It is estimated that as many as 75% of us will have some form of back or neck pain at some point in our lifetime. The good news is that most of us will recover without the need for surgery—and conservative care such as physical therapy usually gets better results than surgery. Degenerative disc disease (DDD) is one cause of back and neck pain. Usually the result of the natural aging process, degenerative disc disease (DDD) is a type of osteoarthritis of the spine.
What is degenerative disc disease?
Your spine is made up of 33 vertebrae that are stacked on top of one another. Between each of these vertebrae is a rubbery piece of cartilage called an “intervertebral disc.” Imagine the disc as a tire, with gelatin filling the hole in the tire. The tire is called the “annulus,” and the gelatin is called the “nucleus.” When we’re young—under 30 years of age—the disc is made mostly of gelatin. As we age, and sometimes with injury or excessive wear and tear, we start to lose some of that gelatin, and the volume of the disc decreases, resulting in less space between the vertebrae. The disc becomes flatter and less flexible, leaving less space between each set of vertebrae. Sometimes bone spurs form in response to this degeneration of the disc, making the spine stiff. When the rough surfaces of the vertebral joints rub together, pain and inflammation may result. Nerves may become irritated or compressed.
Disc degeneration might occur throughout several regions of the spine, or it might be limited to one disc. When it’s part of the natural aging process, the degeneration does not always lead to pain. For some people, however, it can cause a great deal of pain and disability.
How can a physical therapist help?
Your physical therapist’s overall purpose is to help you continue to participate in your daily activities and life roles. The therapist will design a treatment program based on both the findings of the evaluation and your personal goals. The treatment program likely will be a combination of exercises.
Relieve Pain and Increase Movement
Your therapist will design:
- Stretching and flexibility exercises to improve mobility in the joints and muscles of your spine and your extremities—improving motion in a joint is often the key to pain relief
- Strengthening exercises—strong trunk muscles provide support for your spinal joints, and strong arm and leg muscles help take some of the workload off your spinal joints
- Aerobic exercise, which has been shown to be helpful in relieving pain, promoting a healthy body weight, and improving overall strength and mobility—all important factors in managing DDD
This might sound like a lot of exercise, but don’t worry: research shows that the more exercise you can handle, the quicker you’ll get rid of your pain and other symptoms.
Your physical therapist also might decide to use a combination of treatments:
- Manual therapy to improve the mobility of stiff joints and tight muscles that may be contributing to your symptoms
- Posture and movement education to show you how to make small changes in how you sit, stand, bend, and lift—even in how you sleep—to help relieve your pain and help you manage your condition on your own
- Special pain treatments—such as ice, electrical stimulation, or a short course of traction—for pain that is severe and not relieved by exercise or manual therapy
Once your pain is gone, it will be important for you to continue your new posture and movement habits to keep your back healthy.
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