There’s a distinct likelihood that one day you will see your doctor because y
ou have back pain. It’s unavoidable — it’s something everyone deals with at least once — and sometimes multiple times throughout the course of a lifetime.
When that point arrives, your health care practitioner may tell you that you have degenerative disc disease (DDD) — the name given to the process by which the discs that line your spine age and deteriorate.
But don’t panic. DDD is akin to the human experience like graying hair or wrinkling skin — not pretty perhaps, but not fatal either. It’s the level of degeneration that should be concerning, and words like moderate and severe certainly warrant your fullest attention.
As with any problem, it’s easier to put into perspective if you understand a bit about it, so read on for a quick anatomy and physiology lesson on the spinal disc. Hearing and knowing some of the terms ahead of time gives you the best chance of communicating effectively with your doctor.
A lumbar disc
has a primary function of providing a cushioning and buffering effect to the vertebrae. A healthy disc allows for smooth trunk motion and also helps you assume a load through the spine without injuring delicate spinal cartilage.
Often likened to a jelly doughnut, the discs in your back are comprised of a tougher outer layer called the annulus and a soft gel-like inner layer called the nucleus. Although they’re connected and together comprise one body part, they have remarkably different functions.
The annulus
is comprised of a group of cartilage-like rings oriented in a basket-weave formation on the outside of the disc and act to constrain the nucleus during movement of the spine. Damage to the annulus, which is essentially the outer layer of the jelly doughnut (such as a bulge or herniation), could result in a pinched nerve. Sciatica, foot drop, weakness in the leg and excruciating pain are all signs of annular damage and nerve root compression.
The nucleus
of the disc is the primary shock absorber of the spinal unit helping to disperse incoming force evenly across the vertebrae, essentially minimizing wear and tear in the back. Maintaining the integrity of the nucleus is directly correlated with having a healthy spine, hence the reason you should lift with your legs and not from the waist.
Your disc will age naturally
over the course of your lifetime.
In your 20s and 30s, the nucleus has the consistency of toothpaste — it’s very shock absorbent and pliable. In your thirties and forties, the nucleus ages and takes the form of a wet, crumbled blue cheese. The change in consistency of the nucleus is responsible for the sudden spike in the incidence of episodes of severe back pain, explaining why catastrophic back outages are common first-time occurrences in the mid-forties.
In your 50s and 60s
and beyond, the nucleus hardens dramatically and the entire disc assumes the consistency of a bar of soap. But while it’s a bit more sturdy, it offers less shock absorption, in turn transmitting those forces onto the vertebrae accelerating the arthritic process.
The more times you injure your back the faster you speed up the process of disc aging. Changing the constitution of the disc prematurely can lead to a number of heal
th problems down the not-so-distant road, such as sciatica, spinal stenosis and degenerative
arthritis.
If you’re careful, it’s possible to live well into your sixth decade without having a debilitating low-back event. As the old adage goes, you only get one body. We are products of what we’ve done in the past, for better or worse.
Gloucester resident Joe DiVincenzo is a physical therapist and clinical specialist in manual therapy. He writes “On the Mend” weekly. Questions may be submitted by email to joedivincenzo@comcast.net.
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