Degenerative Disc Disease, Osteoarthritis and Spinal Stenosis

In this second part of Lumbar problems we are looking at the more serious conditions of Degenerative Disc Disease, Osteoarthritis and Spinal Stenosis.

Degenerative Disc Disease

The term Degenerative Disc Disease sounds frightening and permanent.  However, it is not as serious as it may suggest.  As we get older our spinal discs start to degenerate.  For some people this will result in chronic pain, most commonly in the lower back or neck, yet for others there will be no physical discomfort at all.  The ‘degeneration’ occurs as the disc’s water content reduces and it starts to lose its spongy quality and shrink.  This subjects it to greater pressures from the vertebrae which can lead to tears and the build up of scar tissue.

There is some debate within the medical community as to the actual cause of pain with this condition, with some suggesting that the pain is due to inflammation of the soft tissues surrounding the damaged disc, and others looking more to the vulnerability of the nerve roots in the affected area.  The pain pattern reported is often a persistent low to moderate ‘baseline’ pain with intermittent high pain flare-ups (described as the back ‘giving out’) following particular activities.  Acute episodes can last a few days to a few weeks before settling back into the low level chronic state.  The pain may stay localised in the lower back or there may be pain, numbness and/or tingling down the leg.  This makes it a very difficult condition to identify as the pain pattern can be similar to Sciatica and Piriformis Syndrome.

This seems to be a condition that is more common amongst the 30′s and 40′s age group, and whilst the disc will continue to deteriorate the pain usually does not get any worse over time.

Treatment for Degenerative Disc Disease includes physical therapy such as Dorn Method and McTimoney Chiropractic, both of which gently help realign the spine and rebalance the body to help minimise irritation to the surrounding soft tissues and nerves.

Spinal Osteoarthritis

Osteoarthritis of the spine is a more serious and permanent condition, most common in people over 50. It is associated with Degenerative Disc Disease as the stresses placed on the vertebrae of the affected area can, over time, develop into osteoarthritis.  The under-lubricated joints rub against each other leading to damage of the protective cartilage and the formation of painful bone spurs.  That is not to say however that one will automatically lead to the other.

Symptoms commonly include pain and stiffness in the affected joints which can also lead on to secondary muscular tension and restricted mobility.  Lower back pain is typically worse first thing in the morning aftar prolonged immobility overnight, easing off during the day with normal movement and then worsening again as the day goes on and the joints become inflamed.

Risk factors for osteoarthritis include ageing, being overweight and physical trauma or prolonged stressing of the joints over time. There may also be a genetic disposition.

Osteoarthritis also occurs in the facet joints of the spine, small joints that assist with flexibility and stability of the spinal column wihch can lead to Spinal Stenosis.

Spinal Stenosis

Most common in the over 50′s, Spinal Stenosis occurs when extra bone is laid down as a reaction to physical repetitive stresses on the spine. When this is laid down between two vertebrae and where the nerve exits the spinal cord, then eventually the nerve is compressed and extreme pain on extension is felt .

The name comes from the Greek word  meaning ‘choking’.  In the neck (cervical spine) pain in the arms is experienced due to the nerve compression.  In the lower back this can lead to sciatica and leg pain, which worsens when walking.  The symptoms may fluctuate in severity, easing when at rest or when leaning forward - for example leaning on a shopping trolley to get relief from the pain is a classic sign of spinal stenosis.

Spinal Stenosis pain management includes ice for the inflammation and heat to help relax the surrounding muscles.  Massage therapy is also very effective to help release the muscles associated with back and leg ache.


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