How a Chiropractor Treats Degenerative Disc Disease

Question: I have been told I have degenerative disc disease, and I have two questions related to that. Is that just a catch-all phrase and diagnosis for back pain because of age? And would going to a chiropractor be a good choice?
—Seabrook, TX

Answer: This is a wonderful question because it highlights the complexity of discussing almost all aspects of back pain.

If we were to examine 100 low back x-rays of men and women over 50 years old, we would find a high percentage of what is often called "degenerative disc disease."

We would find narrowed disc cartilage (discs are the shock absorbers or shock distributors between the vertebrae of your spine), perhaps some bulging of the disc, as well as bony spurs coming out from the vertebra (signs of the body trying to create stability as the disc narrows or "degenerates"). It's also possible that there would be some narrowing in the foramen, or openings, through which nerves exit the spine. There may be some narrowing of the canal which protects the spinal cord.

Many patients with these signs of disc degeneration might not have any back pain, and there is no absolute direct connection between these signs and a true diagnosis of a back condition.

I prefer to use the term "degenerative disc syndrome" for these changes that occur in the discs and spine that may or may not be related to back pain. I think this is more a more useful description and helps my patients understand that they do not have a "disease."

Degenerative disc disease is NOT a catch-all diagnosis, but it is often used—at times inaccurately—by doctors when they see a spinal x-ray, usually of the low back or neck, and see the signs mentioned above, especially thinning discs and spurring in the bones (called "hypertrophic" changes).

In the absence of back pain, and without a correlating comprehensive spinal examination, doctors have to be cautious in telling a patient that they have "degenerative disc disease."

If a patient with signs of disc degeneration DOES have back pain, there are several possibilities for what precisely is causing that pain.

Degeneration in the spinal joints may be disturbing the mechanics of the spine. The spine is not able to manage the various activities it is asked to do because it is lacking motion and the proper shock absorbing qualities of a normal disc. As a result, the load which would normally be taken up by healthy disc and joint mechanics must be taken over by the muscles or ligaments, resulting in injured muscles, inflammation, and pain.

Thinning and degenerative discs might be bulging and putting pressure on spinal nerves. Degenerative changes in the spinal joints might include instability in the disc with the possibility that the disc has bulged or herniated. Degenerative changes may also cause a slight, temporary displacement with an "insult" to the spinal nerve, which creates pain.

It is interesting to note that past a certain point of degeneration, the disc loses its ability to bulge or herniate. That is a very advanced state of degeneration.

There may be a condition known as spinal stenosis, which is a narrowing of the spinal canal and / or the areas where the nerves exit the spine. Spinal stenosis can result in inflammation and pain. As we get older, it is often spinal stenosis that gives us that painful low back with leg pain.

These terms—bulging disc or spinal stenosis—might be considered a more accurate diagnosis than the general "degenerative disc disease" because they describe what is causing your pain.

Chiropractic Care and Degenerative Disc Disease
Your chiropractor is highly trained to diagnose what type of "degenerative disc disease" you might have and the cause of your back pain.

Chiropractic provides conservative, non-surgical care based on improving mobility in the spine, reducing inflammation, and addressing pain at its source. Your chiropractor should provide you with a comprehensive examination, diagnosis, treatment plan, and regular evaluations.

Gentle care, with non-forceful protocols such as Cox flexion-distraction, Sacro-Occipital technique, and other non-thrusting procedures are usually the best approaches for disc degeneration and its complications. Traditional spinal manipulation may be indicated based on a careful evaluation of the individual.

Effective chiropractic management will integrate physical and manual therapies, therapeutic exercises, and stress and lifestyle recommendations in your treatment program for "degenerative disc disease."