Hydration and Back Health
One alternative for relief from pain in the back that is very often overlooked is simply keeping the body properly hydrated, i.e., a necessary and sufficient intake of water. Every organ, tissue, and cell must have an adequate amount of water so that they can function properly. This is particularly true for the vertebral discs and muscles that support the spinal column.
Q: What role does water have in basic human physiology?
A: Water is the primary component of the heart and other muscles (75%), brain (85%), blood (80%), kidney and liver (83%), and lungs (90%). In sum, water accounts for approximately 75% of our body weight. Without water, our body could not survive.
Q: What does water have to do with back pain?
A: There is a strong, positive correlation between back pain and the lack of adequate water intake (dehydration). This is particularly true for the intervertebral discs. The disc serves as a hydraulic shock absorber and experiences downward pressure when we stand or sit. In order for the disc to function properly it must have an adequate water supply. The water in the disc is retained by specialized molecules that are capable of holding more than 500 times their weight in water. This unique capacity accounts for the disc’s hydrostatic pressure when properly hydrated. A disc that becomes dehydrated loses hydrostatic pressure and cannot support the load placed upon it. When this happens the disc becomes inflamed (swells), causing soreness and pain. It can also become herniated and/or susceptible to disc disease. Simply consuming the proper amount of water on a daily basis can prevent back pain due to disc hydration.
Q: What proof is there that discs lose water?
A: Perhaps the most obvious evidence that this happens is referred to as the “Diurnal Change.” This means that our height is greater in the morning than at night by as much as a ¼ to ½ inch. The change is attributed to the fact that gravitational force and various load factors on the spine during the day cause the water content of vertebral discs to diminish. During the sleep cycle the water content of the disc is replenished, assuming adequate water is available. Although some attribute the change in spine length to changes in disc hydration and changes in spine curvature, a recent study found the change is solely attributable to changes in non-degenerated disc height. They also found that 40% of the diurnal change occurs in the lumbar spine. (see John R. Ledsome MD, et.al., “Diurnal Changes in Lumbar Intervertebral Distance, Measured using Ultrasound” at www.johnledsome.com)
Q: What is the proper amount of water intake needed to maintain back health?
A: For years we have been told that we “should” drink 64 ounces of water (8/8 oz. glasses/day). That may well be the correct amount, however, there is no scientific evidence to support that level of intake. The amount of water we need will be a function of the state of your health, level of physical activity, ambient temperature, etc. At a minimum we should take in enough water to replace the amount of water lost due to urination, bowel movements, breathing, perspiration, etc. Of course this amount is highly subjective due to an individual’s physical activity, body weight, age, diet and climate. It should also be noted that we take in about 25% of our water from the foods we eat, e.g., fruits, vegetables, meat, etc.
Q: Does coffee, tea and/or soft drinks and alcohol count towards the needed water intake?
A: They do, but drinking eight cups of coffee a day is not the equivalent of drinking eight cups of water. The reason for this is coffee, tea and drinks other than water are diuretics: they increase the production of urine. Fruit drinks are often overloaded with sugar and power drinks are loaded with caffeine and carbohydrates. It should be noted that consuming multiple cans or bottles of soda pop per day is now thought to be related to various pathologies. One of the most obvious is the development of oral disease, particularly in children and adolescents. Awareness of this phenomenon has caused many school districts to ban soda pop dispensers in their schools.
Q: How will I know if I am dehydrated?
A: Unfortunately, there is a high probability that you already are. This is because various experts estimate that as many as 75% of all Americans are chronically dehydrated. Specific indicators include (but are not limited to) excessive thirst, day time fatigue, dry mouth, infrequent urination, changes in the color of urine, joint pain and non-specific pain in the low back.
Q: Should I drink water even when I’m not thirsty?
A: Yes. This is particularly true as we age. Studies have shown that the perception of thirst diminishes with age. Signs of dehydration in the elderly include back pain, constipation, kidney stones, arthritis and indigestion. A good rule of thumb, irrespective of age, is that we should not wait until we are thirsty to drink water.
Q: Is there such a thing as drinking too much water
A: Yes. This is particularly the case if you have kidney problems or your doctor has you taking prescription diuretics. To be on the safe side, consult your doctor for a recommended amount of water and other fluids you should drink.
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