Degenerative Disc Disease
Firstly a quick recap of the structure and properties of discs. A disc is an incredible shock absorber that transmits and absorbs forces imparted on the spine. They are amazingly resilient and absorb phenomenal load and stress throughout a life time.
An easy way to picture the internal workings of a disc is by picturing a sachet of tomato sauce which has a soft and mobile inside.
Applying pressure at one end of the sachet displaces the soft content to the other and generates pressure at the far end of the sachet. Discs behave in a similar way as we bend and twist our backs in various directions.
The soft content displaces around and helps to distribute and absorb force. Discs essentially consist of two layers, a strong firm outer shell and a soft centre. The outer layer being arranged a bit like onion rings constraining the viscous soft centre. As we age the soft centre loses water content and hence viscosity resulting in a gradual attenuation of its shock absorbing properties which results in a gradual loss of disc height. Overtime the outer layer of a disc can gradually develop fissures and points of weakness due to the accumulative effect of micro forces over time. So since the outer layer contains nerve endings, irritation can result in pain. What's important to stress that degenerative disc disease is not actually a disease but a time related mechanical change. In addition it's quite normal to have degenerative changes but no pain at all.
So what determines who gets symptoms?
Some people may develop symptoms in their 30's; we don't fully understand all the reasons and risk factors however we do know that familial tendency, previous injury, occupation and age play a part.
We all come in different shapes and sizes and we often see a normal but considerable variation in spinal shapes. Some have a flat and soft curve whilst others have an accentuated shape. The greater variation away from the optimal S shape the greater are the
stresses on the spinal joints, ligaments, disc etc. These in turn can lead to the development of early degenerative changes.
Any significant spinal injury such as a high speed crash, a fall from height and direct impact injuries have the potential to disrupt the spinal structures and lead to the early onset of early degenerative disc disease. Again it has to be stressed that it's probably a combination of factors that determines why some individual actually develop symptoms.
What we know is that the shock absorbing properties of discs are optimal in the teens and 20's and gradually change as the water content diminishes through life. This results in a reciprocal loss of disc height which may result in pain.
What we do know is that sitting places greater stresses on discs than standing and very physical occupations place greater stresses on the discs than non physical but active roles. Therefore it's not hard to picture that the accumulative micro trauma is greater in some occupations. So this effect in conjunction with a loss of disc water content and disc height over time can give rise to potential pain from degenerative disc disease.
What should I expect?
Although the degenerative process continues with time the actual pain symptoms usually do not worsen and therefore generally function is not excessively affected. Controlling pain, strengthen the core trunk muscles and preventing stiffness are the primary ways the condition is managed.
So what do we offer to help recovery?
What we will do is thoroughly examine you and provide a professional opinion as to the best way to manage your specific symptoms, provide symptomatic relief if required, help to improve your spinal mobility and core strength, provide preventative and ergonomics advice.
How we help; below is a list of common treatments and ergonomics services.
Soft Tissue Massage
Supportive Taping & Strapping
Carry out a workstation and or vehicle inspection to identify pain provoking postures.
Carry out a home inspection and advice on the interface between you and your furniture for example. whether your mattress is right for you, the suitability of your seating etc
Develop a personal conditioning programme using ergonomics principals.