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The Myths Associated With Degenerative Disc Disease - Relieving Neck Pain, Back Pain, And Sciatica

Degenerative disc disease and the neck pain, back pain, and/or sciatica often associated with it is often misunderstood and even misdiagnosed. We will attempt to shed some light on one of the most misunderstood of all bad back conditions, offering a possible bad back strategy to help individuals struggling with the consequences of this "disease." The spinal column consists of seven cervical vertebrae, twelve thoracic vertebrae, five, sometimes six lumbar vertebrae, five, usually fused vertebrae forming the sacrum, and four very small bones making up the coccyx or vestigial tailbone. The spinal column is made up of a total of thirty-three vertebrae. Together, the vertebrae function to provide stability to the torso, and body as a whole, protecting the spinal cord from exposure and damage. Between each vertebral body is an intervertebral disc or IVD, and each IVD is made up of a fibrous bundle of tissue, fibrocartilage, which serves as a cushion of sorts, absorbing shock to the

spine. The outer portion of the IVD is called annulus fibrosis and its surrounds a fluid filled center with the consistency of jelly, a mucoprotein gel, called the nucleus pulposis. The nucleus pulposis acts as

a sort of shock absorber, keeping two adjacent vertebral bodies separate, while absorbing much of the impact to the spine. I have often used the example of a jelly doughnut to describe an intervertebral disc.

Over time, and as people age, the fluid filled center of the IVD, the nucleus pulposis, begins to dry up,

it dehydrates. As the IVD dehydrates, the spine loses some of its shock absorbing ability. Additionally,

and coincidentally with the dehydration of the IVD, the annulus fibrosis grows weaker and may begin to tear. This condition is called degenerative disc disease and, while some individuals with this condition remain asymptomatic or pain free, others will experience varying degrees of neck pain, back pain and/or sciatica depending on the level of the possible breakdown or pathology. In fact, as the annulus fibrosis begins to weaken and tear, the nucleus pulposis may bulge or extrude anteriorly or foreword, posteriorly or backward, or even laterally, pout to the side, possibly causing a nerve root impingement and, depending on the level, resulting in neck pain, back pain and/or sciatica. The back pain complex caused by degenerative disc disease is generally the result of inflammation, instability, a reduction in the vertebral spacing intervals and/or nerve root impingement. Neck pain, back pain, and/or sciatica may also be due to several of the above consequences together as the spine at a given level fails. It has been demonstrated that proteins in the disk space may cause a great deal of inflammation, thus resulting in chronic pain at the level affected. Instability caused by weakening of the IVDs, and possibly of the anterior and posterior longitudinal ligaments, often results in pain due to micro-motion and the resulting nerve impingement. Furthermore, the pain resulting from instability may be muscular as well. On occasion, the para-vertebral muscles, as well as other core muscles, will spasm as the musculoskeletal system attempts to adapt and adjust to the instability. The degeneration of the discs over time and as we age will bring adjacent vertebral bodies closer together, also resulting in nerve impingement. Degenerative disc disease may result in pain as an aging disc becomes then and the space between vertebral bodies narrows. As spacing decreases

the nervous may be compressed does causing inflammation and pain. Depending upon the level of impingement, an individual may experience tingling or numbness in the buttocks, legs, and even the feet and toes. Additionally, the nerve impingement may result in neck pain, back pain, and/or sciatica. The amount of actual pain may vary from mild to completely debilitating and disabling. Pain levels may vary with periods of almost no pain and other periods of acute and debilitating pain. Degenerative disc disease, as noted above, is an often misunderstood and misdiagnosed condition. In spite of the fact that it is one of the most common "bad back" conditions, and one of the leading sources of neck pain, back pain, and/or sciatica, it is not a disease. Degenerative disc disease is actually an age-progressive phenomenon and the normal part of aging. There are measures that when taken may offset, and even delay many of the consequences of this phenomenon, but ultimately, as we age, the spine ages with us. In many instances sitting actually worsens the pain while standing, as long as it is not in one spot and for a prolonged period of time, it helps to alleviate the pain. Ultimately, the most effective course of action is an individualized and supervised program of stretching and exercise to strengthen the para-vertebral muscles, as well as the remained of the core muscle group. It is crucially important that anyone with this "disease" strengthen the muscles that support the spine. Degenerative disc disease is as common as it is because of inactivity, obesity, and a sedentary lifestyle. Only by implementing a daily activity and exercise routine can one hope to offset the effects of aging as related to this condition. Through daily exercise to strengthen the muscles supporting the spine, combined with ice for inflammation, and the proper shoes for heel cushioning, so important when you must be on your feet for prolonged periods, one can alleviate and ultimately eliminate neck pain, back pain, and/or sciatica associated with degenerative disc disease.