Spinal Degeneration

Our structure influences our function. Optimal Structure = Optimal Function. The opposite, thus, is true — Poor Structure = Poor Function.

Degenerative disc disease (aka DDD) and Degenerative joint disease (aka DJD, osteoarthritis, arthritis, etc) both occur in the spine, and both result from chronic poor spinal structure. Your spinal structure, while best viewed on an x-ray, can easily be seen outwardly as your posture. We know that people who have the best posture as they age have the best health and best quality of life.

The shape of your spine (your posture) can change over time due to the repetitive stresses that we encounter each day – how we sit, sleep, read, talk on the phone, what we do at work, etc. Because of this, our posture changes gradually and we rarely notice it – until something is very different and maybe we start observing symptoms like pain, numbness, or even muscle weakness or fatigue.

During your first visit, if the doctor feels it is necessary, he will recommend we take the appropriate x-rays at that time in the office. Afterwards the doctor will study them and will let you know if any degeneration is present and, if so, what phase of degeneration your spine is in. Below are some examples.


spine-NormalThis is Normal. This is what your spine should look like from childhood until the day you die. Viewing from the front (not shown here) the head should be perfectly vertical with no tilt or rotation. From the side, the middle of the ear should sit directly above the middle of the shoulder. If any of these are off, proceed to Phase 1 below.

Normal healthy posture and spinal curves are indicative of a healthy spine and nervous system. Because the primary role of the spine is to protect and allow passage of the spinal cord, any deviation from a normal curve in the neck, mid back, or lower back can cause significant stretch, twist, or shear on the spinal cord. This is a serious issue that must be addressed as soon as possible to avoid detrimental long term effects.

spine-phase-1Phase 1 degeneration is typically seen as forward head posture (FHP). As shown to the left, the head sits forward from its normal healthy position. On x-ray, you can see the normal curve as viewed above is diminished or no longer present. Often people will have heard the term “straight neck” or “military neck” to describe this degeneration in the neck. This phase is reversible if the doctor recommended care plan is followed, but the longer this has been present, the harder it is to make changes.

Signs of spinal cord interference become apparent. Organ dysfunction creates symptoms that may include headaches, back pain, ear infections in children are quite common, as well as allergies or asthma. This list is by no means all inclusive. A more detailed list of health problems or diseases associated with spinal nerve dysfunction can be found on our Conditions Commonly Treated by Chiropractors page.

spine-phase-2Phase 2 occurs after Phase 1 is left untreated. As you can see, forward head posture becomes more pronounced. You may begin to see a “hump back” starting to appear. In phase 2, the loss of normal curve is complete and we see reversal of the curve. Some disc thinning is observed here as well as the beginnings of bone spur formation. Phase 2 can often be corrected, but with a more intensive treatment plan. The process also takes longer than Phase 1 based on the severity. Health problems begin to accumulate and progress as Phase 1 and 2 degeneration progress.

It has been observed that once you have entered Phase 2, the structures degenerate at a much faster rate and Phase 3 is reached at a rapid pace.

spine-phase-3In Phase 3, a pronounced hump may sometimes be seen in the upper back. Just because there is no hump does not mean that Phase 3 degeneration is not present. Only an x-ray can identify this. In Phase 3, severe disc degeneration is evident as well as bone spur formation. It is very common to have shooting pain down the arms or legs into the hands or feet in Phase 3. Many cases of carpal tunnel may be undiagnosed Phase 3 spinal degeneration.

In Phase 3, your range of motion often will be severely limited, and what motion you do have will likely be painful. Phase 3 is very difficult to correct. Sometimes, if a person has Phase 3 degeneration, aggressive treatment is necessary simply to stop the progression to Phase 4 (complete natural fusion). For some, our objective is just that – to maintain the current level of function and prevent further degeneration.

Phase 4 (not shown)

Phase 4 is the result of the body fusing or immobilizing vertebrae to prevent further degradation of the structure surrounding the spinal cord. If you have Phase 4, you can still be adjusted. Maintaining motion around fused areas is important to prevent further fusion.


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