Ever wake up with your back or neck feeling stiff? Feel like you can't stand up straight right away or turn your head side to side, but it gradually loosens up as you move around? Maybe you have some pain that radiates down into the buttocks area after you have been on your feet for a while? Degenerative Disc Disease, or DDD, may be the culprit.
As the name suggests, Degenerative Disc Disease (DDD) is where the cushion-like disc between the vertebrae, or bones of the spine, begins to thin out and wear down. This in turn decreases the overall height of the spine. Have you noticed you are shorter than you used to be? This narrowing of the disc can make the small windows in which the nerve travels through smaller leading to occasional nerve pain. DDD in the lumbar spine often leads to a diffuse, achy pain in the lower back area and along the beltline as well as stiffness in the lower back after prolonged positions. Degenerative Disc Disease in the cervical spine shares similar symptoms in the lower portion of the neck.
The good news here is that “disease” is a misnomer, and Degenerative Disc Disease is a natural body process that occurs in all individuals with age. There are different levels of severity of the degenerative changes which are based on overall health, repetitive activities, types of work surfaces, and trauma that are experienced throughout our lifetime.
Other Risk Factors for Degenerative Disc Disease include those who have had trauma to the spine, professional drivers (due to high loads of vibration), and gymnasts or other repetitive athletes.
The discs of the spine are primarily water-based (approximately 80% water) when we are younger. Throughout the day, those discs naturally dehydrate, and re-hydrate overnight. As we age, the dehydration continues to occur, but often the recovery is not as complete leading to more smaller and dry discs. Since the discs act as a shock absorber for the spine, the thinning, dry discs do a poor job of supporting weight or repetitive movement over a longer period of time.
Often, Degenerative Disc Disease has no symptoms associated with the natural wear and tear on the discs; however, in more severe cases or where faulty movement patterns are present, a person can experience a diffuse, achy stiffness or pain located in the lower portion of the back or neck. This pain can be one-sided, central, or can spread across both sides like at the back from hip to hip. Occasionally, a person may also experience numbness, weakness, or pain traveling down one or both legs/arms.
Symptoms of Degenerative Disc Disease (DDD) are not always consistent. Sometimes people will report flare-ups of pain without a notable traumatic trigger; however, looking back on a previous days’ activities may point to more repetitive activity (bending to weed the garden or starting a new exercise program), dehydration, or prolonged positioning (a long car ride) which can exacerbate symptoms.
Degenerative Disc Disease (DDD) is most prevalent in individuals over the age of 40 years old, and greater disc deterioration is noted as we age. Degenerative Disc Disease and Osteoarthritis are often seen together as we age secondary to the changes seen on the joint surfaces as the disc continues to reduce in height.
Diagnosis of Degenerative Disc Disease is often found through a thorough history taken by your medical doctor or physical therapist along with a description of symptoms and a movement evaluation to determine your movement patterns. Radiographs will often confirm the suspicion of Degenerative Disc Disease with a visual reduction in disc height between one or more levels of vertebrae. An MRI or CT scan may also be used; however, these are less likely unless severe symptoms are present.
Your manual physical therapist can palpate or feel the differences between the spaces of the vertebrae along the back of your neck or back as well as determine the overall mobility at each spinal segment to help determine the level(s) of restriction. This will help with an individualized treatment program for you at your physical therapy session.
Conservative treatment for Degenerative Disc Disease (DDD) often includes medication for pain control and physical therapy. Medications like Tylenol or a Non-Steroidal Anti-inflammatory (NSAID) such as ibuprofen or prescribed NSAIDs or Gabapentin. Steroid injections into the irritated disc(s) are also an option.
Physical therapy can lend a hand in many areas in regards to Degenerative Disc Disease. Results Physiotherapists and other manual physical therapists can:
We cannot fight all the effects of aging on the spine; however, we can change some things in our lifestyles that minimizes the effects DDD can have on our lives. These things include maintaining a healthy weight, quitting smoking, utilizing good posture/ergonomics with activities, keeping core muscles strong, and staying active.
Balancing your day with movement to combat prolonged sitting can also be beneficial (i.e. using a standing desk or walking a lap around the office every 2 hours).