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Healthy Monday: Spinal degeneration happens to everyone

Some, unlike Lt. Gov. Casey Cagle, don't suffer from pain

POSTED: April 19, 2009 10:50 p.m.

Lt. Gov. Casey Cagle announced last week that he’s been diagnosed with a degenerative spinal condition and will withdraw from the 2010 governor’s race so that he can have surgery.

While his condition sounds exotic, the condition is more common than you may think.

"If you have a birthday, then you are going to have degenerative changes to your spine. It happens to everyone, but it just depends on to what degree. Some people have lots of changes, but are asymptomatic, and others have just a few changes but experience a lot of pain," said Dr. Holmes Marchman, a physical medicine and rehabilitation specialist with the Longstreet Clinic in Gainesville.

"As we age, things tend to wear out. The spine goes through degenerative or arthritic changes. As we get older, the openings in our spine tend to get smaller due to natural wear and tear, causing bony spurs to grow. Depending on where the bony spurs grow, they can push on a nerve, which would cause a patient to experience some sort of pain."

Marchman says that there is some research supporting the idea that some individuals have a genetic disposition that causes the spine to degenerate faster than others. Spinal degeneration can also be increased by through occupational hazards like lots of heavy lifting and playing impact sports.

Pain associated with spinal degeneration can frequently be treated with physical therapy, Marchman says.

"If you have a lot of irritation of the nerves, it can cause muscles to spasm. Physical therapy helps to relieve the spasms," he said.

Steroid injections can also be used to treat the pain associated with spinal degeneration, also known commonly as spinal stenosis.

"When nerves become compressed (in a narrowed spine), they become inflamed. The steroid injections help to decrease the inflammation," Marchman said.

"The problem with the injections is that the bony spurs and other pain causing
arthritic changes to the spine are still there, so the pain will continue."

Surgery, Marchman says, is a last resort. Although the location of the spinal degeneration will dictate the type of surgery that will be required, the process can involve removing portions of the spine and replacing them with artificial fill-ins or fusing several discs in the spine together.

"It’s very hard to predict how individuals will be affected by spinal stenosis," Marchman said.

"If problems persist and are left untreated, a patient runs the risk of more serious spinal injuries, because after all it is a bony spur pushing into the spine," Marchman said.

"Going to surgery is a last-ditch effort; most surgeons usually won’t risk the surgery if the risks outweigh the benefits. But a lot of times even after surgery a patient may still have problems."

Spinal stenosis can cause patients to feel pain and numbness in their arms, backs and legs. If left untreated, spinal stenosis can also lead to the loss of bladder and bowel functions.



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