Lumbar Degenerative Disc Disease
Physical Therapy
by the Brain and Spine Neurosurgical Institute
Degenerative disc disease (DDD) is a condition that involves the gradual breakdown and deterioration of the intervertebral discs in the spine. Despite its name, it's not truly a "disease" in the traditional sense; rather, it's a natural part of the aging process that can lead to various symptoms and changes in the spine.
Intervertebral discs are soft, cushion-like structures located between the vertebrae of the spine. They act as shock absorbers, helping the spine to move, bend, and flex while maintaining proper spacing between the vertebrae. Over time, these discs can lose their water content, elasticity, and structural integrity. This process is accelerated by factors such as genetics, lifestyle, and injuries.
Key features of degenerative disc disease include:
Disc Degeneration: The intervertebral discs lose water content and become thinner. This can result in reduced disc height, making the spine less able to absorb shocks and maintain flexibility.
Pain and Symptoms: The degeneration of discs can lead to various symptoms, including localized pain, stiffness, and reduced range of motion. The pain is often worse during activities that put pressure on the spine, such as bending, lifting, or twisting.
Radiating Pain: If a degenerated disc starts pressing on nearby nerves, it can cause radiating pain that travels down the arms or legs. This is known as radiculopathy and can be associated with conditions like sciatica.
Spinal Changes: As the discs degenerate, the body might respond by forming bone spurs (osteophytes) on the vertebrae. These spurs can further contribute to pain and affect the stability of the spine.
Changes in Disc Shape: The degenerated discs might change in shape, potentially leading to shifts in spinal alignment and curvature.
Diagnosing degenerative disc disease involves a combination of clinical evaluation, medical history, and imaging studies such as X-rays, MRI scans, or CT scans. Treatment options for DDD typically focus on managing symptoms and improving the patient's quality of life. These options include:
Physical Therapy: Specific exercises aimed at improving core strength, flexibility, and posture can alleviate symptoms and prevent further degeneration.
Pain Management: Over-the-counter pain relievers, prescription medications, or muscle relaxants can help manage pain and discomfort.
Lifestyle Modifications: Maintaining a healthy weight, practicing proper body mechanics, and avoiding activities that worsen symptoms can be beneficial.
Injections: Corticosteroid injections or nerve blocks might be used to target pain and inflammation, especially if radiating pain is present.
Surgery: Surgical intervention is considered when conservative treatments fail to provide relief. Surgical options may include discectomy (removing a portion of the disc), spinal fusion, or artificial disc replacement.
Physical Therapy
Here are a few simple exercises that might help you with degenerative disc disease. Please note that each person is an individual and has their own medical problems, therefore you might experience different types of pains that others may not feel. This should be a caution to you not to continue and you can always consult us at any time.
Hip Flexor Stretch
Our first stretch focuses on your hip flexors. Your hip flexors are muscles in the front of your hips that extend to connections on your pelvis and lumbar spine. If they are tight, they will interfere with your spinal motion.
Start by pressing against a wall with both hands and your shoulders back. Your body should be in an upright position.
Bring your belly button in towards your lower spine and squeeze your pelvic floor muscles in order to stabilize your lower back.
Bring your knee up to about hip level and stop for a second.
Bring this leg back behind your other leg and touch your toe to the ground. You will feel a slight stretch in the front of your hip.
Hold this position for one to two seconds. It is very important that you maintain a stable spine while doing this exercise or you will not feel the stretch in your hip flexor.
Slowly repeat this motion 10 to 15 times and then switch to the other leg
Soft Tissue Stretch
The next stretch is a soft tissue stretch designed to increase the mobility of your lower back. You’ll need a chair for this exercise.
Sit in an upright position on the edge of your chair. Your knees should be bent and your feet flat on the floor.
Drop your hands down between your legs and reach for the floor. Stop when you feel a stretch in your lower back. Breath in as you reach for the floor. If it is too painful to reach down toward the floor, place your hands on your thighs and support your body as you bend to a position where you feel a comfortable stretch.
Hold this position for about five seconds.
Return to the starting position and raise your arms upward. Breathe out as you come up.
Hold this position for another five seconds.
Seated Hamstring Stretch
The next exercise is the seated hamstring stretch. For this exercise, you’ll need a chair and a stool.
Begin by sitting on the edge of one chair with one heel supported on a stool. Your leg should be straight and your other foot flat on the floor.
Keeping your back straight, bend at your hips to bring your upper body forward.
Stop when you feel a stretch in the back of the knee or thigh.
Hold this position for about 15 to 20 seconds.
Relax by moving your upper body to the original position. Breath slowly in through your nose and out through your nose and pursed lips.