Quote:
Originally Posted by TheSutterDynasty
Several things wrong with this. First off, the article is very vague and just states "degeneration". Take imaging of anyone's back over the age of 20 and they have degeneration in their lower back. That doesn't mean it's causing pain and not normal.
Osteoarthritis and degenerative disc disease are essentially the same thing. Everyone undergoes an aging & wearing process of the discs, just like everything else in the body. The reason I say they're "the same" is because as we lose disc height/viscosity/etc, we begin to have more movement at that joint, which causes osteophyte formation as an adaptive response. "Osteoarthritis" is the wearing of cartilage. In the case of the spine, that's the discs.
We all have degeneration. We don't all have pain. And only a small portion of those with pain (even if we could reliably say it's 100% from the degenerative disc disease, which we definitely can NOT) have nerve root impingement, "sciatica". This is not the spinal cord.
There is WAY more treatment for conservative management than the things you listed. He will not have a laminectomy/fusion unless he is at the very end of the road.
I don't know anything about the injury other than the article. Just a few musings about your post, hope I didn't come across as confrontational, I just think anything that contributes to the fear of spinal pain should be addressed since it can be so crippling to an otherwise very benign injury.
(I don't know anything about Horton's injury specifically. Obviously his is bad enough to warrant this article but I guarantee it's not due to "degeneration").
|
You absolutely did.
First of all, not everyone over 20 has degeneration. I don't know where you get that from. Is degenerative joint disease or osteoarthritis common? Yes. Is it normal at his age? No. I'm in my mid-30's and I don't have any degeneration in my spine at all (mostly because I get regular adjustments). I will agree that it doesn't always cause pain, but obviously in his case it is.
Osteoarthritis is different than degenerative disc disease and both have different causes. Osteoarthritis usually results from excessive motion or use, while a lack of motion is the main culprit for a loss of fluid in the disc, leading to decreased height and viscosity, and eventually annular tearing and possible protrusion of nuclear material into the spinal canal. Sometimes it's central impinging on the cord, and sometimes (more often) it's more lateral impinging on the nerve root. Sciatica refers to entrapment of the entire sciatic nerve, while disc involvement at the nerve root is referred to as radiculopathy.
Osteophyte formation occurs when there is excessive stress placed on bone, and can occur from a variety of sources. In the spine, when a disc loses height the ligaments that overlie the joint are put under greater stress, pulling on their attachments to the bone, and creating an osteophyte. Osteophytes can also occur at the zygapophyseal joints due to excessive weight bearing from poor spinal alignment. These can also cause radiculopathy if the bone growth constricting around the nerve root is extreme enough, and you rarely see that until much later in life.
I will say this about back pain: it's difficult to narrow down the cause because it's often multi-factorial. In my experience, almost any tissue can cause low back pain and it can be very difficult to treat for some, often never fully resolving or having multiple recurrences over their lifetime. I'm not saying that's the case with Horton, because I know very little about his case, but if it's bothering him this much at 29 after playing years of a very physical and painful sport, it's probably something fairly serious.
Of course there are other treatments for back pain, but I was listing the two most effective ones that I know of for disc degeneration and protrusion (if that's the case). I fully advocate conservative measures since surgeries are around a 50% success rate, but the conservative treatments take a lot longer and are not a sure thing either. Horton's career is short and he will likely opt for the surgery if the conservative approach does not make any progress over the next couple of months. That's just the way it is for athletes.
If you're going to try to make someone look stupid and say there's a lot "wrong" with what they said, make sure you have your facts straight.