There exists an opinion in the spinal health literature that the presence and extent of spinal arthritis and degenerative disc disease (SADD) is unrelated to spine pain conditions and patient health.
In truth, there are both positive and negative study findings regarding the correlation between spinal pain and spinal degeneration; but the number and quality of studies is seemingly weighted on the positive side of the equation; in other words, there is a correlation between SADD and human health and disease.
Background Data Indicates that Cervical Spine SADD Correlates to Pain and Health Disorders
In a minimum 10 year longitudinal study of 159 asymptomatic subjects, Gore found 15% of previously asymptomatic subjects developed neck pain and “…that the presence of degenerative changes at C6-C7 on the initial roentgenogram was a statistically significant predictor of pain” at the minimum 10 year follow-up exam.2
Peterson et al3 found a statistically significant positive correlation (described as weak but still significant) between self-reported pain intensity and the severity of SADD.3 Likewise, in a review of cervical spine radiographs of 5,440 men and women between 20 and 65 years of age, van der Donk et al4 found that “disc degeneration was associated with neck pain in the men but not in the women.”
Norris and Watt5 followed 61 patients involved in motor vehicle accidents for an average of 2-years. The patients were categorized into three groups: 1) cervico-genic symptoms without positive physical exam findings, 2) symptoms with reduced cervical spine range of motion (ROM), and 3) symptoms with reduced ROM and neurologic deficits. Norris and Watt found “…pre-existing degenerative changes in the cervical spine, no matter how slight, do appear to affect the prognosis adversely”.5
In a prospective, cross-sectional survey of 700 consecutive patients, Marchiori and Henderson6 investigated the correlation between cervical SADD and neck pain, disability and chronicity of pain. A significant relationship (p < 0.001) was found between the number of levels of intervertebral disc degeneration and the chronicity of cervical complaint. Multiple-regression analysis of neck disability index scores demonstrated a significant three-way interaction of chronicity, SADD, and gender (p = 0.022).6
Lastly, one investigation identified a correlation between abnormal/altered auditory evoked brainstem potentials and the presence of cervical spine SADD.7 This important study demonstrates that degeneration of the cervical spine is associated with ‘nerve interference’.7
Causes of Cervical Spine SADD
It is noted that moderate-severe radiographic determined spinal SADD can be a serious health disorder associated with a myriad of clinical conditions and that moderate to severe SADD always begins as mild SADD. In Chiropractic clinical practice, radiography is the most efficient means of detecting a patient’s unique state of spinal health. We suggest that the prudent clinician should do their best to control for specific risk factors linked to the development and progression of spinal DJD. These risk factors can include: diet, smoking, body mass (obesity), physical activities, and abnormal spinal and postural alignment.8-11
One of the best solutions to control for the progressive development of Spinal Arthritis and Disc Disease (SADD), is to insure that you have a proper cervical lordotic curvature. Figure 1 demonstrates the normal state of the cervical lordotic curvature and then the progressive development of SADD in different patients over time (Levels 1- 4). This figure is based on experimental modeling results in the literature as well as prospectively studies on subjects over time.11
Break Through Spine Modeling Study By CBP Researchers
In a break through spine modeling investigation, Harrison and colleagues digitized measurements from lateral cervical radiographs of four different patients with 4 different cervical curve shapes (Normal, Complete Reversal, S-curve Lower, and S-Curve Upper) were used to calculate axial loads and bending moments on the vertebral bodies of C2-C7. Since Osteophytes and osteoarthritis (SADD) are commonly found at areas of altered stress (force per unit area) and strain (deformation), an engineering analysis is necessary to determine the exacting loads acting on the cervical spine vertebra in different spine configurations.
Harrison and colleagues identified that the loads acting on the cervical vertebra and discs in kyphotic – reversed curve- areas are very large and opposite in direction compared to a normal lordosis. They identified that in kyphotic areas of the cervical curvature, the combined stresses changed from tension to compression at the anterior vertebral margins; these stresses were also found to be very large (6-10 times as large in magnitude) compared to the normal lordosis of the neck.
This analysis provides the basis for the formation of osteophytes (so called spinal arthritis) on the anterior margins of vertebrae in kyphotic regions of the sagittal cervical curve. “Our model predicted results indicates that reversed cervical curvature at any segment in the neck, is an undesirable configuration in as much as it will accelerate the development or progression of spinal arthritis and disc disease (SADD) due to altered and increased spinal loads.” said Doctor Deed Harrison, lead author of the study.
How Can You Get Help for Spinal Arthritis and Disc Disease and Health Disorders?
Chiropractic BioPhysics® corrective care trained Chiropractors are located throughout the United States and in several international locations. CBP providers have helped thousands of people throughout the world realign their cervical spines back to health, and eliminate a potential source of progressive SADD, chronic neck pain, chronic headaches and migraines, fibromyalgia, and a wide range of other health conditions. If you are serious about your health and the health of your loved ones, contact a CBP trained provider today to see if you qualify for care. The exam and consultation are often FREE. See www.CBPpatient.com for providers in your area.
- Hart J. Structural problems of the spine do not necessarily require intervention. J Canadian Chiropr Assoc 2007; 51(1).
- Gore DR. Roentgenographic findings in the cervical spine in asymptomatic persons. A ten-year follow-up. Spine 2001;26:2463-2466.
- Peterson C, Bolton J, Wood AR., & Humphreys BK. A cross-sectional study correlating degeneration of the cervical spine with disability and pain in United Kingdom patients. Spine 2003; 28(2):129–133.
- van der Donk J, Schouten JS, Passchier J, van Romunde LK, Valkenburg HA. The associations of neck pain with radiological abnormalities of the cervical spine and personality traits in a general population. J Rheumatol 1991;18(12):1884-1889.
- Norris SH, Watt I. The prognosis of neck injuries resulting from rear-end vehicle collisions. J Bone and Joint Surgery 1983;65-B:608-611.
- Marchiori DM, Henderson CNR. A cross-section study correlating cervical radiographic degenerative findings to pain and disability. Spine 1996;21:2747-2752.
- Olszewski J, Kochanowski J, Zalewski P, Chmielewski H. The effect of neck rotation on auditory evoked brainstem potentials in patients with degenerative cervical spine changes. Neurol Neurochir Pol 1993;27:23-29.
- Hassett G, Hart DJ, Manek NJ, Doyle DV, Spector TD. Risk factors for progression of lumbar spine disc degeneration: the Chingford study. Arthritis Rheum 2003;48(11):3112-3117.
- Iwamoto J, Abe H, Tsukimura Y, Wakano K. Relationship between radiographic abnormalities of lumbar spine and incidence of low back pain in high school and college football players: a prospective study. Am J Sports Med 2004; 32(3):781–6
- Kauppila LI, McAlindon T, Evans S, Wilson PW, Kiel D, Felson DT. Disc degeneration/back pain and calcification of the abdominal aorta. A 25-year follow-up study in Framingham. Spine 1997;15(22):1642-1647.
- Harrison DE, Harrison DD, Janik TJ, Jones WE, Cailliet R, Normand M. Comparison of axial and flexural stresses in lordosis and three buckled modes of the cervical spine. Clin Biomech 2001; 16(4): 276-284.