Descriptions of treatment for low back pain date all the way back to Hippocrates (460-370 BCE), who described joint manipulation and use of traction and decompression. As we age, we endure both macrotraumas and repetitive microtraumas and undergo changes in body habitus that alter and redistribute biomechanical forces unevenly on the lumbar spine. Much like your knee, the padding or cartilage is mostly water-based and will progressively degenerate the longer we spend in gravity. Factors such as weight, nutrition, genetics, trauma (macro or repetitive micro), and environment may contribute to accelerated degeneration. Degeneration is universal to structures that comprise the functional spinal unit, composed of 2 adjacent vertebral bodies (the bones) and the disk in between them. The disk and 2 facet joints at the same level function as a trijoint complex.
This degeneration of the lumbar segment progresses with age with characteristic anatomic, biomechanical, radiologic, and clinical findings and is called lumbar degenerative disk disease.
by Nathan S. Walters, MD
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