Degenerative disc disease involves the intervertebral discs of the spine. Intervertebral discs sit between each vertebral bone and provide cushion, shock absorption and support. These discs are made up of a gelatinous center called the nucleus pulposus surrounded by a strong, fibrous outer layer called the annulus fibrosus. Despite its name, degenerative disc disease is not actually a disease. It simply refers to a gradual wearing of these discs with age. Most people will have some evidence of DDD by the time they are 50yo but many will never experience any significant symptoms. It is important to remember when looking at imaging like an x-ray, that evidence of a condition like DDD does not necessarily correlate with the presence of symptoms.

As discs age they become dryer, they can also tear due to injury or repetitive forces placed on the spine from sports or repetitive activities, for example. All of these factors play a role in DDD. The symptoms of DDD can mimic other causes of back and neck pain. Early on, symptoms of DDD are often isolated to the neck or back. If the disc degenerates enough, though, space between the vertebrae decreases which can result in bones rubbing together or increased compression on nearby nerve fibers. Some symptoms commonly associated with DDD are:

• Pain is primarily found in the neck and lower back
• Pain can range from mild to severe
• Pain may come and go
• Pain may be accompanied by numbness or tingling radiating into the arms and hands, buttocks or thighs
• Weakness may develop in muscles innervated by nerves near the affected disc
• Pain can feel worse when sitting, bending, twisting, lifting or carrying items
• Changes in bowel or bladder function can occur with serious nerve compression

If you decide to work with a physical therapist to help with DDD, your entire treatment plan could consist of around 8-20+ different physical therapy sessions that will each last 60-90 minutes. Once you complete your customized physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your PT sessions yet in the comfort of your own home.

HOW DO PHYSICAL THERAPISTS ADDRESS DEGENERATIVE DISC DISEASE?

The goal of physical therapy treatment for DDD is to relieve symptoms while addressing any underlying or contributing factors that may predispose you to recurrence or progression of your pain. As mentioned above, my team and I will create an individualized treatment plan based on your unique presentation and the findings of our exam, but here are some treatments commonly used to manage DDD:

Reduce pain, inflammation and irritation: While completely eliminating your symptoms may take time, making you more comfortable in the meantime is an important first step in your rehabilitation. Applying modalities like ice, heat or electrical stimulation to the affected area can often give you some relief. Soft tissue mobilization or gentle joint mobilization may also be employed by your physical therapist to reduce tissue irritation.

Improve flexibility: When a joint lacks the flexibility needed to perform a movement optimally, extra stress and strain may occur in the spine. Your back PT program may include stretching, myofascial release techniques, joint mobilization and mobility exercises to improve flexibility in the back itself but also in other areas of the body such as the ankles, hips, and shoulders.

Build up your strength: You will learn exercises to help strengthen the muscles around the back and abdomen to properly control the spine and neck and also in the shoulders, arms and legs to minimize excess strain transfer to the neck and back.

Aerobic activity: If you are worried about how participating in aerobic activity may affect your pain, physical therapists can help you begin a low impact aerobic training program like walking or swimming that can help you manage pain symptoms and also promote general health and weight-management benefits.

Optimize your movement and posture: Learning proper biomechanics and posture and enhancing the neuromuscular control of joints and muscles is an essential component of healing and preventing back and neck pain associated with DDD. Physical therapists are movement experts and through analyzing your movements, can guide you in improving how you sit, stand and move.

DON’T WAIT TO GET HELP WITH YOUR DDD SYMPTOMS

If you have neck and back pain or think you might be experiencing symptoms related to DDD, our team of therapists is ready to help you find some relief. Call to schedule an evaluation today.