Degenerative Disc Disease

The process of degeneration of the intervertebral discs causes many problems in the spine. Throughout the day, many of our up right movements test the spine's ability to support our body weight. Minor injuries to the disc may occur and not cause pain at the time of the injury but repeated daily stresses and minor injuries can add up over time and begin to affect the discs in your spine. The disc eventually begins to deteriorate from the wear and tear.

Most of our everyday movements are transferred to the discs. The intervertebral discs are designed to absorb pressure and keep the spine flexible by acting as cushions (similar to shock absorbers to allow for fluid, pain-free movement.

Causes:
A healthy disc has a great deal of water in the nucleus pulposus (the center portion of the disc). The water content gives the nucleus a spongy quality and allows it to absorb spinal stress. Excessive pressure or injuries to the disc can cause the injury to the annulus (the outer ring of tough ligament material) that holds the vertebrae together. The annulus is generally the first portion of the disc to be injured. Small tears show up in the ligament material of the annulus. These tears heal by scar tissue, which is not as strong as normal ligament tissue. The annulus becomes weaker over time as more scar tissue forms. This can lead to damage of the nucleus pulposus. It begins to lose its water content and dry up. allowing the two vertebrae above and below to move closer to one another. This results in a narrowing of the disc space between the two vertebrae.

Bone spurs, sometimes called osteophytes, may begin to form around the disc spac. This is thought to be due to the body's response to try to stop the excess motion at the spinal segment. The bone spurs can become a problem if they start to grow into the spinal canal and press into the spinal cord and spinal nerves. This condition is called spinal stenosis.

Signs & Symptoms
The most common early symptom of degenerative disc disease is usually pain in the lower back that spreads to the buttocks and upper thighs. It may be described as a constant burning pain or may result in numbness and tingling down the legs and into the feet, depending on the severity.

Often there is a shifting of weight during walking (leaning to one side) in an attempt to alleviate the pressure felt in the lower back.

Treatment:
Treatment will depend on the seriousness of the condition. Some problems need immediate attention-possibly even surgery. The vast majority of back problems do not require surgery. Treatment may be as simple as reassuring that it is not a serious problem and doing nothing but watching and waiting. In most cases, simple therapies, such as mild pain medications and rest are effective in relieving the immediate pain.

Resting lying down with a pillow under the knees for no more than a 2 day period (otherwise back muscles may become weakened).

The physiotherapist will focus on calming pain and inflammation, improving mobility and strength.
Regular exercise is the most basic way to combat back problems. Exercises focus on improving strength and coordination of the low back and abdominal muscles.