The season of winter brings with it a number of opportunities; from peaceful outdoor activities such as skiing or snowshoeing, to cozy nights around a fire. Winter can bring some challenges as well, namely slippery sidewalks and shoveling.
During the winter, there tends to be an uptick in falls and sore backs. One of the most commonly diagnosed afflictions for the low back is a disc problem. Whether it’s something more mild like a “slipped” disc to a more serious, herniated disc, disc problems account for many sick days, rehab and surgeries.
While I was in Chiropractic school, I worked in an office that specialized in treating patients with disc problems. I enjoyed learning about the various problems that patients would present with and how to address each one.
The disc itself sits sandwiched between vertebrae and acts as a cushion and a point of stability, like one leg of a three-legged stool. The disc is like a jelly donut: it has a fibrous outer layer and a jelly-like centre.
When a patient is developing arthritis in the low back a.k.a. degenerative disc disease (DDD), the disc itself gets thinner, dryer and the jelly centre starts to get pushed out.
The main reason patients develop DDD is from longstanding lack of movement in the spine. When the vertebrae in the low back lock up and stop moving, the disc suffers.
In order to maintain healthy discs (and vertebrae), movement is required. As the vertebrae move, the disc in between them gets compressed and decompressed, like a sponge. As the disc gets compressed, it releases waste products. As it gets decompressed, it absorbs water and nutrients. So if the vertebrae get locked up for long enough, the disc doesn’t get its proper nutrition and can’t get rid of waste products.
What would happen to you if you couldn’t get proper nutrition and you weren’t able to get rid of waste? Degeneration.
So one helpful strategy for a healthy spine is to make sure that your vertebrae are not locked in position. But disc health goes further than that.
Spinal biomechanics in the low back are such that the low back gets affected by what’s happening above and below. For example if you develop Anterior Head Syndrome, and your head moves forward of your body (rather than being over your shoulders), you automatically increase the pressure on the low back.
When we examine patients in the clinic, one of the measures we look at is how much Anterior Head Syndrome you have. It’s typically measured as an angle between your ear and your shoulder. Between 0 and 5 degrees is considered normal. Beyond that, the more of an angle there is, the heavier your head gets and the more pressure is put on your whole spine, including your low back.
Your low back becomes like a fulcrum and the discs in the low back sustain pressures that they’re not designed for. I typically see measures of between 10-20 degrees in the general population. The worst I’ve seen is around 40 degrees!
Consider the next time you that you’re shoveling snow, you not only want to lift with your legs, but you also want to consider how your head position is affecting your low back. Are you predisposed to developing a disc problem?
We do consider ourselves biomechanics specialists because we not only look at the area of concern. We also look at how the rest of your body is impacting the area of concern. And while you may have DDD and you may have low back pain. But the key to unlocking your spine may lie elsewhere.
What happens with someone who addresses their disc problem with surgery without considering the rest of the body? A common finding among orthopaedic surgeons is that if they do surgery on one disc, inevitably the disc right above will eventually deteriorate to the same point.
Often when we hear of someone with low back pain after shoveling, we attribute the pain to the activity. But what if the person already has an unstable low back and they shovel some heavy snow? Would they feel any different if their back was healthy? My guess is yes:).