Disc Degeneration Symptoms
The most widely recognised symptoms of disc-related pain is sciatica (nerve pain in the leg). Some patients with sciatica will also have pain in the back but a significant proportion will not report much back pain but will have leg symptoms. When the disc is bulging but not compressing a nerve it can cause pain in the back and refer into the buttocks and hip region but not usually down the leg.
When the disc itself is painful it is usually described as a “deep” pain which can’t be easily located through the skin ie hard to find a pressure point. It can be very sharp (often confused as nerve pain) or more generalised aching discomfort depending on the degree of irritation. A disc that is irritated but has not prolapsed through the annulus fibrosis can feel very vulnerable just like any other sprained structure like knee or ankle ligaments.
People are often also report feeling “too much pressure” on the back and need to lie down to ease symptoms or sometimes even a feeling that they could separate in half (this never happens fortunately!).
Other common disc degeneration symptoms include:
- pain on sitting
- pain coughing or sneezing
- pain bending
- pain on lifting
- morning stiffness
- pain turning in bed
- hips or shoulders shifted to one side (lateral shift)
Degenerative Disc Disease Treatment
Physiotherapy treatment is dependent upon the stage and severity of the condition. The first priority may be to unload the disc which can be achieved through specific muscle activation work, support strapping, corrective exercises or in some cases a Lumbar corset. It is important, if possible, to prevent the disc bulges progressing to a full herniation because that can require surgical procedure. This is one of the major complications of inappropriate, thrusting manipulation trying to “put the disc back”.
If the disc is showing signs of recovery (which can vary from days to weeks) the next phase of rehabilitation is to increase movement, ensure good postural muscle function and increase loading tolerance with a very structured sequence of exercise progressions. This is a key part of rehabilitation and if this is done incorrectly can easily provoke or reverse recovery. Dosage of exercise is like prescription medication – it needs to be precisely selected, executed and progressed.
In the final stages of rehabilitation all tasks of normal daily living need to be comfortable and then more advanced challenges depending on your lifestyle need to be incorporated into the rehabilitation programme. If you hobby is gardening then rehabilitation needs to focus on ensuring that your spine has the capacity to bend and tolerate a sustained position as well as lift & carry.
In some cases the spine may not recover sufficiently in order to tolerate these types of loads so from some form of ergonomic adaptations may be required to facilitate activity.