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What
does it mean
when my doctor says
I have degeneration
in my spine? |
The term degeneration refers to an arthritic condition,
where either the disc has lost its normal height or bone spurs
have appeared on the vertebra or a combination of these has
occurred.
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First
lets discuss the disc. For degeneration to occur, the disc has
had to loose vital fluid thus undergoing a drying and weakening.
This can occur from injury or aging. It is readily seen in a
MR scan. To understand what happens from here, a little knowledge
of the anatomy of the disc is necessary. Picture the disc as
a donut but instead of a hole in the middle there is a substance
like jelly. The donut part is composed of such tough fibrous
dough that you would not want to eat. The jelly needs to be
in the middle all the time. Using the donut model, you would
not want to eat this part of the donut, as it would cause intense
pain, as the jelly is neuro-toxic.
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When a disc is injured, some of
the outer fibers of the donut start to tear. As this worsens,
it allows the jelly to move usually posterior (backward).
This will cause a response in the body where inflammation
and muscle spasms occur. As this process progresses, motion
between the vertebrae is lost. In time the normal biomechanics
of the spine is compromised thus placing additional stress
and pressure on the injured disc. As the fibrous part of the
disc is compromised the jelly part moves posterior pushing
toward the nerve root. First a protrusion of the fibrous part
occurs and in addition to pain you may feel some tingling
or numbness or pain from the disc and vertebral area downward
into your leg. As the protrusion gets worse so does the pain.
If the jelly extrudes through, as can happen suddenly due
to hard work or heavy lifting or intense sports, severe pain
will likely result with the pain radiating down the leg. This
condition can become so bad that almost any activity is met
with severe pain and must be curtailed or stopped.
A
herniated disc with an extruded nucleus can become so bad
that surgery is the recommended solution. Unfortunately, surgery
is recommended to often with only about 20% of the cases actually
requiring surgery. The remaining 80% will do well with conservative
care. Rest, ice, specific skilled Chiropractic adjustment,
and short-term anti-inflammatory medication should be enough
for short-term resolution.
After the acute phase is over it is very important
to rehabilitate the injured area and associated areas that
have become week due to the disc problem. The rehabilitative
phase is particularly important is avoiding further problems.
At this point there is no cure, only management of the condition.
Those with the most successful management strategy have the
fewest problems going forth.
In my experience the highly successful strategy
involves both specific skilled chiropractic adjustment of
the dysfunctional vertebrae, and a program of exercises targeted
to increase spinal strength and flexibility. The chiropractic
adjustments will decrease pressure on the damaged disc and
nerve root allowing for a return to normal intervertebral
motion. The normal intervertebral motion will allow for increased
exercise and strengthening thus reversing the degenerative
spiral. |
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