Living with Degenerative Disc Disease
Low back pain self care
The vast majority of people with low back pain and/or sciatica symptoms from lumbar degenerative disc disease will be able to successfully manage their pain and avoid surgery. Indeed, over 90% of individuals specifically diagnosed with degenerative disc disease will find that their low back pain and other symptoms go away or subside with three months.
But even patients whose pain does not subside within three months can undertake a range of actions—including a number of self-care activities—to manage their pain. Furthermore, the pain of disc degeneration usually subsides with time—by age 60 a degenerated disc will have stabilized and will usually not be painful. Consequently, the goal for patients living with degenerative disc disease should be to control their low back pain and other symptoms enough to maintain their ability to function in everyday activities and if possible avoid major surgery.
This article identifies the four key components of a self-care program patients can undertake to manage the pain of degenerative disc disease, and describes actions that can be incorporated into daily routines, including:
- Pain management and treatment
- Exercise and active rehabilitation
- Behavioral and activity modifications
- Improved nutrition
Control the pain of degenerative disc disease
The first objective for patients is to control their pain enough so that they can perform everyday activities and engage in active physical therapy and exercise. Quick steps to control pain include:
- Applying ice to muscles that are painful after activity or exercise will help control pain and inflammation. Using ice packs on the lower back for 10 minutes can be a cost-effective, easy approach to take at home. Having ready-made packs in the freezer will allow patients to grab one quickly when needed.
- Alternatively, a heating pad or moist heat compresses (a moistened towel warmed in a microwave is easy to make) can relax muscles or joints around the degenerated disc that have tightened up. Warm muscles make stretching and exercise easier, and decrease the chance of injury.
- Taking over-the counter medication such as NSAIDs (non-steroidal anti-inflammatory drugs, such as Advil or Motrin) can decrease the inflammation around the degenerated disc. Pain can also be treated with acetaminophen pain relievers such as Tylenol.
For pain that doesn’t respond to over-the-counter medications and home remedies, stronger anti-inflammatory medications can be prescribed (such as COX-2 inhibitors) or administered directly into the low back (e.g., epidural injections) for pain relief.
Patients can also take advantage of alternative therapies like massage therapy, acupuncture or chiropractic manipulation to relieve tightness and decrease pain.
Stay active to slow the disc degeneration
Once pain is adequately controlled (it will most likely not go away completely) the most important thing patients can do is stay active. Exercise not only preserves what functionality exists, it is the single best way of healing the back. Exercise increases the flow of blood and oxygen and other nutrients to the back and discs, thereby keeping them hydrated and as pliable as possible. Exercise can also improve one’s sense of well-being by promoting the release of endorphins, a natural pain-reliever and stress reducer.
Staying active does not require a lot of innovation, but it does require planning to
- Alternating 30 minutes of strengthening exercises with low-impact exercise like walking, biking or swimming every other day can maintain flexibility and mobility, as well as control weight
- Doing five minutes of stretches (e.g. hamstring stretches) first thing in the morning and the last thing before bed will also significantly increase mobility
- Investing in a few hour-long sessions with a physical therapist or certified athletic trainer knowledgeable about low back pain can provide adequate guidance and ideas for exercises that can be done with and without exercise equipment
Modify daily activities that stress the low back
The corollary to undertaking productive activity is stopping destructive activity, and there are many opportunities throughout the day to modify common actions that can hurt a degenerated disc, such as:
- Correcting posture and using low back support. Degenerated discs are frequently more painful when an individual is sitting, especially if he or she is slumped forward putting more pressure on the lower back. Sitting upright in an ergonomic chair that provides low back support for the natural curve in the lumbar region can prevent irritating discs. Also, hanging a small mirror near their desk can allow patients to check posture and remind them to straighten up.
- Changing position often to relieve stress and increase blood flow. Just standing and walking 10 paces every 20 or 30 minutes is enough to prevent low back stiffness from setting in.
- Lifting heavy objects correctly. This involves holding the object close to the body, engaging the large quadriceps muscles in the thighs and placing the object by pivoting the feet, not twisting the back or torso. Leaning over from the waist should be avoided.
- Finally, sleeping on a comfortable, supportive mattress can make the difference between waking up refreshed and waking up stiff and sore. There are many mattresses designed to provide support to the natural curves of the back, and patients should choose the type of mattress they feel most comfortable in to help them sleep soundly at night.
Improve nutrition to improve low back health
The health of one’s spine reflects the overall health of the body, and a healthy diet plays a role in moderating the low back pain of degenerative disc disease. Specifically, intervertebral discs benefit from hydration and oxygenation. Patients can achieve both with small changes:
- Hydration can be improved by sipping water throughout the day, especially during and after exercise, as well as eliminating or reducing use of caffeinated drinks such as coffee, some teas, and soda
- Alcohol use should be minimized. Alcohol not only decreases hydration, it is a depressant. Using alcohol to self-medicate and numb pain can start a cycle of unhealthy actions, interfering with everything from sleep quality, the ability to make healthy food choices, and the motivation to exercise.
- Smoking should be curtailed because it interferes with nutrition for the spinal discs by preventing good oxygen flow.
Although the term degenerative disc disease sounds fearsome, for most people the low back pain and other symptoms from lumbar degenerative disc disease can be managed quite effectively with self-care By making a concerted effort at managing the pain, most patients will find that they can keep the pain to a tolerable level and continue to enjoy their favorite activities without having to undergo major surgery.
