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1st Jan

2010

Can Exercise Strengthen the Spinal Discs?

I would first like to wish you a Happy New Year, and good health for the coming year. In this newsletter, I’ll address a somewhat controversial topic. According to the current literature, “conventional wisdom” leads us to believe that anything beyond modest physical loading on the back may be detrimental to the intervertebral discs, and cause cumulative trauma, and accelerated disc degeneration. More recent high quality research is now refuting such a notion.

TWO RECENT STUDIES FAVOR DISC LOADING

A Finnish research team headed by Dr. Videman, conducted two separate large twin studies, the first in 2006 and the second study in 2009, both of which appeared to indicate that added loading, unless excessive, may improve the health of spinal discs, rather than harm it. Both studies have been presented at large international spine conferences, and received much praise, but as always when “conventional wisdom” is challenged, also received some criticism.

The first twin study looked at the subjects’ lifestyles with regards to lifting and bending/twisting, their occupations, exercise habits and measurements were taken with MRI scans, body weight, lifting strength etc. The researchers found that subjects with higher body mass, higher lifting strength and higher physical loading levels were all associated with MRI signs indicative of healthier discs.

The second study last year was done on twins, where one of the siblings was an average of 30 lbs. heavier than the other sibling. The researchers again found, that the low back discs appeared healthier (along with the bone) in the heavier twins.

The researchers concluded that, even though spinal discs have extraordinarily slow metabolism and ability to regenerate, they appear to benefit from increased physical loading, within reason, and gradual adaptation, just as joints, bones, muscles, tendons and ligaments do.

A DIFFERENT PATTERN EMERGES IN OLDER AND DEGENERATED DISCS

Videman and his team also found that with advancing age, and in people with more pronounced disc degeneration, higher levels of physical loading appeared to have a negative effect on the health of the discs, with increased degeneration, just as is the case with arthritic joints and other musculoskeletal structures in the body.

EXERCISE MAY SERVE AN IMPORTANT PREVENTIVE ROLE

Based on these findings that reasonably healthy discs behave in a similar way to other musculoskeletal tissues, in that progressive loading is beneficial and can strengthen the tissues, a well designed exercise program with emphasis on core stabilizing back and trunk muscles, may provide important protection for the back, and prevent future back pain or injuries.

This model fits well into our clinic’s rehabilitation philosophy, and experience in treating patients with low back pain and disc disorders.

With best wishes for a healthy 2010,

Gunnar

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