Between the ages of about 18-24, we reach our full height and our spinal column has reached its full size. From there, it all goes downhill…sort of. There are really only two growth processes as it's pertains to our human body and development: generation and degeneration. Generation, means growth, as defined in terms of human development. From birth until our body and spine has reached its maximum size, we continue to grow as our body produces new bone, muscle tissue, and other tissues at a rate that outpaces the rate at which our body tissues break down due to injury or becoming worn out. With the exception of a few anatomical structures in our body, including the neurons and ligaments, our body cells have a certain shelf life of functionality before they age and eventually die and are reabsorbed by the body. When we are young and growing and are approaching our physical peak, our body is able to produce new, healthy cells and tissues at a faster rate than our older cells become worn out.
This process becomes reversed as we get older, and our aging body is not able to produce new healthy tissues at a faster rate than our older tissues are becoming worn out. At this stage if development, our bodies begin to degenerate. Don't be alarmed by this revelation, however. Our bodies continue to produce growth hormone and new healthy tissues to replace those that become worn out throughout our lifetime, and this is a process we all endure, including healthy individuals with no back pain or spine pain.
What does this mean for our spines and backs, particularly those who have back pain. The human spine goes through the same changes as would be seen in other bones and joints in the body following maturity to full size. These degenerative changes may occur in the event of the intervertebral discs losing their inflatability (water volume), arthritis in the facet joints, loss of muscle mass in the muscles supporting the spine, and bone spurs between the vertebral bones as they begin to touch and produce friction against one another. Not all the age related changes to the structures of the spine cause spine pain, however. Some age related changes may actually increase stability of the spine and provide back pain relief. For example, as we age, the ligaments of the back gradually lose their elasticity and become more stiff, and the joints of the back become less flexible. These changes of the spine render it less flexible, more stable and less susceptible to both injury and pain. Recent findings published in scientific journals indicate that, the majority of back pain sufferers are not people in their 60s-80s, but are actually in their lat twenties, thirties, forties, and fifties. These studies indicate that back pain tends to get better with age not worse.
Changes to the intervertebral discs of our back appear to be the cause of back pain in a majority of patients. These age related changes are the easiest to diagnose on medical imaging studies. We do know that the size of the intervertebral foramina, where the nerve roots exit the spine, does decrease, and that this change may cause the nerve roots to become compressed.
How and why do the parts of the spine age, and how are we affected. Let's take a closer look.