August 2019 Edition. Volume XIX

Carefully Choosing One’s Parents
The most single most important factor in regard to possessing a healthy back, and not being seriously disabled during one’s life, is to exercise great care in the selection of your parents. We now know this because of the gift of modern non-invasive spinal imaging (particularly magnetic resonance imaging) which has allowed for the diagnosis of genomic spine disorders we now know that all spines, at birth, are not created equal and they are not necessarily endowed by their parenteral creators to be structurally optimal for the purpose of biped ambulation on a high gravity planet such as earth.  For the moment, however, this planet remains our only practical choice.

Not only are there many different types and patterns of abnormalities which can  be present occur at birth but it has also become clearly evident that many of these types of problems have a strong genetic basis. That is to say that there are high incidences of these recurring problems within family groups. Geneticists are only now beginning to take notice of this fact. In a recent study conducted on 326 pair of twins genetic factors were implicated as accounting for 60% of the total risk of developing disc degeneration in the twin’s lifetime.

Nutrition is a most important factor in maintaining a healthy back. In this regard it needs to be stressed that the smoking of cigarettes represents the single greatest nutritional liability to any individual in a modern environment. Cigarette smokers have a circulating level of carbon monoxide and nicotine in their blood streams. These are poisons and are toxic to all body tissues. The greatest amount of insult occurs in those tissues having the poorest blood supply. Intervertebral discs do not have a blood supply in adult life. Discs obtain their nutrition by the process of diffusion and convection from the adjacent vertebral endplates. Because of this borderline nutrition smokers have been shown to be subject to a 3-4x higher rate of degeneration in their intervertebral discs than non-smokers. They also have a 3-4x higher failure rate of bone fusions. One must have been a non-smoker for about 3 months to clear the body tissues of the accumulated nicotine.

Occupational Considerations
In some occupations the accumulation of daily insult and injury to the spine can be destructive. Back problems are particularly common in occupations such as trucking. Pilot Seating, because of poor ergonomic considerations is associated with an inordinately high incidence of back problems.  In some athletic endeavors, such as in gymnastics, direct and constant repetitive trauma is typically directed to the spine over many years. The effects of this are cumulative and can lead to significant disability and incapacitation later in life. This is particularly true in the case of those born with congenital structural liabilities. Not only does common sense need to be applied to reducing occupational risks but it seems that those at high risk should be made aware of this at an early age so that they can institute effective preventive measures.

Investing In Your Back
Most individuals think of “investment” only in the monetary sense. Monetary rewards are meaningless if one is disabled.  Being incapacitated later in life and not being able  to enjoy the fruits of one’s own labor is a sad and frustrating circumstance. It is however, much too common. The accumulated insults and injury which are directed to normal spines simply from the activities of daily living on a high gravity planet such as earth is appreciated by very few at this point in time. An important reason for this is that there is very little, if anything, taught about the spine in lementary school or later.. It appears that the only individuals who pay any attention to this issue are only the ones who have experienced episodes of incapacitation and do not wish to experience it again. The sad fact is that at that point in time the “window of opportunity” for early identification of these problems and optimal prevention has already passed.

The basics of prevention are known today but have not been widely disseminated. Unlike interventional or surgical therapy where the potential for profit is high and thus associated with extensive and expensive marketing efforts preventive programs tend to be “orphans.” To search out these “orphans” takes considerable effort which is usually well rewarded.

The Role of Exercise
Daily exercise is good for backs. Stabilization exercises and stretching, low impact aerobics and aquatic aerobics are all particularly beneficial. The maintenance of good muscle tone, strength and flexibility is not only healthy but also acts to prevent musculo-ligamentous the spine injury. While all exercise is beneficial it must be recognized that running and jogging place significant stress on the spine (and knee joints). The beauty of aquatic aerobic exercise is that when someone is immersed in water to the neck there is essentially no loading on the spine. Those who place their spines “in harm’s way” usually reap the sad results later in life.  One can not judge the “risk versus benefit” ratio unless one is well informed regarding the subject (or can possesses any awareness at all of the issue). For sedentary individuals who are endeavoring to become more active it is extremely important togradually acclimate the body to the exercise program.  It is also most important to set safe and realistic initial goals so as to avoid permanent injury.

Best Buys In Self-Exercise Programs

Image19Power Striding- Walking, rather than running, on an elevated treadmill avoids the spine stress created by running. Treadmills are expensive. A reasonable alternative is to do step aerobic exercises on a sturdy step stool purchased from a hardware store.


Image19Yoga-There are many different yoga disciplines. Some of these are: Ashtanga, Bikram, Hatha, Integral, Lyengar and Kundalini. What they all appear to have in common is balance, relaxation, flexibility and pain reduction. An important advantage of yoga is that the only equipment required is a floor mat.


Image19Pilates- Developed in the early l9th century by Joseph Pilates this discipline of fitness has been particularly helpful to dancers and athletes over the years. The major liability is the high cost of its sophisticated equipment.

 Joseph Pilates in his studio in New York City, circa 1920

Joseph Pilates in his studio in New York City, circa 1920

Summary of Observations As To How To Maintain A Healthy Spine

Be A Non-Smoker
Daily Aerobic Exercise
Daily Physiologic Spinal Distraction
Avoiding Excessive Spine Loading
Daily Core Strengthening Exercise
Daily Extension Exercises
Maintaining Good Nutrition
Maintaining a Healthy Weight

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