If you rub two sticks of wood together slowly and long enough, there will be a divot where the rubbing occurred (if you rub it fast enough you’ll generate fire!) But what this goes to show, is that over time when two surfaces rub on each other there will be “wear and tear” on those surfaces. Something different happens with bone.
You see bone actually grows, gets stronger, and thrives under pressure and movement. That’s why it is so important to add resistance training and movement on a daily basis. Stressing the bones actually improves bone density, a necessary quality in health and longevity. When you rub two bones together, you’ll actually promote cellular growth, I like to think like boney overgrowth. This is not the same as the normal wear and tear of the joints (which is often referred to when cartilage wears a way like in the knee joint).
If we take a closer look at the spine, there can be a lot of motion. Bending forward/backward/side to side and rotation. The spine was actually built to stabilize and support the rest of the body. However, excessive motion can cause the “rubbing” of bones in the spine, causing boney overgrowth. You can see this in an x-ray or an MRI, and it is often labeled as degeneration, arthritis, DDD, spondylosis. But there has been research saying that these changes that occur in the spine are quite normal, a regular process in aging, and there are plenty of people who have these changes without pain.
So why can there be these “changes” with pain in some people and without pain in others? There are many factors involved and they include: biomechanics (how the body moves), tissue trauma (actual injury), psychosocial (how someone perceives the pain in relation to society), and others.
Usually joint degeneration does not happen overnight. Meaning that it would have taken thousands and thousands of cycles, or years and years of moving a certain way; enough stress to the point where the nervous system says “I’ve had enough”.
Often times the accumulation of stress is due to altered mechanics that were the cause and were caused by inefficient mechanics. What this means is that if there is too much movement at the spine, there is going to be a lot of rubbing, and that COULD cause pain and irritation.
How would this be seen in someone dealing with sciatica pain?
In foraminal stenosis, the area of which the nerve exits the spine gets smaller in size. As a result, there is a higher risk for the nerve to be pinched. This will often occur in movements like backward bending. We can address this issue with forward bending and opening up the hips to allow upright standing at the hip joint rather than the low back.
In central canal stenosis, the area surrounding the spinal cord is affected. This could be due to a herniated/bulging disc, and even in some cases we are looking at degeneration between two vertebrae. And this can cause a sliding of the tissues, and altered mechanics on how the spine bends and straightens. We address this issue with trying to find the positions and exercises that relieve pain. Interestingly enough, the solution is also related to increasing movement at the hips.
The two above examples are also showing that when there is too much movement at the spine, we need to increase stability in that area and maximize motion at the hips. We can do that through very simple things: Bracing and hinging.
Bracing allows us to stabilize the core and protects the back when moving and living heavy objects.
Hinging allows us to use the hips properly so that spinal motion is reduced. It is also an opportunity for us to generate the most amount of force, as the hamstrings and glutes are at work.
When trying to relieve sciatica, we are looking at reducing the pain (which does often include a spinal motion or two), and then building up strength and confidence to ensure that the pain does not come back.