Lumbar Degenerative Disc Disease or Degenerative Disk Disease

Lumbar degenerative disc disease is known by lots of different names, they include:

• Spinal Disc Degeneration
• Lumbar spondylosis
• Changes of age
• Facet syndrome or arthropathy
• "Wear and tear"

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These are lots of names for more or less the same thing and some of them sound alarming. However, lumbar degenerative disc disease and changes of age in your spine are very common - in fact NEARLY ALL of us will, in time, get these changes in our spines. It's as inevitable as getting grey hair and wrinkles -it's going to happen.

Lumbar degenerative disk disease is rarely serious - normally the changes occur quite gradually and cause no serious ill effects. As we age the discs in our lower back naturally become more dehydrated and thinner, this can show on an X-Ray as narrowing of the disc space.

Lumbar X-Ray from the side

Lumbar X-Rays are good for showing bones and spaces, they don't show us any soft tissues and they don't show us lumbar discs either. All you can see on X-ray is the space where the disc sits.

Lumbar Spine MRI scan from the side

Lumbar Spine MRI scans do show degenerative disc disease. Look for the characteristic narrowing of the disc with a loss of fluid levels.

Usually degenerative disk disease does not come alone. Often the facet joints are involved too. They become less smooth and they develop changes on the joint surfaces where the cartilage, instead of being smooth, slippery and shiny becomes a bit scuffed and worn. This is called lumbar facet joint arthropathy.

Sometimes in response to these age changes the body tries to generate more stability by growing more bone, not always exactly where we want it. These bony growths are called lumbar osteophytes. They are nothing to worry about unless they are either irritating a nerve causing leg symptoms (such as those described in the nerve root irritation section) or unless they are closing down the space in the spinal canal and restricting the spinal cord (spinal stenosis).

The only time lumbar degenerative disc disease become a serious problem is when they cause compression of the spinal cord or a nerve root irritation see this section on identifying serious problems.

What is the Best Treatment for Lumbar Disc Disease?

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Lower back exercises to strengthen and stretch are helpful

Lots of my patients who come to see me with this problem are fearful of movement because they associate degenerative changes with instability and wearing away. It makes sense to them to keep still in order to prevent more wear and tear on their joints.

Actually, keeping still is the worse thing you can do for this, as movement is the thing that gives the joints nutrition and helps improve day to day activities.

Physiotherapy treatment for this condition involves encouraging stiff areas of the spine to move more normally and using exercises to train the muscles that help to support and stabilise the lower back. I have had some really good success stories with people who have felt very much better by managing the problem in this way.

Many different things influence whether we get back pain or not - and the actual physical findings on scan or X-Ray are actually less important then you might think. If you want to know more about all the different factors that determine whether you get back pain or not - and what to do about them - then my e-book Back Pain Action Guide might interest you.

Injections and Surgery

If usual care for this problem fails to help then the next step is usually to try a lumbar injections or or a facet joint injection. Surgeons will sometimes perform lumbar fusion surgery to ease symptoms.

What Tests are Useful for Lumbar Degenerative Disc Disease?

X-rays and MRI scans are often arranged and they may help with the diagnosis. But, there is a problem with them too. It is really important to understand is that there is rarely any relationship between the changes seen on lumbar X-ray and MRI scans and symptoms. It is also good to know that these changes are very common - even in people who don't have any lower back pain at all.

A recent study (1) actually shows that people with back pain who are told the results of their MRI scans have a lesser sense of well-being. I'm sure that is because when someone points out that you have lumbar degenerative disc disease it becomes frightening.

References

1. Modic M, Obuchowski N, Ross J, Brant-Zawadzki M et al
Acute low back pain and radiculopathy: MR imaging findings and their prognostic role and effect on outcome. Radiology, Nov 2005, vol. 237, no. 2, p. 597-604

Causes of lower back pain

Understand more about lumbar degenerative disc disease by checking the anatomy section.

Lower Back Pain Toolkit Home Page

November 5, 2010