Degenerative disc disease (DDD) is one of the most common causes of back and neck pain, particularly as we age. Despite its concerning name, it's not actually a disease but a natural process that can be effectively managed with the right approach. At M.O. Therapy in Markham, we help patients with DDD live active, fulfilling lives through evidence-based treatment.
Understanding Degenerative Disc Disease
What Is Degenerative Disc Disease?
Degenerative disc disease refers to changes in the spinal discs that occur with aging and use. These changes are nearly universal and don't always cause symptoms.
Key Points:
- Normal aging process of the spine
- Not a true "disease"
- Changes may or may not cause symptoms
- Very common (most people have some changes by age 40)
- Manageable with conservative treatment
Normal Disc Anatomy
Healthy Disc:
- Nucleus pulposus (gel-like center)
- Annulus fibrosus (tough outer layer)
- Acts as shock absorber
- Allows spinal movement
- Contains water for cushioning
What Happens in DDD
Disc Changes:
- Loss of water content (dehydration)
- Decreased disc height
- Small tears in annulus
- Reduced cushioning ability
- May develop bulges or herniations
Secondary Changes:
- Facet joint changes
- Bone spur formation
- Spinal stenosis (narrowing)
- Muscle and ligament changes
Causes and Risk Factors
Primary Factors
Age:
- Most significant factor
- Changes begin in 20s-30s
- Progress throughout life
- Nearly universal by age 60
Genetics:
- Strong genetic component
- Family history matters
- Affects rate of progression
Modifiable Risk Factors
Lifestyle:
- Smoking (impairs disc nutrition)
- Obesity (increased mechanical load)
- Sedentary lifestyle
- Poor posture
- Heavy physical labor
Occupation:
- Repetitive lifting
- Prolonged sitting or standing
- Whole-body vibration
- Heavy manual work
Symptoms
When DDD Causes Symptoms
Many people have DDD without any symptoms. When symptoms occur:
Back Pain:
- May be constant or intermittent
- Often worse with sitting, bending
- May improve with walking or position changes
- Can be mild to severe
Neck Pain:
- Stiffness and aching
- Worse with prolonged positions
- May have associated headaches
Radiating Pain:
- May spread to arms (cervical)
- May spread to legs (lumbar)
- If disc affects nerve roots
Other Symptoms:
- Stiffness, especially after rest
- Muscle spasm
- Reduced range of motion
- Weakness in severe cases
Symptom Patterns
Typical Patterns:
- Symptoms come and go
- Flares and remissions common
- Often activity-related
- May have triggers
Diagnosis
Clinical Assessment
History:
- Symptom pattern
- Aggravating/relieving factors
- Functional limitations
- Previous treatments
Physical Examination:
- Range of motion
- Neurological testing
- Provocative tests
- Functional assessment
Imaging
X-Ray:
- Shows disc space narrowing
- Bone spurs visible
- Alignment assessment
- Usually sufficient for diagnosis
MRI:
- Detailed disc visualization
- Shows soft tissue changes
- Identifies nerve compression
- Not always necessary
Important Note: Imaging findings often don't correlate with symptoms. Many people with severe imaging changes have minimal symptoms, and vice versa.
Treatment Approaches
Conservative Treatment
Most patients respond well to non-surgical treatment:
Activity Modification:
- Avoid prolonged positions
- Take movement breaks
- Proper lifting techniques
- Ergonomic adjustments
Exercise Therapy:
- Core strengthening
- Flexibility exercises
- Aerobic conditioning
- Progressive loading
Manual Therapy:
- Spinal mobilization
- Soft tissue techniques
- May provide symptom relief
Physiotherapy
Goals:
- Reduce pain
- Improve function
- Strengthen supporting muscles
- Prevent progression
Components:
- Individualized exercise program
- Manual therapy as indicated
- Education on self-management
- Activity guidance
Pain Management
When Needed:
- Over-the-counter medications
- Prescription medications
- Injection therapies
- Multimodal approach often best
Surgery
Rarely Needed:
Considered for:
- Failure of conservative treatment (6+ months)
- Significant nerve compression
- Progressive weakness
- Intractable pain
Options:
- Disc replacement
- Fusion procedures
- Decompression
Exercise Program for DDD
Core Stability
Essential Exercises:
Dead Bugs:
- Lie on back, knees bent
- Engage core
- Alternately extend opposite arm and leg
- 2-3 sets of 10 each side
Bird Dogs:
- On hands and knees
- Extend opposite arm and leg
- Hold 5 seconds
- 2-3 sets of 10 each side
Modified Planks:
- Start on knees if needed
- Progress to full plank
- Hold 15-30 seconds
- 2-3 sets
Bridges:
- Lie on back, knees bent
- Lift hips off floor
- Hold 5 seconds
- 2-3 sets of 10-15
Flexibility
Important Areas:
Hip Flexors:
- Kneeling hip flexor stretch
- 30 seconds each side
- 2-3 times daily
Hamstrings:
- Supine stretching preferred
- Avoid forward bending
- 30 seconds each leg
Piriformis/Gluteals:
- Figure-4 stretch
- 30 seconds each side
Aerobic Exercise
Recommendations:
- Walking (excellent starting point)
- Swimming or water aerobics
- Cycling (with proper setup)
- 20-30 minutes most days
Movement Breaks
- Stand and move every 30-45 minutes
- Gentle stretches throughout day
- Avoid prolonged static positions
Lifestyle Management
Ergonomics
Workstation:
- Monitor at eye level
- Supportive chair
- Feet flat on floor
- Regular position changes
Home:
- Proper mattress support
- Good sleeping posture
- Appropriate chair heights
- Reduce awkward positions
Weight Management
Important Because:
- Reduces mechanical load on spine
- Decreases inflammation
- Improves mobility
- Enhances overall health
Smoking Cessation
Critical:
- Smoking impairs disc nutrition
- Accelerates degeneration
- Increases pain
- Reduces treatment effectiveness
Stress Management
- Chronic stress worsens pain
- Relaxation techniques helpful
- Address psychological factors
- Build support systems
Flare Management
During Flares
What to Do:
- Modify activities temporarily
- Use ice or heat for comfort
- Gentle movement is beneficial
- Avoid complete bed rest
What to Avoid:
- Aggravating activities
- Prolonged bed rest
- Ignoring symptoms
Prevention
- Consistent exercise program
- Avoid sudden increases in activity
- Maintain good posture
- Listen to your body
Long-Term Outlook
What to Expect
Reality:
- DDD is manageable for most people
- Symptoms often improve with treatment
- Many live normal, active lives
- Surgery rarely needed
Keys to Success:
- Stay active
- Maintain healthy weight
- Regular exercise
- Good posture habits
- Early treatment of flares
Treatment at M.O. Therapy
Physiotherapy
Our physiotherapists provide:
Assessment:
- Comprehensive evaluation
- Movement analysis
- Functional testing
- Treatment planning
Treatment:
- Individualized exercise program
- Manual therapy
- Education and guidance
- Progressive rehabilitation
Massage Therapy
Our RMTs help with:
- Pain relief
- Muscle tension reduction
- Relaxation
- Improved mobility
Chiropractic Care
May include:
- Spinal assessment
- Appropriate treatment techniques
- Mobility improvement
- Exercise guidance
Frequently Asked Questions
Is degenerative disc disease serious? Despite its name, DDD is not a serious disease. It's a normal aging process that can be effectively managed. Most people with DDD live normal, active lives with conservative treatment.
Will my degenerative disc disease get worse? Some progression is normal with age, but proper management can minimize symptoms and maintain function. Staying active, maintaining healthy weight, and avoiding smoking all help.
Can exercise help degenerative disc disease? Yes, appropriate exercise is one of the most effective treatments. Core strengthening, flexibility work, and aerobic exercise all benefit spinal health and reduce symptoms.
Do I need surgery for degenerative disc disease? Most people with DDD do not need surgery. Conservative treatment including physiotherapy, exercise, and lifestyle modification effectively manages symptoms in the vast majority of cases.
Book Your Assessment
If you're dealing with degenerative disc disease, M.O. Therapy in Markham can help. Our team will assess your condition and develop a comprehensive management plan.
Call (905) 201-5827 or book online for your assessment. We offer direct billing and same-day appointments.