Truths & Myths About Degeneration And What The Future Holds - Is Degeneration Really Due To Old Age?

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Joint Degeneration Is Not Due To Old Age

Degeneration is a normal part of life but claiming that degeneration is due to old age is pure ignorance. When someone suffers from knee pain, especially with ascending or descending stairs, it's immediately labelled as osteoarthritis, a degenerative condition of the knee joints. But is it really due to old age? You have two identical knees, they have the same age and they walk the same amount of steps in your life. Assuming everything else is equal (ie. no history of trauma to one knee), we would expect both knees to degenerate evenly. But in most cases, this is not true. Patients with osteoarthritis commonly experience one-sided knee pain at onset, then develop pain on the other knee over time due to gait compensation and altered biomechanics. A study claims that "among adults 60 years of age or older the prevalence of symptomatic knee OA is approximately 10% in men and 13% in women (1)." If only a tenth of the elderly population suffers from knee pain, how can we blame old age? What about the remaining ninth of the elderly population without OA? Researchers do note that osteoarthritis is a complex condition with various factors including old age, gender (females), obesity, knee injury, repetitive use of knee joints, bone density, muscle weakness and joint laxity. The truth is that age and the ageing process is commonly blamed for our health conditions. Why? Because it's easy and nobody holds responsibility. The symptoms become more palatable for both patients and health practitioners when we think that it’s “normal”. Nobody did anything wrong. This can’t be further than the truth. Whether it's degeneration of joints or a particular health condition, age is only a contributing factor, never a decisive factor. Yet most health practitioners are still informing their patients that you have this and of course you have that because you’re 60!

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Degeneration of the Spine

Is degeneration really due to old age? Take a look at the x-rays below. It's a time-series neck x-ray of the same person (notice the identical neck alignment over the three X-rays).

The patient is facing left. Note that a 40-45 backwards curve is needed for it to be a healthy cervical alignment.

The patient is facing left. Note that a 40-45 backwards curve is needed for it to be a healthy cervical alignment.

There are seven different bones in the cervical spine and they are joints just like our knees and elbows. Now take a closer look at the lower joints of C5, C6 and C7. Over time, the disc spaces have significantly closed down (degenerative disc disease) and the bones have changed their shapes and developed osteophytes (degenerative joint disease). They have severely degenerated. What most people don’t get is that the seven bones have the same age! So if they lived the same amount of years, why is it that the lower bones/joints have severely degenerated while the upper bones remain well-preserved? Common sense tells us that the damages present at C5/C6/C7 simply cannot be due to old age. If it were, the upper bones should have changed too. So if degeneration is NOT due to old age, why does this happen?

Ever heard of 'use it or lose it'? It's a common phrase used in psychology to aptly describe the best way to offset the problems that come with ageing. According to Psychology Today, people "assumed that cognitive performance declined substantially as a part of normal ageing. However, recent research suggests, in fact, that is not the case...". Dr Maxwell Maltz writes in his book Psycho-Cybernetics that “the latest findings show that a man reaches his peak mentally somewhere around the age of 35 and maintains the same level until well past 70.” The saying “you can’t teach an old dog new tricks” is a proven nonsense and yet it still pervades the minds of both patients and clinicians of today.


The same principle applies to our joints. Joints that are misaligned with improper segmental motion will start to degenerate at an alarming rate. If the joints are not utilised properly, you start to lose it. In the case of the above x-rays, the lower cervical spine was not moving correctly due to its loss of normal cervical curve. As you can see on the far right x-ray, the neck is meant to curve backwards with a curve of 40-45 degrees. Therefore degeneration is not due to old age but the duration of time how long the joints have ceased to function correctly. You can see how the difference is subtle and may confuse or trick people into believing that degeneration is synonymous to old age. But I will say it again, degeneration is not due to old age but how long the joints have stopped moving for. This loss of normal alignment and motion of joints (includes ALL of our joints, not exclusive to the spine) will lead to an abnormal rate of joint degeneration.

This is one of many reasons why chiropractic is so powerful. Chiropractic adjustments work to restore the normal motion of the joints and their biomechanical relationship to their nearby structures. Normalising joint function allows degeneration to stop. On top of that, a chiropractor can also realign the shape of the spine to further improve the health of the joints and create longer lasting results.

Below is an actual before-and-after X-ray result from my clinic. The patient has kindly allowed me to share her x-ray results for educational purposes. Results like these are not uncommon.

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It gets better. Recent studies have revealed that chiropractic not only normalises the abnormal rate of degeneration but can also reverse degeneration that has already taken place to a certain degree. 

 

 

Teens are more prone to degeneration than elderly.

Degeneration not being related to old age is again proven when we study x-rays of teenagers and young adults. Nowadays it is common to see more degeneration and damage in the spines of younger adults compared to the elderly. Surprised? Despite seeing it more and more, my colleagues and even my front desk and CA’s (Chiropractic Assistant) and I become shocked when we see x-rays of a mother and daughter side-by-side.

A systematic review of spinal degeneration among asymptomatic (no symptoms) populations showed that "37% of asymptomatic 20-year-old individuals had disk degeneration" (2). The main reason why younger adults are suffering from premature degeneration is due to increased hours spent in front of electronic devices such as tablets, computers and smartphones. A poll recently showed that "a person (young adult) ends up spending 1.8 hours using their tablets and phones, 1.4 hours gaming and 3.7 hours using their laptop or computer." That's almost 7 hours a day with our heads down on a screen!

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An orthopaedic specialist, Dr Nancy Craven states: "it is very likely that young adults with poor posture habits are likely to suffer chronic neck and upper back pain, headaches, and even arthritis (degeneration)… because the [spine] alignment is not correct. With these kids' spinal alignment being off at a such a young age, arthritis (degeneration) will set in earlier, which could lead to the need for medications or surgery."

 

What The Future Holds

From teenagers to working adults, sitting and the use of electronic devices have become the new norm without exception. The vast majority of our waking hours are spent on electronic devices with compromised postures and this means trouble. Our ancestors did not sit for hours nor did they have access to home computers and smartphones. Today, young adults are aggressively developing spine misalignments and premature degeneration well ahead of their time.

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Distancing ourselves from computers and smartphones are near impossible. It's the way to get things done, connect with the world and do business. If this is the reality we live in (for the time being), I urge you to take action and do something about it. The health and structure of the spine dictate the overall function and well-being of your body. Whether you're in pain or not, it's time to take care of your body. Abnormal or premature degeneration IS preventable. Not all degeneration cause symptoms! The first step in solving a problem is recognising there is one. Degeneration is not a result of old age but a net product of poor posture, spine misalignments and joint malfunction. Many people seem to really care about their health. They take annual chest X-rays to look into the lungs. They have blood work done. And some even exercise on a regular basis too. But when was the last time you had your spine checked? Don’t let the lack of symptoms or the medical profession’s ignorance towards spine fool you. Whether you address it or not, if there are abnormal degeneration happening in the joints (look at the time-series neck X-rays again), it will continue to degenerate until something is done about it.  

 

 

  1. Epidemiology of Osteoarthritis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2920533
  2. Systemic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4464797/