![]() These changes are often referred to as ‘degenerative disc/joint disease’, however, the changes seen are actually the body reacting and adapting to the stresses exerted upon it over the course of our lifetime (1, 2). The facet joints and vertebral bodies also show changes, they begin to lose their cartilage and instead deposit bone to compensate, changing the shape of the bone, this is the process that leads to osteoarthritis and what is referred to as spinal stenosis. These changes also lead to an increase in the amount of pain-producing nerves around the disc. This damage creates ‘fissures’ in the annulus allowing the nucleus to move more freely to exert pressure on the outside of the disc (where the nerves that transmit pain are located), this is how ‘bulging discs’ occur. This results in the annulus having to take up more of the strain, resulting in damage. The nucleus of the disc becomes less fluid, elastic and ‘spongy’, changes to its structure make it much ‘drier’ and therefore less able to cope with the forces exerted upon it. As we get older the vast majority of us begin to show changes in these structures, leading to a change in how they perform their tasks. Only the outer few millimeters of the annulus has nerves that transmit sensation and pain. VERTEBRAL ENDPLATES – These form the top and bottom of the disc and are mostly cartilage, they are extremely tough and are the barrier between the nucleus and the vertebrae. Its main function is to dissipate force by its fluid nature, a bit like a water balloon if you squeeze it then it will move in any direction.ĪNNULUS FIBROSIS – This part of the disc is made up of tough collagen fibers, precisely arranged in ways to resist the pressures placed upon it by the movement of the nucleus proplusus. NUCLEUS PROPULSUS – This is the more fluid centre of the disc, it is said to have the consistency of toothpaste. Their structure and their relationship are designed to allow the spine to move and to cope with the loads we place on our backs over the course of a lifetime (1). The intervertebral discs and vertebrae from the principle joints in your spine, at each level of the spine there is one intervertebral disc and two ‘facet joints’. ![]() What happens to the spine as we get older? In the context of hearing the words ‘wear and tear’, these terms are describing a set of changes that happen to the vertebral column as we get older. If you get to see the written report that accompanies your MRI then it will commonly have words such as ‘degenerative disc disease’, ‘spinal stenosis’, or ‘bulging/prolapsed discs’. If there has not been a traumatic onset of the pain then the language that the radiologist is using could more accurately be described as ‘age-related changes’. In the broadest sense, it means that the person explaining your MRI results to you is paraphrasing to explain in layman’s terms the technical language contained in the radiologist’s report of your imaging. What does ‘wear and tear’ of the low back mean? We also will explain what to do if you have low back pain and have been told that your MRI shows you have ‘wear and tear’. What we will explain in this article is why the term ‘wear and tear’ is not only inaccurate but also that it is harmful to low back pain sufferer’s future outcomes. Often, they will have had an x-ray or an MRI showing that ‘some of the discs in the back are wearing out’. Many people who have back pain arrive at our practice after being told by their doctor that they have ‘wear and tear’ in their spine, or that ‘it is part of getting older’. Age-related changes in the spine can be present without any pain. The use of the term ‘wear and tear’ when attempting to describe MRI results has been shown to be detrimental to a person’s recovery from back pain and therefore should be replaced with ‘age-related changes’. Results like this from an MRI are only a snapshot of the structures in the spine and do not indicate a limit on the ability of the spine to perform effectively or place a limit on a person’s capacity to improve any back pain they may be having. The term is commonly used to describe the results of an MRI or X-ray to a person who has been experiencing low back pain. Wear and tear of the low back is a ‘catch-all’ term used to describe changes in the intervertebral discs and the spine as we get older.
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