The musculoskeletal system exhibits a significant number of changes as we age, not only do the joints change but the surrounding tissue changes as well, thus causing varying degrees of neck pain, back pain, and/or sciatic nerve pain, also known as sciatica. Two of the changes that we will focus on in this article are osteoarthritis and osteoporosis. Osteoarthritis, as the label of a condition, is somewhat misleading because inflammation is not generally related to this condition, although pain may be. Degenerative joint disease is perhaps a better label. Osteoarthritis generally affects individuals over 50 years of age. Osteoporosis is caused by an imbalance in bone absorption over bone formation and is thought to be found most frequently in postmenopausal women. In both conditions, other factors come into play and may be exhibited in other segments of the population, other demographic groups, as a result. In both osteoarthritis and osteoporosis inactivity, immobility, and a sedentary lifestyle may exacerbate the condition leading to more neck pain, back pain, and/or sciatica.
Osteoarthritis is a degenerative process affecting the joints, particularly in the elderly, and may be asymptomatic (pain-free) or may cause considerable pain, particularly in the lower back and legs (sciatica). Joint changes may include erosion of the cartilaginous surface of the joints, degenerative changes to the soft tissue in and around the joints, and ossification or calcification of the connective tissue, particularly the ligaments and the edges, both superior and inferior, of the vertebrae themselves (osteophytes or bony bridges, spurs). All of the aforementioned factors may lead to a pain complex of back pain and sciatica. While it is difficult to say just how much these changes are directly associated with aging and how much is due to trauma, accident, and/or inactivity, it is obvious, both microscopically and macroscopically (to the naked eye), that aging is a factor. During research I conducted at the Cleveland Museum of Natural History (CMNH), the American Museum of Natural History (AMNH), and the National Museum of Natural History (NMNH) The Smithsonian, it was immediately apparent that osteoarthritis is an age progressive, degenerative phenomenon. Osteoarthritis appears most frequently in the secondary curvatures of the spine, those of the cervical and lumbar regions. With each decade after the age of 30, calcification and ossification grow increasingly prevalent. It seems likely that this is an adaptive response to weakening muscles and connective tissues as we age. With decreased activity and increased age-progressive phenomena, it is likely that pain, particularly neck pain, back pain, and sciatica, will become increasingly prevalent.
Osteoporosis, as noted above, has to do with an imbalance between bone absorption and bone deposition. While generally believed to affect the long bones, the vertebrae are markedly affected by osteoporosis. A few of the factors contributing to this condition are the inability to absorb calcium through the gastrointestinal tract, diminished or loss of gonad function in postmenopausal women, inactivity, immobility, and a lack of weight-bearing stress on the skeletal system, the bones themselves. Additionally, osteoporosis may be caused by heightened levels of cortisone in the body, both exogenous (coming from outside of the body) or endogenous (being manufactured in the body). Regardless of etiology or cause, osteoporosis is increasingly evident as we age and is responsible for a large number of fractures experienced in individuals over 50 years of age. With fractures, particularly fractures of the vertebrae, neck pain, back pain, and sciatica are evident and, in fact, quite common.
Both osteoarthritis and osteoporosis are age-progressive phenomena, growing ever more prevalent with each successive decade of life. While different factors come into play, it is apparent that inactivity, immobility, and a sedentary lifestyle contribute to both of these conditions, and the associated neck pain, back pain, and sciatica. While it is true that there is a progression, it is not true that it is unavoidable or irreversible. In both instances, it seems apparent that there is an adaptive response on the part of the body to offset inactivity and immobility. The fact that osteoporosis seems more prevalent in individuals who are inactive and underweight, and osteoarthritis seems more prevalent in people inactive and immobile, this would seem to indicate that an individualized and medically supervised program of exercise would help to offset both conditions, in varying degrees. The complex factors involved in both conditions are neither inevitable nor irreversible, as noted above, and should be evaluated holistically and individually. The musculoskeletal system, and the body as a whole, is remarkably resilient and adaptive. Given the proper exercise program, an individual may, in fact, reduce his or her "skeletal age" significantly, thus alleviating or eliminating neck pain, back pain, and/or sciatica.
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