Degenerative Disk Disease
It is estimated that as many as 80% of us will have some form of back or neck pain at some point in our lifetimes. The good news is that most of us will recover without the need for surgery. Conservative care, such as physical therapy for many types of back pain, provides similar results to those obtained from surgery. Degenerative disk disease (DDD) can be one cause of back and neck pain. However, DDD is part of the natural aging process, like getting gray hair, and in many cases is not painful at all.
What Is Degenerative Disk 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 disk." (See images: Degenerative Disk Disease - Cervical | Lumbar.) 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, 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, which could make the spine stiff. Often, this flattening and additional stiffness to the spine is not at all painful. However, in some cases, when the rough surfaces of the vertebral joints rub together, pain and inflammation may result. The nerve root, the point where a spinal nerve exits the spine and extends to other parts of the body, may become irritated or compressed.
Disk degeneration may occur throughout several regions of the spine, or it may be limited to 1 disk. 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:
Do heavy physical work
Don't get very much exercise
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. Your physical therapist will design a treatment program based on both the findings of the evaluation and your personal goals. The treatment program may include:
Stretching and flexibility exercises. Your physical therapist will teach you specific exercises to improve movement in the joints and muscles of your spine, arms, and legs. 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. Regular aerobic exercise, such as walking, swimming, or taking a low-impact aerobics class, has been shown to help relieve pain, promote a healthy body weight, and improve 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 treatment program should include:
Manual therapy. Your physical therapist will apply manual (hands-on) therapy, to improve movement in stiff joints and tight muscles that may be contributing to your symptoms.
Posture and body mechanics education. Your physical therapist may 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.
Note: Studies show that recurrence of neck and low back pain is common when a condition such as DDD is not properly treated. Regular performance of the exercises your physical therapist chooses for you is extremely important to make sure your pain does not return.
Can this Injury or Condition be Prevented?
DDD is a natural result of aging. However, you can make choices that lessen its impact on your life and slow its progression. Your physical therapist can help you develop a fitness program that takes into account your DDD. There are some exercises that are better than others for people with DDD, and your physical therapist will choose the right ones for you. For instance:
Exercising in water can often be a great way to stay physically active when other forms of exercise are painful.
Decreasing exercises with bending and twisting. If you start to notice some aching or pain after exercising, consult with a healthcare professional, such as a physical therapist, who can improve the way you move—and help reduce or eliminate your back or neck symptoms.
Weight-training exercises, though important, need to be done with proper form to avoid stress to the back and neck. Your physical therapist will work with you to ensure your weight training is safe and effective.
If you have question call us at Lakeway Aquatic Physical Therapy 512 261-0620. We can help!
Macedo LG, Maher CG, Latimer J, McAuley JH. Motor control exercise for persistent, nonspecific low back pain: a systematic review. Phys Ther. 2009;89:9–25. Free Article.
Beattie PF. Current understanding of lumbar intervertebral disc degeneration: a review with emphasis upon etiology, pathophysiology, and lumbar magnetic resonance imaging findings. J Orthop Sports Phys Ther. 2008;38:329–340. Free Article.
Chou R, Qaseem A, Snow V, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society [published correction appears in: Diagnosis and treatment of low back pain. Ann Intern Med. 2008]. Ann Intern Med. 2007;147:478–491. Free Article.
Roh JS, Teng AL, Yoo JU, et al. Degenerative disorders of the lumbar and cervical spine. Orthop Clin North Am. 2005:36:255–262. Article Summary on PubMed.
Authored by Chris Bise, PT, DPT. Reviewed by the MoveForwardPT.com editorial board.
Created: June 06, 2011 | Last Reviewed: January 08, 2018