Talking About Degeneration

What is degenerative disc disease?

For one thing, it’s a horrible, scary and nasty term.

I have treated so many people with low back pain who are advised their discs are “degenerating” or “crumbling.” Cue images of ancient ruins falling to the ground. So it’s a horrible label given to what is in actual fact the natural ageing process of the spine. Just as we change with age on the outside, the same happens on the inside. So really it should be called ‘maturation’.


doughtnut spine What are age related changes in the discs?

When we are young our intervertebral discs are squidgy like jam doughnuts, then as we age they become more like car tyres in consistency and less good at shock absorption. This means they become thinner and so more wear and tear can occur between vertebrae.

But I had a scan which showed degeneration?

Much evidence now suggests that, even in the asymptomatic population (people without low back pain), scans would show degeneration. According to the Chartered Society of Physiotherapy there is an increasing amount of evidence that suggests results for scans such as “degenerative” discs correlate poorly with symptoms of low back pain.

Most people without back pain show changes in x-rays and scans, so imaging alone is not as helpful or informative as perhaps we have been led to believe. Obviously there is a huge caveat that not all MRI scans are unnecessary, but they are not always useful and can have a negative effect on symptoms.

So how should I manage it?

It’s an understandable many people worry about this word, especially in the throes of an acute episode of pain, but the term is only adding to the anxiety. During this nasty stage it’s a case of taking painkillers, not being in one position for too long and more importantly knowing you will get out of this episode.

The body is an amazing machine and can heal, but emotive words such as degeneration affect this significantly. Unfortunately the same attention is not given to the regeneration abilities of our body with simple changes such as exercise, diet and being aware of our triggers. The link between mind and body is being researched all the time and it was recently suggested in the chartered society of physiotherapy guidelines that getting enough sleep, physical activity and managing stress all are conducive to managing low back pain.

So yes, seek advice and guidance during an episode of low back pain, but avoid the terms degeneration, it’s a term I hope will eventually degenerate itself.

For more information have a look at the following links produced by the Chartered Society of Physiotherapy

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