In the human spine, between vertebrae, we have discs between in order to absorb the shock and pressure, and to enable smooth movement.
It is important for an active lifestyle to have healthy spinal discs, but among the other unfortunate effects of aging, these spinal discs tend to degenerate as we grow older.
Lumbar degenerative disc disease, which is the word generally used to describe severe or problematic degeneration of the spinal discs between the lumbar vertebrae (in the lower back).
This typically occurs in people between age 30 and 50, and can happen to anyone naturally.
It can be exacerbated, however, by trauma, and is more common in smokers than in non-smokers.
What Does This Disease Mean for You?
In most cases, degeneration of lumbar discs is not a problem. As I have said, it is quite normal to see some degeneration of spinal discs as people age, but not all people will experience pain or become symptomatic in any way.
However, there are rare cases where degeneration of lumbar discs leads to pain and discomfort.
Even in the cases that pain from this degeneration does occur, is typically minor or uncommon, and requires minimal or no treatment.
This pain is most commonly caused by
- irritation and compression of nerves as degenerating lumbar discs lessen the space between vertebrae.
- leaking of proteins from discs, and the consequent irritation of the surrounding areas.
- destabilization of the spine.
In certain people, this pain can hinder the quality of their everyday life, and will require treatment.
How Can You Treat Lumbar Degenerative Disc Disease?
Lumbar degenerative disc disease is typically very treatable, but it is necessary to take steps early and deliberately.
There are a number of changes people can make to their activity.
- Avoid heavy lifting, or learn the safest possible form for heavy lifting
- Correct your posture to put less strain on your lower back
- Buy an ergonomic chair
These are all relatively easy lifestyle fixes. Much of one’s lifestyle can impact the severity and the progression of the disease, so it is important to take note of your contributing activities (such as jobs which require heavy lifting).
Physical Therapy and Chiropractic
Additionally, people might find it useful to see a physical therapist, or engage in activities which can increase blood flow to, and ease stress on, the lower back. These include:
- Hamstring stretches,
- Aerobic activity, such as swimming
But of course, it is always recommended to see a physical therapist or your doctor before pursuing physical activity as a treatment option. In addition to a physical therapist, one can see a chiropractor.
The work of a chiropractor can increase blood flow and range of motion in the lower back, and reduce muscle tension and pressure on nerves, making living with lumbar degenerative disc disease much more manageable than otherwise.
In cases where pain is very severe, certain medications can be taken. Some non-steroid anti-inflammatories are sold without a prescription, and are a good option.
Painkillers, prescription and nonprescription, can also help patients of lumbar degenerative disc disease.
In more severe cases, an epidural injection, or stronger prescription medication, can be used to ease pain and make the disease more manageable.
It will be important to speak with your doctor to see if medication can help.
It should be noted, however, that I have only mentioned ways of managing the symptoms of lumbar degenerative disc disease.
Medication, exercise and chiropractic do not cure the disease. Although, note that it exists on a spectrum, from the normal spinal disc degeneration of aging people, to slightly more severe degeneration, and all the way up to those requiring drastic intervention to preserve mobility and quality of life.
For most people, managing the symptoms and taking steps to prevent any worsening of their condition will be enough.
Some people however, if degeneration is severe enough, will require surgical intervention.
Surgery for lumbar degenerative disc disease usually consists in either fusing the vertebrae between which the problem disc sits, or replacing the disc.
These are invasive surgeries, and any decision regarding them should be conducted with extreme caution.
To fuse vertebrae can effectively solve the problems of the disease in the long-term, as it simply cures it.
A spinal fusion involves placing implants and bone grafts in and around the lower spine, cutting off mobility between the two vertebrae.
Thus surgery halts the nerve inflammation and compression, disc leakage, and spinal instability, which are the main causes of pain in lumbar degenerative disc disease. Fusions can be done between one, two, or three vertebrae.
But multi-level fusions are uncommon, because they can be painful in their own right, and can significantly reduce mobility.
Fusions in general, even single-level fusions, do cut off some mobility, and recovery can take a long time (up to 18 months for the bone graft to solidify).
So it must be noted that spinal fusion, while it can be a permanent cure for the disease, is an option which needs extensive discussion with your doctor (or doctors!)
An important note on recovery. Nicotine, the active ingredient in tobacco, is a bone toxin, and contributes to deterioration.
Recipients of bone grafts are advised to not smoke cigarettes or otherwise consume tobacco.
Of course, it is an individual decision, but nicotine significantly reduces the chances of a successful recovery from a spinal fusion.
Another surgical option is to replace the problematic spinal disc with an artificial one.
Disc replacement is a newer innovation, and we have yet to really see the long-term results of this procedure.
A major concern is needing to replace the artificial disc, meaning a second surgery with its own costs, recovery time, and risks.
But we will see the developments of this technology in coming years, and it may prove to be an essential part of treating lumbar degenerative disc disease.
Solving the problems caused by lumbar degenerative disc disease will require a holistic approach, and a combination of lifestyle, physical, medicine, and (perhaps even) surgical, solutions in order to effectively treat.
Because much of the treatment of the disease involves mitigation and prevention, a carefully balanced approach, including an understanding of the impacts of one’s lifestyle, such as heavy lifting, poor posture, and smoking, is important in ensuring continued quality of life despite the degeneration of lumbar discs.