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How is my back like my face?

Updated: Feb 23, 2022

It’s not unusual for patients with back pain to be told, to their surprise and concern, following an x-ray that they have degenerative disc disease of the spine.

But many 55-year-olds are quite pleased to learn that they look 45. And of course, it would be rare for a 55-year-old to expect to appear 25.

Terminology is somewhat responsible. While our faces age decade by decade, no one thinks of it as “degenerative face disease.”

But in fact, the changes are quite similar, recognizing certain anatomic differences.

Healthy facial tissues have a high intrinsic water content and an inherent strength and elasticity of the muscles and connective tissues.

Most people recognize how much their faces have changed when they compare the mirror image with their high school yearbook. It’s obvious things have dried up and lost a bit of shape.

The same kind of changes occur in the spine. The tissues lose their water content and the aging of the proteins of the muscles and ligaments tissues results in loss of strength and flexibility. The cartilage covering of the spinal joints thins and the bones around the joint make extra bone to compensate in carrying the load which may narrow the nerve channels.

The result is an x-ray which at 55 has changed as predictably as our facial appearance.

Important differences of course are that facial aging changes aren’t associated with pain and spinal aging changes generally don’t much affect our appearance.

Just about everybody recognizes that there are things we can do to minimize the changes in our appearance. Sun protection, smoking cessation, weight control and aerobic fitness are all important.

Like the face, spinal aging will occur but with proper care often gives us far less signals of aging than our appearance.

While there is an obvious difference in tissues, the same kind of care applies.

Sun damages our skin.

Various protracted loading activities damages our spine the same way heavy loads and rocky roads damage our tires. A 20-pound bag of potatoes tucked under your arm in the supermarket feels pretty heavy after 2 or 3 aisles. Think of those 20 pounds of extra load on our spine the very moment we are upright, year after year.

Smoking, which impairs the cellular nutrition of all tissues, importantly ages those of our face and spine.

The absence of exercise encourages tissue aging. Compare the appearance of the 55-year-old 3 mile a day walker and the sitter.

All this is discussed in the articles below. Take a quick look. We are here to provide guidance.

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