Chủ Nhật, 12 tháng 1, 2014

Degenerative Disc Disease

Degenerative Disc Disease Due to continuous wear and tear the disc of the vertebral column gets deteriorated (degenerated) causing degenerative disc disease. Actually these disks serve as cushion keeping the vertebral segments intact. Degeneration of the discs makes it prone to herniated disk causing pain in your lower back. It can cause arthritis or disk herniation or spinal stenosis. Treatments like medications and physical therapy is available for reducing the symptoms.

The spinal cord is made up of several vertebrae which are sandwiched by gel like portions called disk. These disks serve like “cushions” preventing the vertebrae from rubbing. Each disc contains an outer wall called annulus and a soft inner portion called nucleus. The disk is filled with 80% of water and the remaining portion with jelly like substance. As one grows old, water content gets reduced causing rupturing of discs. This would eventually cause irritation on the adjacent nerves and tissues leading to ligament injury. As the disc degenerates it will cause chronic pain due to rubbing of vertebrae.

Causes :

• Exact cause of degenerative disk disease is unknown. It is believed to be caused by old age and wear and tear of the cartilages.

• Due to loss of water/protein content on the cartilages the vertebrae becomes weak and fragile.

• This problem does not happen overnight and is a process taking years of time.

• Any accidental injury to the spine can cause DDD or osteoarthritis.

• Not all the aged people would get degenerative disc disease and again pain is not felt in the same extent and intensity by the affected person.

• People with autoimmune disorder are likely to develop DDD in early ages.

It is not mandatory that DDD will affect only the lower back region. If the degeneration occurs on the neck region of the spine, it would cause cervical disc disease. Similarly if the disk degenerates or deteriorates in the middle of your back then it will cause thoracic disc problem. If the lumbar disc gets affected it would cause low back pain/lumbago.

Symptoms :

Symptoms are not the same for all people affected with degenerative disc disease. Some may not have any pain at all while others would feel intense pain. Symptoms of DDD can affect young adults in 25-35 years having back pain.

Symptoms of Pain Occur in the Following Ways :-

In the first type spine will undergo major injury causing sudden and intense pain. Next type is the trivial injury which will produce sudden pain in the lower back and last type is the throbbing pain that starts gradually but gets worse over time.

Pain will be experienced in the lower back region, legs, and even buttocks. Some people will not have any feeling due to numbness in the legs and tingling sensation in the foot. Intense muscular pain is felt by some people on set of intervals. There will be pain for few days with an interval of absence and again dull pain after few days. Certain activities like getting up after prolonged sitting can intensify the pain.

Who are at risk?

Degenerative disc disease affects middle aged people or young adults who are leading sedentary lifestyle. Smoking puts you in risk of developing DDD in early ages. Genetic factors also play a role and hence you can get this disease if any of your family members already have it.

Diagnoses :

Your doctor will physically examine your body checking for the symptoms of intense pain. He would examine the nerves closely for any irritation and inflammation. A neurologist may ask you to lie down on the couch and slowly lift your legs until pain is felt. Nerve testing is done using electroymyogram and nerve conduction velocity testing. Radiology tests like X-ray, CT or MRI scanning is done for getting clear picture about the herniated disc.

Treatment :

Practicing exercises regularly and by carefully managing your movements you can prevent chronic disc degeneration disease. You need not have to worry if you have disc degeneration in your middle age since it will cause only less pain when you become old. The condition of degeneration of disc cannot be reversed but you can improve the quality of life by simple techniques of exercises. There are several non-surgical treatments available for treating disc degeneration disease.

Self Care Method :

You should know how to stand up after sitting for long hours and how to stay in the correct posture for managing pain. Make sure that you are keeping the spine in proper alignment. Ask your physiotherapist and make adjustments in sitting and standing habits. You need to learn how to sleep in right position. Similarly you should know how to lift any object and about the ways of bending your lower back. You should use the chair designed according to the alignment of the spine in the workplace or else you can use some pillow or cushion for additional support.

Managing Stress :

It is true that stressful events and emotions will aggravate your back pain. So practice relaxation techniques regularly to get rid of stress. Deep breathing exercise and visualization techniques are highly recommended methods of relaxation techniques for managing the pain.

Physical Therapy :

Physical exercises are helpful in managing pain caused by degenerative disc disease. Your therapist will teach you about proper walking and lifting methods. By practicing these exercises you will gain strength on your lower back. Stretching exercises for legs and lower back are useful to reduce the pain. It will give you enough flexibility for the spine and will gradually strengthen your vertebral column. You can also try hot and cold compress for managing acute pain. Use muscle relaxants available over the counter for giving flexibility to the rigid muscles.

Alternative Approach :

Some people follow chiropractic approach for degenerative disc disease. Trained chiropractors will gently massage your lower back region giving pressure to the muscles that are immobile. The joints will return to normal position after efficient massage therapy. Having good movement of muscles will reduce muscle spasms and improves nervous function. You can also prevent stiffness of joints caused by this disease by chiropractic massage.

Holistic Approach :

Acupuncture and biofeedback methods are followed by many people to get rid of unbearable pain caused by DDD. You will learn the methods of dealing with pain and how to cope with the deteriorated joints by this method.

Medications :

Prescription medications include NSAIDs like aspirin, ibuprofen, celecoxib and steroid drugs like Medrol and prednisone and muscle relaxants and analgesics like Tylenol. But long term usage of these medications can cause adverse effects.

Surgery :

Surgery will be considered as the last option for DDD if no other methods are giving positive results. In case your pain is not reduced and you are not able to manage routine activities by the throbbing pain surgery is done. In this process the pressure exerted on the nerves is removed and the segment is decompressed. Spine fusion is done for joining one or more vertebrae permanently so that it gives extra strength and stability to the spine. Very often fusion surgery on spine is performed on the Lumbar and Cervical regions.

Prognosis :

The outlook of degenerative disc disease depends on the severity of the problem and nature of treatment given. Many patients will respond well to conservative methods of treatment rather than medications and surgical procedure. In severe cases, surgical repair can improve the quality of life of the patient. There is no way you can prevent this disease. But you can be careful in avoiding spinal injuries and following stretching exercises. You should understand what position will intensify the pain and avoid it completely.

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