Physical Therapy Guide to Degenerative Disk Disease

It is estimated that as many as 80% of us will have some form of back or neck pain at some point in our lifetimes. The good news is that most of us will recover without the need for surgery. Conservative care, such as physical therapy for many types of back pain, provides similar results to those obtained from surgery.

What Is Degenerative Disk Disease?

Your spine is made up of 33 vertebrae that are stacked on top of one another. Between each of these vertebrae is a rubbery piece of cartilage called an "intervertebral disk."

Imagine the disk as a tire, with gelatin filling the hole in the tire. The tire is called the "annulus," and the gelatin is called the "nucleus." When we're young—under 30 years of age—the disk is made mostly of gelatin. As we age, and sometimes with injury, we start to lose some of that gelatin and the volume of the disk decreases, resulting in less space between the vertebrae. The disk becomes flatter and less flexible, leaving less space between each set of vertebrae. Sometimes bone spurs form in response to this degeneration of the disk, which could make the spine stiff.

Degeneration does not always lead to pain. For some people, however, it can cause a great deal of pain and disability.

You are more likely to develop DDD if you:

• Smoke

• Are obese

• Do heavy physical work

• Don't get very much exercise

How Does It Feel?

With DDD, you may experience mild to intense neck and back pain—or no pain at all:

• A degenerative disk in the neck may cause pain in the arm, shoulder, or neck.

• A degenerative disk in the low back may cause pain in the back, buttocks, or legs.

The pain is often made worse by sitting, bending, and reaching. It may be worse first thing in the morning and after staying in any one position for a long time.

In severe cases, when DDD results in pressure on the nerve root, it can lead to numbness, tingling, and even weakness in the arms or legs.

How Can a Physical Therapist Help?

• Stretching and flexibility exercises

• Strengthening exercises

• Aerobic exercise

• Manual therapy

• Posture and body mechanics education

Can This Injury or Condition Be Prevented?

You can make choices that lessen its impact on your life and slow its progression.

• Exercising in water can often be a great way to stay physically active when other forms of exercise are painful.

• Exercises involving repetitive twisting and bending need to be performed with some caution. If you start to notice some aching or pain after exercising, consult with a health care professional, such as a physical therapist, who can improve the way you move—and help reduce or eliminate your back or neck symptoms.

• Weight-training exercises, though important, need to be done with proper form to avoid stress to the back and neck. Your physical therapist will work with you to ensure your weight training is safe and effective.

What Kind of Physical Therapist Do I Need?

• A physical therapist who is experienced in treating people with pain, orthopedic, or musculoskeletal, diagnoses.

• A physical therapist who is a board-certified clinical specialist or who completed a residency or fellowship in orthopaedic physical therapy. This therapist has advanced knowledge, experience, and skills that may apply to your condition.

• You can find physical therapists who have these and other credentials by using Find a PT, the online tool built by the American Physical Therapy Association to help you search for physical therapists with specific clinical expertise in your geographic area.

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