Chiropractic Care for Degenerative Disc Disease

If you are suffering from the aching and stiffness associated with degenerative disc disease, chiropractic care is a good treatment choice. Chiropractic care can improve spinal mechanics by optimizing spinal joint motion and reducing muscular pain secondary to degenerative disc disease.

The first step the chiropractor takes in patients with degenerative disc conditions is to carefully determine whether there is a true disc-related problem.

In older patients without back pain, there often are indications of narrowed disc cartilage and bone spurs seen as a normal process of aging. Some of these patients have been told they have degenerative disc disease based on x-ray findings.

It is more accurate to call this condition of signs of degeneration without active symptoms "degenerative joint syndrome" rather than label it a "disease".

If a patient with signs of disc degeneration does have back pain, the chiropractor looks at three major causes:

• Degeneration in the spinal joints may be disturbing the mechanics of the spine. In this case, the spine is not able to manage its various activities because the spinal joint is lacking motion and the disc is unable to fully provide its normal shock absorbing function. The load that would normally be taken up by a healthy disc and proper joint mechanics must be taken over by the soft tissues, resulting in injured muscles, inflammation, and pain.
  
  The goal of chiropractic is to gently improve joint mechanics by optimizing spinal motion and allowing inflamed soft tissues to normalize. Your chiropractor may also improve disc function, but not if there is advanced degeneration.
• 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 that can compress the spinal nerve, which causes pain.
  
  Chiropractic has embraced non-forceful approaches to treating injuries to the disc, including those secondary to degenerative disc disease. Flexion distraction technique, a hands-on, non-thrusting approach, is utilized by many chiropractors to treat disc injuries.
• Spinal stenosis can cause back and leg pain. Degenerative changes in the disc and the bones of the spine may cause a narrowing of the spinal canal and/or the areas where the nerves exit the spine.
  
  Using non-forceful approaches, such as flexion distraction technique, chiropractors may reduce inflammation secondary to spinal stenosis and treat the cause of associated back and leg pain.

Chiropractic Care and Degenerative Disc Disease
Chiropractors are doctors who specialize in the care of non-surgical conditions of the spine with gentle, time-saving approaches that address the mechanical and neurological causes of back and neck pain.

Chiropractors are rigorously trained to diagnose the different types of neck and back injuries. Your chiropractor will take an extensive history and provide a comprehensive examination to determine what tissues have been injured, what spinal joints may be restricted in motion, and the nature of your degenerative disc disease.

The goal of chiropractic care in treating degenerative joint disease is to optimize motion in the spine, treat the spinal discs, reduce muscle spasm, and improve muscular strength.

Chiropractors are specialists in spinal manipulation—an active, hands-on care that returns motion to the spine. The restricted motion and disturbed mechanics that characterize degenerative joint conditions are especially helped by spinal manipulation in patients who are considered good candidates for this approach.

How a Chiropractor Diagnoses Degenerative Disc Disease
Even if you go to the chiropractor complaining of neck or low back pain, and you have been told you have degenerative disc disease, he or she will evaluate your spine as a whole. The chiropractor will check your neck (cervical spine), mid-back (thoracic spine), and low back (lumbar spine). It's important to examine the entire spine because even though it's just your neck or low back that hurts, other regions of the spine may be affected.

Your chiropractor will determine areas of restricted joint motion, disc injury, muscle spasm, and ligament injury. One way the chiropractor does that is through motion and static palpation, diagnostic techniques unique to chiropractic. Motion and static palpation is an examination by means of touch. The chiropractor will feel for tenderness, tightness, and how well each spinal joint moves.

The chiropractor will also analyze how you walk and look at your overall posture and spinal alignment. Those details will help your chiropractor understand your body mechanics and how well your spine is working and moving.

You'll also go through your past medical history with the chiropractor. Your chiropractor will have x-rays of your spine taken to evaluate possible degenerative changes, or an MRI if it is indicated.

After the examination, the chiropractor will be better able to create an effective treatment plan for your neck or back pain.

Possible Chiropractic Treatment Approaches for Degenerative Disc Disease
The exact treatment plan depends on your diagnosis. Your chiropractor may use a type of spinal manipulation, or spinal adjustment, to improve joint motion and soft tissue health.

Some spinal manipulation techniques are:

• Specific spinal manipulation: The chiropractor identifies the joints that are restricted or show abnormal motion, also called subluxations, and returns motion to the joint with a gentle thrusting technique. This gentle thrusting rapidly stretches soft tissue and stimulates the nervous system to return normal motion to the spine.
• Flexion-distraction technique: This is a gentle, non-thrusting type of manipulation used to treat bulging or herniated discs with or without arm or leg pain. Spinal stenosis is also treated using this approach. This treatment is still hands-on, utilizing a specialized table to assist the chiropractor, but uses a slow pumping action on the disc instead of direct force.
• Instrument-assisted manipulation: This is another non-thrusting technique. Using a hand-held instrument, the chiropractor can apply force without thrusting into the spine. This is especially appropriate in older patients with degenerative joint syndrome.

The chiropractor may also use manual therapy to treat injured soft tissues such as ligaments and muscles. Some examples are:

• Trigger point therapy: The chiropractor identifies specific hypertonic (tight), painful points on a muscle. He or she puts direct pressure (using the fingers) on these points to relieve the tension.
• Manual joint stretching and resistance techniques
• Therapeutic massage
• Instrument-assisted soft tissue therapy: The chiropractor may use Graston technique, an instrument-assisted therapy to treat the injured soft tissue. Your chiropractor will perform gentle repeated strokes of the instrument over the area of muscle injury.

In addition to spinal manipulation and manual techniques, the chiropractor may use various therapy modalities to help reduce inflammation caused by DDD. Some examples are:

• Interferential electrical stimulation: This uses a low frequency electrical current to stimulate your muscles in order to reduce inflammation.
• Ultrasound: By increasing blood circulation, ultrasound helps reduce muscle spasms, stiffness, and pain. It does this by sending sound waves deep into your muscle tissues, creating a gentle heat that enhances circulation and heating.

To reinforce the improved joint mechanics (return of normal spinal motion), your chiropractor will prescribe therapeutic exercises.

Chiropractors are "whole person" doctors who view neck and back pain as unique to each patient. Therefore, they don't focus on just your spinal pain. Chiropractic care includes nutrition, stress management, and lifestyle goals (because all of those can add to neck and back pain, so you need to address them if you really want to relieve your pain).

Chiropractors emphasize prevention as the key to long-term health—another example of chiropractors looking at the whole person, not just the painful problem. Keeping the neck and back healthy is vital to the chiropractic approach to care.

How Chiropractic Helps Patients with Degenerative Disc Disease
A chiropractor will help you return to your normal activities quickly so that you can enjoy your daily life without pain. He or she will work to address the underlying mechanical (how the spine moves) or neurological (nerve-related) causes of your degenerative disc disease.