Normally, the health of our physical body can be achieved through physical exercises (physical qigong), and the storage of our qi in the lower dan tian (human bioelectric battery) can be obtained from correct breathing and meditation When these yin and yang aspects of our body are cultivated, then health and longevity can be expected.
When we age, the first things to degenerate in our body are the muscles and tendons. Muscles reach their peak capacity by age twenty, then decline without proper exercise. When our muscles and tendons are degenerating and weakening, the body's motor capacity is going down. Consequently, the pressure between the joints of our body increases and the degeneration of the joints speeds up. This degeneration process is even greater in the spine, which supports our body's weight and activity.
The degeneration or deterioration of a part of the spine, especially the lower back, may result from a gradual wearing down of bone or soft connective tissue over time. It can also result from a reduction in the circulation of blood, which brings oxygen and other nutrients to the area. Degeneration is most likely to occur in the disc (cushion between the bones—vertebrae) or in the cartilage of the facet joints (joints between the vertebrae). In fact, both disc and joint disease are eventually present together. "Degenerative lumbar spondylosis" refers to both. Therefore, degenerative disc disease can lead to degenerative joint disease and vice versa. When both the disc and the joint become involved, the pain is difficult to separate clinically.
Disc degeneration begins in the early 20s. Though discs in babies are about 90 percent water, by age seventy fluid loss reduces the water content to 70 percent, flattening the discs. Because discs constitute 25 percent of the spine's length, as the discs become flatter and less elastic, people lose height. In fact, most of us can expect to be about a half inch to two inches shorter in old age.
In addition, when discs deteriorate, they can crack and slip outward (herniate), tear, or flatten, causing excessive movement and irritation of the cartilage at the facet joints. The nucleus pulposus changes into fibrocartilage from the second decade of life on. The loss of elasticity allows shearing forces to cross the disc unopposed. In addition, annular fibers can undergo localized myxomatous (degeneration caused by the presence of a benign tumor). This can lead to an osmotic gradient with the formation of a cyst within the annulus. This cyst can slowly enlarge and produce atraumatic disc bulging with consequent clinical signs and symptoms.
One or more discs might actually flatten, causing collapse of the vertebral column. When discs are flattened, they lose their ability to act as shock absorbers, putting greater stress on supporting ligaments, causing back pain. Pain can also result from the narrowing of the spinal canal (stenosis), which results in increased pressure on the nerves that branch out from the spinal cord.
Spinal Wear and Tear
In addition, as we age, various degrees of wear and tear on the spine may cause inflammation. This is commonly referred to as degenerative arthritis or spondylitis. If the degeneration is mild, no symptoms may appear. However, arthritis can destroy cartilage in the spine and cause bone overgrowth (spurs).
Another degenerative disease frequently affecting the back and causing back pain is osteoporosis. Osteoporosis is a condition in which bones become porous and susceptible to crushing or fracture. Though both men and women lose bone density after age thirty-five, the disease appears most often in women past menopause.
Spinal joints are also affected by various forms of arthritis. One type that most of us will experience if we live long enough is degenerative joint disease, or osteoarthritis. The cartilage that cushions joints gradually breaks down, resulting in back pain and stiffness, especially in the morning. Osteoarthritis may appear as early as the twenties and thirties, though without symptoms, and nearly everybody has it by age seventy.
In many cases of arthritis, pain that begins in the morning upon arising from sleep improves throughout the day with activity. Because the nerves that branch out from the spinal cord conduct impulses to all parts of the body, pressure on one or more nerves may cause pain that radiates into the hip and down the leg (sciatica) or tingling or numbness of an arm or leg. In more serious cases, there may be interference with bowel and bladder function, or, if nerves in the neck are compressed, difficulty speaking or respiratory problems.
Spinal osteophytosis, a normal function of aging, is produced by traction of the spinal ligaments on the periosteum of the vertebral bodies. It is not related to degenerative lumbar spondylosis.
In spinal osteophytosis, the disc spaces are well preserved. The condition appears to be worse on the right side, probably due to inhibition of spur formation by the pulsating aorta along the left side. Approximately 90 percent of men older than fifty have some of these traction osteophytes in the lumbar area.
When spinal osteophytosis is excessive, it may represent a "forme fruste"—an atypical or incomplete form—of diffuse idiopathic skeletal hyperostosis (DISH), a predisposition toward ossification of the ligaments and tendons throughout the patient's body. DISH begins with ossification of the anterior longitudinal ligament of the dorsal spine, and then spreads to the cervical and lumbar spine. It is associated with widespread osteoarthritis as well as spurs where the ligaments and tendons attach to bone (enthesopathy). DISH is typically found in middle-aged men, 80 percent of whom appear to have adult-onset diabetes. It is also seen as a side effect of isotretinoin (Accutane) and excessive fluorine intake.
Degenerative spondylolisthesis is a condition where there is a forward slippage of one vertebra over another, usually of a lumbar vertebra on the vertebra below it, or upon the sacrum. This condition is also called spondyloptosis. It is caused by subluxation, or slight misalignment, of degenerated joints. Spondylolisthesis almost always occurs at L4-5.
From the above summary, we can see that the most common symptom of physical degeneration of the spine is an aching back. It is believed that failure to develop adequate bone mass during youth, lack of exercise, and a diet low in calcium and other nutrients (i.e., poor physical fitness) may be contributing factors.
The above is an excerpt from The Pain Free Back: 54 Simple Qigong Movements for Healing and Prevention by Dr. Yang, Jwing-Ming.