It’s 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 disk disease (DDD) is one cause of back and neck pain. Usually the result of the natural aging process, degenerative disk disease (DDD) is a type of osteoarthritis of the spine.
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 disk. Imagine the disk 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 disk 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 disk decreases, resulting in less space between the vertebrae. The disk becomes flatter and less flexible, leaving less space between each set of vertebrae. Sometimes bone spurs form in response to this degeneration of the disk, 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.
Disk degeneration might occur throughout several regions of the spine, or it might be limited to one disk. 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.You are more likely to develop DDD if you smoke, are overweight, do physical work or don’t get very much exercise.
You might have mild to intense neck and back pain—or no pain at all. A degenerative disk in the neck can cause pain in the arm, shoulder or neck. A degenerative disk in the low back might cause pain in the back, buttocks or legs. The pain is often made worse by sitting, bending, and reaching. It may be worse first thing in the morning and after staying in any one position for a long time. In severe cases, when DDD results in pressure on the nerves, it can lead to numbness, tingling, and even weakness in the arms or legs.
If you have muscle weakness and loss of sensation or very severe pain, special diagnostic tests, such as x-rays, or MRI’s may be needed. Physical therapists work closely with physicians and other health care providers to make certain that an accurate diagnosis is made and the appropriate treatment is provided.
Research shows that in all but the most extreme cases (usually involving muscle weakness or high levels of pain), conservative care, such as physical therapy, has better results than surgery. After the evaluation, if your therapist suspects you have DDD and there are no major medical problems, treatment can begin right away.
Darren Marchant, PT,MSPT,OCS
FIT Physical Therapy