Degenerative Disc Disease


What is Degenerative Disc Disease (DDD)?

Many patients have been told they have DDD. At first glance this sounds quite horrible and many patients are very worried about their discs. First of all, like many of the problems in the spine, DDD doesn’t actually describe a diagnosis. It is simply a descriptive term that describes the degree of “wear and tear” in the discs of the spine.

  • It should also be noted that DDD is misnamed. It is not a disease at all but rather a description of wear and tear.
  • Recent scientific studies have demonstrated that DDD can be present in 10 year olds! What this all means is that DDD is normal, everybody has some wear and tear and just because your doctor has diagnosed you with this condition does not mean you are doomed to have continuous back problems.

DDD is not a disease, but rather a description of wear and tear.

Anatomy/Bio-mechanics of DDD

  • Our discs are shock absorbing structures in the spine located between each vertebrae. Each vertebrae has a cartilaginous end plate that provides the “roof” and “floor” of each disc.
  • Discs look something like “jelly doughnuts”. Like the infamous doughnut, our discs have a jellylike substance in the middle called the nucleus pulpous. The nucleus pulpous is encased by several layers of fibers called the annulus fibrosis.
  • Discs are primarily made out of collagen (the building blocks of ligaments, tendons and muscles) and water. The annulus (outer layer) has much more collagen and less water than the nucleus (inner portion). Your discs are designed to hold water making them flexible and increasing their shock absorption abilities. A young healthy disc contains about 90% water.
  • As we age the discs lose their ability to hold water and they become stiffer and more rigid making them more susceptible to injury.
  • As we move throughout the day, our discs experience a variety of different forces and the relationship between the nucleus and the annulus disperses and absorbs these forces.

Aging and Degeneration

  • As we age the composition of our discs change. Discs lose their ability to hold water thus becoming more stiff, non flexible, and brittle. As a result, discs lose their ability to resist compressive forces and more stress is placed on the tissue.
  • The decrease in water content also may lead to loss of disc height which in turn produces slack within surrounding ligaments. This excessive slack can then lead to increased instability which may cause more degenerative changes. However, the really good news is aging alone has not been linked to increased back pain.
  • Degeneration as referred to above is “the wear and tear” on our tissues. Structural changes occur in response to mechanical loading over several years. Structural changes may include: different kinds of tears in the discs, inwards buckling of inner annulus, increased radial bulging of outer annulus, reduced disc height, formation of bone spurs, end plate defects, and vertical bulging into adjacent end plates (Schmorls nodes).

Just because your doctor has diagnosed you with this condition does not mean you are doomed to have continuous back problems!


How can RehabAuthority Help Me?

  • The Physical Therapists at RehabAuthority have specialized training in the evaluation and treatment of disc pain. Not all physical therapy is created equal! At RehabAuthority all of our therapists are required to become certified in Mechanical Diagnosis and Treatment (MDT). MDT is currently one of the most scientifically based treatment methods in the world.
  • Therapists certified in MDT have led the charge over the past 20 years in researching disc related problems and injuries. It requires hundreds of hours of training and thousands of hours of patient care to become certified. Our therapists are the absolute leaders in spine care in their communities and we believe every patient deserves an MDT assessment to determine the cause, and develop a specific treatment plan for their specific back pain problem.

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