Can our spine and nerves be replaced? How to look after your back

Dentures. Knee replacements. Organ transplants.

It seems that just about everything in our body can be replaced (or at the very least, fixed up a little) when it goes wrong or wears out.

The one exception?

Our spine and nervous system.

Why can’t our spine be replaced?

The spine serves to protect the nervous system, which is an incredible complex structure. Motor nerves (the ones that control movement) have a time limit for healing after injury. This is due to a something called a “motor endplate”, the structure where the nerve attaches to a muscle. If the motor endplate doesn’t receive any nerve impulse for longer than 18-24 months, it dies away. This leaves the muscle with no nerve to activate it, and so the muscle begins to atrophy (waste away).

Cell division (or mitosis) is when a healthy cell divides, making two new genetically identical “daughter” cells. When you cut yourself, the injured cells are removed from the area. A scab forms, to protect the underlying area as the skin cells around the wound divide. This creates more and more healthy cells through the process of mitosis, eventually producing a new layer of skin. Fabulous.

The nervous system is different.

It’s postmitotic, which means that unlike other cells in our body, mature cells cannot replicate. In fact, nerve cells that do try to replicate or reenter into the cell cycle may actually be involved in neurological diseases such as Alzheimer Disease. There are a few reasons why nerves can’t be replaced, but here’s a simple explanation of the problems that could be caused by replicating nerves:

Imagine a road from A to B. You’re in a car, travelling along that road.
(In this scenario, the car is a nerve signal being sent from the brain to the muscle.)
Now, imagine that right before your very eyes, the road starts multiplying. First two roads, then four, then eight.
What are the chances of you reaching your destination now, with eight roads to choose from? (Unless you had an excellent sat nav or a very lucky guess.)
This is why nerves can’t regenerate. Nerve cells cannot divide, because if they did, it would cause more problems than it would fix- the car (nerve signal) can’t reach it’s destination because of all the replicated roads (nerves) confusing it.

 

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Whilst discs and vertebrae can be replaced in extreme cases, these types of surgery are highly invasive. They may result in severe complications like ongoing back pain, loss of normal range of motion, nerve damage and more.

So you can see, we really ought to be taking better care of our spine and nervous system.

Why then, do we ignore back pain?

A good question.

Sadly, back pain is normalised.

“I just get the usual aches and pains.”
“Just the normal back pain most people get.”
“It comes and goes every few years/months/weeks.”

We wouldn’t ignore a recurrent toothache, but we do ignore our back pain.

The back pain burden is worsened by poor management and advice. The guidelines for managing low back pain are very clear- drugs and surgery should be a last resort. Unfortunately, there’s still an overreliance on scans, x-rays and medication. In the case of scans, they’re largely unhelpful, often only causing more fear and worry- which in turn aggravates your back pain further.

Leading medical journal The Lancet released a series of papers on low back pain in March 2018. These showed that despite guidelines recommending non-invasive treatment as a first-line approach, chronic low back pain remains poorly managed. It’s the leading cause of disability in the world.

It seems that somewhere along the line, we were told that back pain was normal.

It’s common, but it isn’t normal.

Back pain can have a huge impact on daily life, affecting work, family, relationships, and even your mental health. It’s also a vicious cycle for healthcare providers, as people with chronic low back pain use more health resources than others.

In the UK it is estimated that low back pain is responsible for 37% of all chronic pain in men and 44% in women and the total cost of low back pain to the UK economy is reckoned to be over £12 billion per year. Furthermore, in 2006, one in seven of all consultations with GP’s was for a musculoskeletal problem, with back pain being the most common. (Source)

You can easily see how back pain is contributing to the stress on the NHS, limiting the number of GP appointments available, creating a burden on the UK economy and perpetuating harmful myths that stop you from getting better.

What can I do about my back pain?

If you suffer with low back pain, the recommendations are simple:

Chiropractors are regulated primary healthcare practitioners who are trained to offer you a package of care which incorporates the above recommendations. In addition, we work with you alongside our resident health coach to identify to help you manage and cope with your back pain while you recover. This might involve modifying your activities, managing your stress levels or setting aside time in your day for mindfulness activities.

Back pain cannot be “fixed” overnight. Chiropractors do not “push joints back into place” and are instead working with precision to improve the function of your spine, nervous system and muscles. It takes time, so patients usually start with a short course of four to six treatments. It doesn’t take many treatments for a change in symptom pattern to become obvious and we have excellent outcomes from care.

Remember, the quicker you receive appropriate help for your back pain, the faster you’ll recover. (Source)

So next time you feel that familiar niggle, it might be time to address it, rather than ignore it.

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