Arthritis, i.e. degenerative changes of the spine, is the appearance of degenerative, deforming anatomical changes of the spine that occurs as a result of degeneration of the discs between the vertebrae. Degenerative bony changes, which is what we see on x-ray and MRI scans, only happen as a consequence of previous degenerative disc changes. This is why it is so essential to improve the status of the disc in treating neck and back problems, whenever possible. Not only does this provide the most effective treatment for the present pain, but it improves the future prognosis of a person’s spine. It is essential, if one is trying to maintain a person’s spinal function as long as possible, to improve the status of the disc, so that it will last as long as possible for a person’s lifetime.
The process of bony “arthritis”, which is not my favorite term, as I prefer the term “degenerative changes”, is the progressive deformity of the vertebral bones, which happens as above-mentioned. The reason I don’t like the term arthritis is that I think it generates fear and hopelessness in patients. Degeneration I think connotes a more realistic conception and is less inclined to generate fear. People understand that degenerative changes really are a normal process, if they are not excessive, (although it’s also true that some people have beautiful looking spines even into old age). We don’t have to undo degenerative changes. We simply have to treat the problem sufficiently to improve or resolve your pain and function, in the context of your immutable degenerative changes.
When we see arthritis we are speaking of the vertebral body and the joints of the vertebrae. The vertebrae can become deformed and enlarged. That is they enlarge and deform as a result of more pressure on them, as a result of greater stress from the collapsing disc. As a result of more pressure the vertebrae also become swollen and inflamed, changes we call Modic changes. This bony enlargement, also accompanied by ligamentous enlargement, then encroaches on the central canal space, where the nerves descend, and on the little holes on the side, i.e. foramina, where the nerves exit on the right and left sides of the spine. Arthritic or degenerative changes of the spine cannot be changed but we can make meaningful improvements to the disc structure, which will slow the degenerative process. By improving the disc degeneration, and slightly increasing the height of the disc, we reduce the stress and pressure on the bones to stem the progressive, degenerative, arthritic, deforming process of the bones.
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