Degenerative Disc Disease
July 25, 2008 · Print This Article
Degenerative disc disease is a term often used to explain the process of low back pain. Although the intervertebral disc can be is a potential source of low back pain, it’s important to remember that low back pain has many causes and we aren’t always 100% certain of exactly why people experience back pain. The purpose of this article is to describe the process of degenerative disc disease , the symptoms associated with the condition, and the treatment options available.
The spine is made up of 24 moving vertebrae stacked one on top of each other. Between 22 of these vertebrae are the intervertebral discs (there are no discs between the base of the skull and the first cervical vertebra or between the first and second cervical vertebrae). Health care practitioners will often use terms like degeneration or degenerative disc disease to describe the natural changes that take place to the disc due to aging, but in no way do these terms mean your spine is degenerating or that you’re headed for pain in the future.
As mentioned above, the intervertebral discs sit between each pair of vertebrae and are made up of 12 - 14 rings of cartilage surrounding a central jelly like substance. The discs essentially function as shock absorbers and allow for the mobility necessary during our daily movements.
As we age, the discs change by losing their ability to retain fluid causing the disc to narrow. There are many reasons for these changes including hereditary factors, daily wear and tear, muscle imbalances, major back injury and smoking. Any of these factors can affect how the spine works and accelerae the degenerative process.
Disc degeneration follows a predictable pattern. First, as previously stated, the disc begins to lose its ability to retain fluid resulting in dehydration. As a result, the disc’s ability to absorb shock is reduced resulting in tears in the outer rings of the disc. Over time, the disc will begin to collapse causing the bony vertebrae to become compressed.
Although this disc degeneration can appear to be quite severe, it does not always mean the disc is the source of pain. In fact, X-ray and MRI scans show that as high as 85% of people with severe disc degeneration don’t always feel pain.
Symptoms associated with degenerative disc disease are mainly mechanical in nature, meaning the pain comes from the parts of the spine that move during activity: the discs, ligaments, and facet joints. Typically, pain will be experienced in the central lower back and will be worsened with heavy activity or during prolonged sitting or standing. The symptoms usually last a few days and tend to recur every 3 to 18 months. Over time, the symptoms may extend into the buttocks and thighs.
The diagnosis of degenerative disc disease is made by correlating the findings of clinical examination and x-ray studies. The tell tale sign is a clearly defined narrowing of the space between the bony vertebrae and may involve more than one level. If symptoms are severe, other diagnostic procedures such as MRI or discogram may be considered.
Treatment options rarely include surgical intervention. Initial treatment usually focuses on symptom reduction so that the patient can resume normal activities as soon as possible. Physicians will usually prescribe medications that relieve pain, reduce inflammation, and calm associated muscle spasm.
To assist patients in staying active, a back brace can be very helpful. The correct back brace will provide not only external support to the back, it will also assist to “unload” the spine. Read more about the use of back braces here: Back Supports
At this stage, physical therapy is often prescribed. The goals of physical therapy treatment include symptom reduction, restoration of function, and instruction in avoiding problems in the future. here’s a video that goes into more detail on the role of physical therapy: Low Back Pain Treatment
If symptoms continue to limit a person’s ability to function and the pain persists beyond tolerable levels, more aggressive treatment is considered. These treatment considerations include epidural steroid injections and/or surgery. Here’s additional information on EPIDURAL STEROID INJECTIONS and BACK SURGERY.
If you’ve been diagnosed with degenerative disc disease and would like more specific information about your particular condition, you can request a free phone consultation by clicking here:
Written by Malton A. Schexneider, PT, MMSc
