Degenerative Disc Disease
Is it Really a Disease?
Although it is termed as a disease, degenerative disc disease is not actually a disease. It is really a natural process in which the condition of your discs gradually become worse over time. This is a very slow and steady process. With this ‘disease’, the discs slowly become smaller in size and more dense as the internal water composition decreases.
As this happens, there is less protective cushioning from the discs when force is applied on them. The discs lose their original height resulting in the neighboring vertebrae coming closer together. As the vertebrae come closer together and the discs become thinner, there is less available flexibility of the spine.
With age, you then become less able to naturally bend your spine. When you do bend your spine, the edges of the vertebrae are much more likely to touch. This is not a safe movement as there is increase risk of bone damage and the potential for osteophyte formation.
Progressive Wear with Aging
Degenerative disc disease affects everyone from about age 30 and above. When you are in your 60’s to 70’s it has significantly progressed to the point of causing chronic lower back pain. Disc thinning can be accelerated if there is a history of early lower back pain, back injuries and disc herniations.
A lifestyle which includes heavy and repetitive lifting, physically demanding sports or even chronic sitting with poor posture make these discs prone to both rupture and thinning. The most common discs of the spine to first wear are the lowest in position in your spine. This begins with the L5-S1.
The L5-S1 is normally the largest disc but it also the most used and abused. It connects your lumbar spine with your pelvis. It must bear the full weight and torque of the upper body under all conditions. Therefore it is very common to have symptoms of lower back pain which involve this disc. Its sustains the most torque and pressure anywhere up to 70% of the general load that the upper body bears.
The discs above, such as the L4-L5 and L3-L4 are generally the next in succession to wear and also in tandem with the L5-S1. These higher discs must assume the tasks and abuse that the L5-S1 is no longer able to bear.
Disc herniations are very easy to detect as immediate pain is first generated. However, disc thinning from degenerative disc disease is very slow and sometimes undetectable until the thinning has progressed too far to treat.
When the discs have thinned excessively, there is likely to be nerve root impingement on the nerves that immediately exit from the vertebral space that they occupy. Symptoms may include pain but will also include a slight numbness or tingling sensations running down the leg or thigh to the foot. Motor function may also be affected.
The facet joints are very prone to wear when disc height is compromised. As the vertebrae sit closer together so do the facet joints. They bear more of the load as the discs lose this ability. The discs within the joint capsule of the facet joints themselves also begin to wear. Facet joints have a rich nervous supply and will also show signs of pain when irritated from wear. This pain also is experienced with lower back pain.
There are many ways to correct or slow down this degenerative process. It is very unlikely that disc height will ever be restored. There is disc decompression therapy that claims to have successful results but it is not for everyone and there is no guarantee in the long run that the discs will maintain their height.
Tips for Degenerative Disc Disease
Some general tips to reduce or limit the progression of disc degeneration are:
- Hydration – Drinking sufficient water to rehydrate the discs
- Correct posture to prevent disc imbalance
- Traction therapy/exercises to help restore disc height or volume
- Exercise and stretching to relieve tension and imbalances
- Sufficient sleep to help rehydrate the discs overnight
- Avoiding or minimizing heavy lifting
- Weigh loss to reduce disc load
- Relaxation techniques to reduce tension of the lower back
It is common to have degenerative disc disease and no symptoms of lower back pain. Pain felt from lower back pain is usually from pressure on the adjacent nerves, disc rupture and facet joints inflammation. Mechanical, muscular pain is common with these conditions, so by correcting these problems you can alleviate a very large contributor to your pain.
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