Degenerative Disc Disease

Degenerative Disc Disease is a misunderstood condition, despite being one of the leading sources of back pain and neck pain. This condition is not actually a disease -- it is part of the normal aging of the spine. In this condition, the discs in the spine (the pillow-like pads between the bones) lose their cushioning. When this happens, it can cause persistent pain in the lower back, legs, neck or arms. Treatments for pain caused by degenerative disc disease can include medications and physical therapy. Sometimes back surgery is needed if the pain is severe and causes a person the inability to participate in everyday activities.

Many patients diagnosed with low back pain caused by degenerative disc disease are left wondering exactly what this diagnosis means for them. Common questions that are often on patients’ minds include:

• If I have low back pain from degenerative disc disease in my thirties, how much worse will it become with age? 

• Will the degenerative disc disease become a crippling condition? Will I end up in a wheelchair? 

• Should I restrict my activities? 

Common Symptoms of Degenerative Disc Disease: Along with MRI scan results that show disc degeneration, there are some common symptoms that are fairly consistent for people with low back pain from degenerative disc disease. The typical individual with degenerative disc disease is an active and otherwise healthy person who is in their thirties or forties. In general, the patient’s pain should not be continuous and severe. If it is, then other diagnoses must be considered. Degenerative disc disease pain is usually more related to activity and will flare up at times but then return to a low grade pain level or the pain will go away entirely.

Degenerative Disc Disease: the Natural Degenerative Process: When we are born, the disc is comprised of about 80% water, which gives it its spongy quality and allows it to function as a shock absorber. As we age, the water content decreases and the disc becomes less capable of acting as a shock absorber.

The proteins within the disc space also change composition, and most of us will develop tears into the annulus fibroses (the outer hard core of the disc).

Degenerative Disc Disease Exercises Facts: There is no denying that exercise therapy DOES HELP many patients. Exercise increases regional circulation (blood flow) and therefore combats the most common and least diagnosed form of chronic back pain treatments. Exercise becomes one of the many tools in the diagnostic process which can confirm the suspect causation and guide the patient towards a real cure. In addition, active exercise is also important for the health of the spinal discs. Movement helps exchange nutrients and fluids within the discs to keep them healthy.

Interesting Facts about Back Pain

1. Going under the knife. In only 2% of cases where people have pain, is surgery necessary. Physiotherapists, chiropractors and doctors can often sort out backaches. Surgery is sometimes necessary when back pain is relentless or the patient is experiencing nerve compression or incontinence.

2. The lowdown on pain. Most people have lower back pain. This is because the lower back bears the weight of the upper body. It also twists and bends more than the upper back.

3. Bending over backwards. The spine consists of 33 bony segments, the vertebrae. The discs lie between these. They are tough and spongy and work as shock absorbers, and give the spine flexibility - the spine can in fact bend far enough to form two-thirds of a circle.

4. Slipping up? If your pain started after a trivial movement, such as picking up a book from the floor, you could have a slipped disc or a joint problem in your spine.

5. Branching out. Nerves from the spinal cord branch out and leave the spine through spaces between the vertebrae at the levels of the discs.

6. Not tonight, dear. I have a backache. Backache is second only to headaches as the most common location of pain.

7. Sitting ducks. Many people who often have back pain, either lead inactive sedentary lives, or have inherited a genetic susceptibility to back pain.

8. They don't call them stones for nothing. Severe intermittent pain that goes down to your groin, could indicate that you have kidney stones.

9. Not such good vibrations. Vibration often causes back problems, which is why truck drivers often have backache.

10. You've got lots of company. In any two-week period of time, between 25 - 33% of all adults get some form of back pain.

11. Tilt that angle. Cyclists often experience pain, which can often be rectified by adjusting the angle of the bicycle seat.

12. Down on all fours. Back pain became a part of life when humans started walking upright, rather than on all fours. The vertebrae were never really designed to deal with walking upright.

13. Right down the middle. Pain in the middle of your back, which becomes worse after eating, could indicate a stomach ulcer.

14. The centre of it all. The spine, for all intents and purposes, is like central scaffolding for the rest of the body. The skull, the ribs, the pelvis and the limbs are attached to it.

15. So why does this happen? In about 85% of acute pain cases, the exact cause cannot be identified.

16. Neighbouring organs problematic? Pain can also be the result of abscesses, blood clots or tumours in other organs near the spine.

17. Try this for strength. The spine is so strong that it can withstand the pressure of hundreds of kilograms.

18. All on its own. Eighty to 90% of back pain treatments resolve itself within a month to six weeks.

19. Help or hindrance? Prolonged use of back braces and supports can actually weaken the muscles in your back, thereby contributing to the problem.

20. Red alert. When certain conditions, are present together with back pain, such as loss of bowel or bladder control, numbness, pins and needles, rapid weight loss, a history of cancer, or drug use, pain unrelated to movement, the patient should receive immediate medical attention.

Back Pain Treatments

Pain in the lower back or low back pain is a common concern, affecting up to 90% of people at some point in their lifetime. Up to 50% will have more than one episode. Low back pain is not a specific disease. Rather, it is a symptom that may occur from a variety of different processes. In up to 85% of people with low back pain, despite a thorough medical examination, no specific cause of the pain can be identified.

Back pain can have many underlying reasons, but often no specific cause will be found and the pain will stop. We try to touch on many of the causes of back pain and proper evaluation and diagnosis. Please make sure to discuss your individual symptoms as well as the suggested treatments with us to determine the appropriate diagnostic and treatment plan for your circumstances.

• Low back pain is second only to the common cold as a cause of lost days at work. It is also one of the most common reasons to visit a doctor's office or a hospital's emergency department.
• Doctors usually refer to back pain as acute if it has been present for less than a month and chronic if it lasts for a longer period of time.
Causes Back pain is a symptom. Common causes of back pain involve disease or injury to the muscles, bones, and/or nerves of the spine
• (a nerve is directly irritated), often due to a herniation (or bulging) of the disc between the lower back bones.
• Herniated discs are produced as the spinal discs degenerate or grow thinner. The jellylike central portion of the disc bulges out of the central cavity and pushes against a nerve root.
• Spondylosis occurs as intervertebral discs lose moisture and volume with age, which decreases the disc height.
• spinal-canal narrowing (spinal stenosis
• Osteoporosis , degeneration of the bones 
• Poor postures while sitting, Standing etc
• Work related repeated 

Symptoms

Pain in the lumbosacral area (lower part of the back) is the primary symptom of low back pain.

• The pain may radiate down the front, side, or back of your leg, or it may be confined to the low back.
• The pain may become worse with activity.
• Occasionally, the pain may be worse at night or with prolonged sitting such as on a long car trip.
• You may have numbness or weakness in the part of the leg that receives its nerve supply from a compressed nerve.

*This can cause an inability to plantar flex the foot. This means you would be unable to stand on your toes or bring your foot downward. This occurs when the first sacral nerve is compressed or injured.
* Another example would be the inability to raise your big toe upward. This results when the fifth lumbar nerve is compromised.

Tips for preventing back strain

• Don't lift by bending over. Lift an object by bending your knees and squatting to pick up the object. Keep your back straight and hold the object close to your body. Avoid twisting your body while lifting.
• Push rather than pull when you must move heavy objects.
• If you must sit at your desk or at the wheel of a car or truck for long hours, break up the time with stops to stretch.
• Wear flat shoes or shoes with low heels (1 inch or lower).
• Exercise regularly. An inactive lifestyle contributes to low back pain.
• Sit in chairs with straight backs or low-back support. Keep your knees a little higher than your hips. Adjust the seat or use a low stool to prop your feet on. Turn by moving your whole body rather than by twisting at your waist. 
• When driving, sit straight and move the seat forward. This helps you not lean forward to reach the controls. You may want to put a small pillow or rolled towel behind your lower back if you must drive or sit for a long time.
• The best way to sleep is on your side with your knees bent. You may put a pillow under your head to support your neck. You may also put a pillow between your knees. 
• If you sleep on your back, put pillows under your knees and a small pillow under your lower back. Don't sleep on your stomach unless you put a pillow under your hips. 
• Use a firm mattress. Use a firm mattresses for back pain in India, if your mattress is too soft, use a board of 1/2-inch plywood under the mattress to add support.  .Some specific exercises can help your back. One is to gently stretch your back muscles. Lie on your back with your knees bent and slowly raise your left knee to your chest. Press your lower back against the floor. Hold for 5 seconds. Relax and repeat the exercise with your right knee. Do 10 of these exercises for each leg, switching legs.

While some exercises are specific for your back, it's also important to stay active in general. Swimming and walking are good exercises to improve your overall fitness.
Home Remedies

If you're not experiencing any of the above symptoms, there are several things you can do at home to help soothe your sore back:

Bed Rest Isn't Best. Going about your normal, everyday activities—but perhaps at a slower pace, and definitely avoiding what may have caused your pain in the first place—is a good way to start the healing process. A little "couch time" won't hurt, but light activity speeds recovery, so avoiding lying down for long periods of time. 

Hot And Cold. Heat and cold, in the form of a hot bath or hot and cold compresses, can help relieve sore and inflamed muscles and tissue. Remember—cold comes first! Wrap an ice pack (or a bag of frozen vegetables) in a thin cloth to avoid frostbite, and apply to the affected area for up to 20 minutes several times a day. Ice slows inflammation and swelling, numbs tissue and slows nerve impulses to the injured area.

Once the acute pain and muscle spasms subside (about 48 hours after the first onset of pain is recommended), you can apply heat—to loosen muscle tightness - by taking a warm bath or using a heating pad, heat pack or heat lamp. 

Pain Relief In A Pill. Non-steroidal anti-inflammatory can ease pain, swelling and stiffness. 

Support Yourself. If you must sit or stand for long periods of time, consider using a brace or corset. Worn properly, they can relieve pain and provide warmth, comfort and support. But, don't rely on this type of external support too long—allowing it to perform your muscles' job will eventually weaken them, making re-injury easier. 

If your back pain hasn't improved noticeably after 72 hours of self-care, contact your health care provider.
Modalities 

These methods are called passive therapies, or modalities. They are done to the patient and not by the patient. There are other modalities that are commonly used. Heat and ice packs are a well-known form of passive physiotherapy. They can be used separately, or they can be used alternately by a person who is suffering from acute lower back pain.