Degenerative Disc Disease
A 49 year-old schoolteacher came to Healthwise complaining of low backache for the past 16 years. He recalls falling off a small ladder onto his buttocks when he was 15 years of age. At that time he had significant back pain. Up until his early thirties he did not experience any back discomfort, although once over 35 years he began to experience periodic mild discomfort that became chronic over time. He currently complains of pain every day, which begins every morning as a stiff aching. After a hot shower and simple exercises, symptoms improve within 30 minutes.
What is this patient's diagnosis?
His practitioner diagnosed Degenerative Disc Disease.
The clinical examination and history taken is a classic presentation for degenerative disc disease. Initially precipitated by the traumatic incident in his youth, this set the stage for disc degeneration that caused the progressive symptoms.
What is the most likely cause of this patient's symptom's?
At some point in the patient's life the amount of motion at the lower spine caused more wear than could be tolerated leading to wear and tear of the muscles, bones and joints of the lower back. As this process continues structural degeneration may eventually manifest as disc herniation, spinal instability, and as time goes on, moves back towards the joints of the back causing arthritis. The diagram opposite shows the degeneration of the spine.
What can help manage degenerative disc disease?
Treatment by your practitioner is aimed at improving mobility, and function of your spine using hands on massage, mobilisation, acupuncture, manipulation and ultrasound treatments.
Exercises are particularly important for patients with poor posture, a protuberant abdomen, and who are overweight.
Stretching - correction of inflexibility of the trunk muscles and the lower legs is imperative toward optimal maintenance of the low back.
Standing - to avoid symptoms when standing for long periods, patients may find relief by raising one foot on a step or stool, as this reduces pressure on the back.
Walking more briskly is often more comfortable than walking slowly.
Bending the back forwards with straight legs causes a pull on the hamstrings and strain on the lower back. Patients with back pain can avoid this by bending at the hips and knees.
Sleeping - choose a mattress that maintains the spinal curves in as natural position as possible. A firm (not hard) mattress with a non-sagging base is recommended.
Weight reduction - obesity aggravates symptoms of back pain, regardless of its cause. Reduction of body mass is essential if overweight.
Anti-inflammatories - a natural alternative shown to be highly effective is glucosamine. Speak to your practitioner about this product.