The human spine was never
optimal in its design for biped ambulation on a high gravity planet such as earth. Its
structure clearly indicates that it was more favorably suited for use by a four-legged
creature. It was probably about 3
million years ago that one of our ancestors decided to try walking on two
legs. For those born with genetically "good equipment"
biped ambulation has generally worked out well.
For those who have chosen their
parents less carefully and thus have become endowed with less-than-optimal spine structure at birth
the path down the road turned out to be a great deal more difficult, particularly if the individual's life-expectancy was greater
than 50 years.
Unfortunately, for those who
have come into the world with poor anthropomorphic spinal equipment the world
(so far) has provided little
in the way of understanding, sympathy, or reasonably effective
assistance. Things, in this regard just haven't changed very much
so far. The typical back sufferer still receives little in
the way of common sense assistance and the early identification and prevention
of spinal genomic disease are still words not well understood in
the health care
community despite the great amount of time and money expended in attempting
to effectively treat back problems.
Given these unfortunate realities it has become essential for those afflicted with back
disabilities to
engage in self-education and begin to seek rational assistance on their own. The daily
environmental and occupational compressional and rotational forces/stresses
exerted on the spine through the normal daily activities of standing,
sitting, walking, or riding in a motor vehicle are remarkably
high and have been understood by only a few
professionals.
We know that many back problems are a job-related disease in occupations such
as trucking where the acquired daily insult and injury are inordinately
high. We also know that individuals who have good muscle
strength, tone and flexibility and who exercise on a daily basis have relatively less in the way of back
problems and associated disability.
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Following Russian cosmonaut Yury Gagarin (April 12, 1961) and
American astronaut Alan Shepard (May 5, 1961) space adventures their flight
surgeons were surprised to note that a common problem among space
explorers
was low
back pain acquired while they were weightless. Scientific studies
relating to this concern initiated by the United States Space Agency and their Soviet counterparts documented that the elimination of the force of gravity was
producing an over distention of their intervertebral discs. |
Due to ambient weightlessness many of the early space explorers
increased their body height as much as 2½ inches during the first 72
hours of weightless flight due to the increased disc volume.
Height returned to normal within 24 hours following a safe landing
on earth. After almost 50 years of space exploration this
phenomenon still exists. Minnesota woman astronaut Heidemarie
Stefanyshyn-Piper noted, upon returning from space aboard the
shuttle Atlantis in September, 2006, that she had gained 1 inch in
height during the mission.
Low back pain experienced by astronauts is caused by an increase in
diffusion of fluid
across the
vertebral endplates because of the decrease in intradiscal pressure
(much like the over-inflation of a balloon). In order to counteract this effect artificial
gravitational environments and pressure suits were introduced and low back
pain has not been a serious concern because of this.
The important lesson drawn from this experience was that if
intradiscal pressure were to be decreased on earth it should then be
possible to enhance disc nutrition. The key would be to carry this
out in a controlled, regular, and safe fashion.
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Few among us give much attention to the subject of
spinal loading or the amount of
stress and insult being directed to our spines on a daily basis. As it turns
out discal loading varies considerably during a normal day depending
on body position.
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The illustration at
left has been redrawn
from the classic work of Alf Nachemson (Nachemson
A: The Load on Lumbar Disks in Different Positions of the Body, Clin.
Orthop., 45:107-122, 1966). In shows loading (in kilograms) recorded
from intradiscal pressure transducers inserted into the L3 disc
space of volunteers. |
| Not many realize that there is more
loading in the sitting, rather than the standing position.
Even when recumbent there remains some loading on the spine. |
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The great advantage of floating in
water is that there is no associated body loading. For
this reason swimming, and particularly aquatic aerobic exercise are
spine friendly. A number of different devices including
aquatic treadmills (to be placed in swimming pools) have been
produced and self-contained aquatic exercise tanks have also been
developed to assist aquatic aerobic exercise.
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Anti-Gravitational
Spinal Unloading & Distraction |
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The
Logic of Intermittent Spine Unloading/ Distraction
(Traction)
Unloading simply means that the amount of loading is
decreased. Traction (or distraction) relates to an
influence beyond zero loading. This has been a
difficult concept for most individuals to understand. The
simile is that of the accordion player who does not
simply continue to compress the instrument but compresses, and then
expands. The human spine is compressed throughout
the day by standing, sitting, or walking. |
At night
spine loading is minimal but still present. To
intermittently expand (distract) the spine allows for
better trans-endplate diffusion and convection of
nutrients, reverses the degenerative process and also
begins to reverse disc protrusion as well as providing a
reversal of the process of lateral foraminal stenosis
and progressive scoliosis. In fact spinal traction has been an
important therapy in health care for
thousands of years.
Intermittent spinal distraction, through exercise or
devices, experienced on a regular and
long-term basis is very important, not only for spinal
health maintenance, but for spine disease prevention.
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Once the adversities of poor parent selection (genomics) and
the acquired insults of loading of the
spine in daily life becomes better appreciated it then becomes possible to begin to explore
more logical and scientifically established means
of safely improving spine health. The key to good spine health
maintenance is to decrease the daily insults to it as well as enhance
spine nutrition and health by the induction of safe and intermittent
negative discal pressures designed to enhance nutrition and healing
by reversing the effect of gravity. We know that when
intervertebral discs degenerate they loose their normal strength and
become subject to tears, from rotational stress, and herniation from
compressional forces. By the regular introduction of safe anti-gravitational
distractive influences it is possible for an individual to actively promote
good disc
health. The term "safe" refers to distractive forces
not exceeding the compliance of normal disc or ligamentous
tissue. The science of
increasing the life expectancy of the disc normal beyond
"normal" is part of the concept of "eugonomics."
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This image shows clients at a health spa in Kiev,
Russia being suspended from harnesses in natural warm springs. This spa has
been actively treating clients in this manner for centuries.
The treatment being provided is basically sound.
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The problem
with such insightful technologies is similar to the Gaiffe
TENS device produced in Paris in the 1880s. While the basic concept is
logical the designed application is inadequate to achieve
intended results (as were many of the devices designed by Leonardo da Vinci).
This support shown has only minimal effect on the
discs themselves. From the standpoint of treating associated
pain and spasm by applying "heat therapy" the activity
benefits the patient by addressing the symptoms
of the problem rather than the problem itself.
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Aquatic
Spine Unloading/ Distraction
A more modern, and much more effective Kiev Spa therapy is shown at the
left. Here the individual's body weight is being supported by a
inflated inner tube and scuba diver weights are being worn around
the waist to allow for spinal distraction. The method is inherently safe
because the force exerted is self-limited and the compliance of normal tissue is
never exceeded. |
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