
healthy person or animal will adapt to the loads under which it is placed.
If loading on a particular bone increases, the bone will remodel itself over time in response to  that sort of loading. The internal architecture of the trabeculae undergoes adaptive changes, followed by secondary changes to the  external cortical portion of the bone, perhaps becoming thicker as a result. The inverse is true as well: if the loading on a bone decreases (less physical activity), the bone will become weaker due to turnover, (think osteoporosis).  The body says, "This person is doing less work (spinal loading), so we don't need as much calcium in the bone" (see What to do below).
So what causes this?
Subluxation:  This is a chiropractic term for when a bone gets out of alignment, usually from some sort of trauma (see below).  This causes extra biomechanical stress on the joint and the body, doing the only thing it knows to do in response to that increased stress (see Wolff's Law above), lays down more bone to support that joint.  Ta-Da!  Bone spur!
Gravity: The simple fact that the core of the earth constantly pulls on you (9.80665 m/s2 or 32.1737 ft/s2).
Time:
The longer you are alive the more weight or load your bones have to support.
However, bone spurs are NOT just a function of age - I've seen degeneration of spinal joints in people as young as 18, usually due to trauma they've experienced. 
Trauma
Think about how many times you fell learning to walk, ride a bike, play a sport, etc.  As adults, if we fell as many times as a toddler, we'd be bed-ridden!  Common causes of trauma include slips/falls, car accidents  and sports injuries.
Repetitive micro-trauma: This is usually seen in people who do a few motions over & over - office workers doing computer keyboarding, electricians turning a screwdriver, waiters/waitresses carrying heavy trays with their wrists bent back.
The consequences?
Bone spurs typically limit joint motion, which leads to: pinched nerves, joint degeneration, tight muscles, adhesion build-up and trapping of chemical fluids, all of which can lead to acute or chronic joint and muscle pain.
What to do?
Chiropractic adjustments: Surprise!  You knew that was coming;)
Routine care is the best way to maintain proper joint motion and decrease the risk of bone spur formation and/or slow the progression.
Stretching/exercise: Motion, motion, motion!  As humans, the adage "Use or Lose It" really holds true.  Keep your joints healthy with daily activity, ideally low impact such as yoga, or Thai Chi, bicycle riding, eliptical machine, swimming or a rowing machine.  Avoid long episodes of sitting or standing.
Keep the weight off: Fewer pounds = less stress on the bones = fewer bone spurs