A common cause of low back pain is the degeneration of a disc in the lumbar spine. This condition is called degenerative disc disease (DDD). Though “disease” is a frightening word, DDD occurs as a natural part of aging. Spine-Health.com reports that at least 30% of people between 30 and 50 experience some level of disc degeneration, though it is not always painful. The lower back is most susceptible to early signs of DDD since it undergoes the most wear and tear. The lumbar spine takes the brunt of the upper body’s weight and absorbs the most shock.
Spinal discs are composed of a tough exterior and a gel-filled center. The gel consists of inflammatory proteins. As the exterior of the ring wears down, it creates two problems: 1) worn discs cannot effectively act as shock absorbers for the spine, resulting in motion instability and 2) the inflammatory proteins begin to leak out of the disc, irritation nerves along the spine. Both of these situations create pain.
To effectively treat pain due to DDD, then, it is necessary to address both the inflammation component and the instability component of the disease.
Behavioral changes that should be made to manage DDD include exercise and ergonomic mindfulness. Strong muscles are needed in and around the back to take weight off of worn discs. A technique called dynamic lumbar stabilization can be employed with the help of a physical therapist; this technique involves training your back muscles to hold the spine in its most comfortable position both when resting and moving.
Aerobic exercises are considered helpful to those with DDD, since keeping the heart rate up will allow oxygen and nutrients to be delivered to the painful area via increased blood flow. Low-impact exercises are best for those with DDD, such as water aerobics and walking. These methods do not jar the spine.
Ergonomics is an important component of back health; it focuses on adjusting your environment to the needs of your body. Posture that conserves the natural curvature of the spine and does not place strain on the muscles around it can be maintained through the help of ergonomic furniture, such as chairs, adjustable desks and footrests. Workstations should be set up in a way that does not encourage extensive reaching or lifting while twisting.
Passive treatments such as massage, chiropractic care and medications can supplement your behavioral changes to achieve relief from pain. Massage therapy and medications work to fight inflammation around a degenerated disc. A good massage will push out inflammatory materials and allow increased blood flow to the area. It also relieves muscle tension. Medications, such as NSAIDS, fight inflammation internally. These should not be relied on for prolonged use, however.
Chiropractors work to restore range of motion to the spine and remove pressure from nerves. DDD may come with nerve irritation, since the space between the vertebrae it separates has changed. Chiropractors can adjust any misalignment issues that may have occurred.
Surgery for DDD
If at least six months of conservative treatment have failed to relieve your pain and if that pain is debilitating, then the last resort of surgery may be considered. Two types exist for DDD; spinal fusion and artificial disc replacement. Both are complicated procedures.
Disc replacement generally entails the removal of the worn disc, resetting of the space between the relevant vertebrae and placement of an artificial disc. The main concern with this form of operation is that it is very new to the U.S. and nothing is known about how long the artificial discs last. Adverse effects the procedure could have on the back are not known, either. It is also very difficult to place an artificial disc in the proper position; you could be part of a surgeon’s “practice phase.” Always question a surgeon about his or her experience.
Given the risks of surgery, it is always best to work hard at conservative treatments and preventative measures. If you have pain due to DDD, make time for exercise and, if available, professional assistance. If you are considering surgery, make sure you are able to make an informed decision.
For more information on DDD and surgery, see Spine-Health.com.