Degenerative Disc disease (DDD) is a long-term condition that develops over many years, it is characterised by a reduction in disc height and a reactive change of the joint line. As seen in the picture below. To be clear here, everybody will have degenerative changes at some point in their lives. Recent evidence is showing that from as early as 21 people can have what would be termed degenerative changes on X-ray or MRI (now just because this is “normal” does not make it optimal but that’s a post for a later date) without any pain what so ever. Pain from degenerative changes is only termed DDD when it starts to cause pain.
Although degeneration can be present from a young age, 90% of those with DDD are 65+ this is due a lifetime of mechanical “wear and tear” on the discs and joints but also from around 50 years of age there are collagen changes (the substance that makes up your connective tissues) that result in the tensile strength of the collagen diminishing. Females tend to suffer more than men likely due to hormonal differences, but their may also be a genetic component.
The symptoms of Degenerative Disc Disease are: -
- Pain in the lumbar or buttock region, sometimes referring down towards the knee
- Pain often comes and goes and can range from a nagging ache to sharp and severe.
- Pain can last for days to months
- Aggravated by sitting for long periods
- Relieved with general movement especially walking
- Bending is often a problem and can aggravate symptoms
- Lying down can also relieve pain
As the saying goes an ounce of prevention is worth a pound of cure, therefore trying to catch it early before it becomes an issue is the ideal situation, typical early onset symptoms include morning stiffness, gradual ache in low back and looking at family history, does your parents and/or grandparents have any back problems?
From an osteopathic or physiotherapy perspective working on the strength of muscles and postural alignment is the first place to start. Suenimeire et al found older adults with greater abdominal strength had significant improvement pain intensity and quality of life scores it has also been my experience that back pain patients almost always have a weakness in one of the abdominal or core musculature. These results are unsurprising as the stronger your abdominals and core is the less stress there is on the spine. There are other factors that also come into play here, such as your diet, lifestyle, occupation and sleep quality to name a few. So, while there is likely to be a bio-mechanical component to your pain these other factors can also play a huge part in your bodies ability to heal itself and resist degeneration.
For example, sleep quality is often completely overlooked, but if you’re not getting enough sleep and not getting to sleep at the right time you are missing the vital time your body needs to repair itself. To keep things simple here in an ideal world, try and get to sleep when the sun goes down and get up as the rises, this will also aid in maintaining healthy hormonal patterns throughout the day, improving energy levels. I plan on doing a blog post that will go into more depth into nutrition and lifestyle factors at a later date.
So, what can you do if you’re in pain now or are experiencing a flair up? Well, the first thing to do is try and move as much as possible. Simply going for a walk and can help mobilise and massage the small joints in your spine which will help with general pain relief.
If your pain hasn’t eased off after a week or so, it maybe time to seek professional help either a Physiotherapist or Osteopath who can take a detailed assessment and manually mobilise your joints and tissues and give you specific exercises to aid your rehabilitation journey.
Hope this helps
Andrew Graves, Back Pain Specialist.
Andrew is a registered osteopath with the General Osteopathic Council and has over 10 years experience working in the health and fitness industry helping a wide range of people recover from injury and pain. To book a consultation call or text 07500059064 or email firstname.lastname@example.org
Andy has been involved in the health & fitness industry for over 10 years, specialising in corrective exercise, injury prevention and rehabilitation of low back, neck and shoulder pain. He also has an interest in the use of Osteopathy for the management of headaches.