Degenerative disc disease
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Degeneration of the intervertebral disc, which is often called "degenerative disc disease" (DDD) of the spine, is a common disorder of the lower spine. Disc degeneration can lead to disorders such as spinal stenosis (narrowing of the spinal canal that houses the spinal cord and nerve roots; can be lumbar or cervical), spondylolisthesis (forward slippage of the disc and vertebra), and retrolisthesis (backward slippage of the disc and vertebra). DDD is in fact not a disease but, rather, a degenerative condition that can be painful and can greatly affect the victim's quality of life. Disc degeneration is a normal part of aging and is generally not a problem by itself. However, for certain individuals, a degenerated disc can cause pain, such as when bone spurs grow adjacent to the discs and pinch or put pressure on the nearby nerve roots or spinal canal.
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[edit] Causes
Aging is the most common cause of disc degeneration. As the body ages, the discs in the spine dehydrate, or dry out, and lose their ability to act as shock absorbers between the vertebrae. The bones and ligaments that make up the spine also become less flexible and thicken. Unlike muscles, there is minimal blood supply to the discs so they lack the ability to heal or repair themselves. Repetitive stress injury (RSI) and/or several injuries over time that involve the same disc can also increase the likelihood of disc degeneration as may a poor body mass index. However, an active lifestyle that combines regular light exercise and a good diet can help to repair or prolong the life of the disc.
[edit] Symptoms
With symptomatic degenerative disc disease, chronic low back pain sometimes radiates to the hips, or there is an aching pain in the buttocks or thighs while walking; sporadic tingling or weakness through the knees may also be evident. Similar pain may be felt or may increase while sitting, bending, lifting, and twisting. While the degeneration of the disc will likely progress as a natural part of the aging process, symptoms such as low back pain often decrease over time.
[edit] Understanding disc pain
It is not clear why some degenerative discs are painful and some are not. After an injury, some discs become painful because of inflammation. Some people have nerve endings that penetrate more deeply into the annulus fibrosus, or outer layer of the disc, than others, making the disc more susceptible to becoming a source of pain. Pain that radiates down the leg, known as sciatica or lumbago, is the result of the nerve root encountering the inner disc material, or the nucleus pulposus, an inflammatory substance that also puts pressure on the nerve. These conditions can cause symptoms such as severe leg pain, difficulty standing and walking, and weakness or numbness in the legs. Degenerative disc disease can lead to a chronic debilitating condition and can have a serious negative impact on a person's quality of life. When pain from degenerative disc disease is severe, traditional nonoperative treatment is often ineffective.
[edit] Treatment options
Often, degenerative disc disease can be successfully treated without surgery. Physical therapy, osteopathy, anti-inflammatory medications such as nonsteroidal anti-inflammatory drugs, chiropractic treatments, or spinal injections often provide adequate relief of these troubling symptoms. Glucosamine and Vitamin C supplements can also help with the repair of discs.
Surgery may be recommended if the conservative treatment options do not provide relief within 2 to 3 months. If leg or back pain limits normal activity, if there is weakness or numbness in the legs, if it is difficult to walk or stand, or if medication or physical therapy are ineffective, surgery may be necessary, most often spinal fusion. Artificial disc replacement may be an option in treating DDD under certain conditions.
Osteopathic treatment treats various aspects of the degenerative process returning the back to optimal functioning. The treatment involves gentle stretches and manipulation to the facet joints of the spine. Relaxation techniques to the resultant muscle spasm. The osteopath will not just treat the degenerated area but treat the whole spine.
