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You are here: Home » Physical Therapy » What is Degenerative Disc Disease?

What is Degenerative Disc Disease?

By Mike Uhrlaub

Hey everybody, this is Mike Uhrlaub with Power Your Life.  I wanted to talk to you about degenerative disc disease. This is something I get a lot of questions about because we see it all the time in the clinic. This is such a common problem that most of us have and don’t know. It can affect us at any point in our life. In previous episodes we talked about herniated discs, sacroiliac joint problems, and spinal arthritis. Degenerative disc disease is just another part of wearing out the cartilage discs between the vertebrae. What tends to happen with degenerative disc disease, is the disc will start to lose its hydration, thus becoming dehydrated, and starts to collapse down becoming narrow.

Spine with discs and psoas muscle I like to think of vertebrae as Coke cans; One stacked on top of the other, and then you have a soft cartilage pad in between them. The soft cartilage pad’s job is to maintain the spacing of those vertebrae. By doing so, the little nerve roots coming off of the side and going down your leg has enough room for everything. Cartilage is not picked up on an x-ray because x-ray’s only show bone. When you have an x-ray of your spine, you’ll see gaps between each of your vertebrae. Now, there’s no such thing as an empty gap in the human body. There’s always something there. The gaps shown on your x-ray is the cartilage. If the doctor sees the spacing between your vertebrae has narrowed at a certain level, then he knows your disc is wearing out and you’re being faced with degenerative disc disease.

No Nerves Mean No Feeling

These discs in between your vertebrae do not have any nerves. They have very low blood supply and are what we call aneural, meaning without a nerve. Since there aren’t nerves going to this disc, you can’t feel it. If you go to your chiropractor or a physical therapist and they try treating your discs, its not going to do any good. You can’t fix these discs because you can’t feel anything.

The Disc Itself is Not the Cause of the Pain

The problem is all of the muscle attachments around the spine. The psoas, part of the hip flexor, creates a pole directly on your spine. This combines with the iliac and goes down to your femur. When you have a muscle spasm, it creates a forward tilt of your pelvis creating more extension and compression on the spine. We call this an anterior pelvic tilt. Its as if somebody was to grab ahold of your spine and pull forward, tipping your pelvis down. Imagine being like that 24/7, all the time. No wonder the compression and squeezing pushes all of the fluid out of the disc, they can never get any rest. Without staying hydrated and nutritious through circulation of the fluid, the disc wears out.

The number one thing you have to fix if you want your spine to be healthy is your hip flexors. They are key, the number one thing you have to fix if you want your spine to be healthy. The cause of the pain is all of the soft tissue adaptations that have occurred. Imbalances are causing the compression and wearing out of the discs. This isn’t something that just happens overnight. It takes several years for a disc to degenerate and collapse down.

Movement is Life

Running on roadIn order for your disc to stay healthy, you have to have proper and healthy movement of the spine. A disc goes through periods where it’s compressed, but then gets distracted through healthy movement which in turn keeps your disc healthy.

You cannot have healthy movement of the spine if your psoas muscle is so spasmed and hypertonic it creates compression on the spine. This then compresses those discs. If that’s left long enough, it’s going to wear those discs out and then they’re going to collapse. That creates a weakening and shutdown of your gluteal muscles called the disappearing butt syndrome which we’ve talked about before. Your psoas is so hypertonic and active the gluteal muscles neurologically just shut down. They start to atrophy and then you start losing the ability to extend your hips and spine.

Once you lose the support to the spine, your back muscles start to tighten up. Then you get an anterior pelvic tilt. The psoas is pulling down, tipping the pelvis forward creating a pull on your lower abdominals. Those lower abdominals start to get stretched out.

A leading sign in individuals is a protruding abdomen and no gluteal development. Do an x-ray or MRI and it will show certain degrees of degenerative disc disease because of the imbalances in their system. It creates compression and the hip flexors get spams thus becoming hypertonic. The amount of sitting, repetitive bending, or doing the same movement over and over causes the muscles to start doing this.

Think of it Like This

Take your fist, squeeze super tight, and just hold it. Your knuckles go white because the blood flow is being reduced to that part of the skin. Unless you let up, the blood flow is not there. That’s what happens with hypertonic hip flexor muscles. They are beings squeezed and tightened down so much that blood flow is decreased. This then creates a chemical reaction as you get a buildup of waste products in the muscle. The muscle becomes unhealthy, clamps down even more causing more hypertonicity, which then creates more compression.

Until you start to shut off those hypertonic hip flexors, and redevelop your gluteal strength, you won’t be able to get your discs or spine healthy again.

It’s Not too Late to Be Pain Free Even When the Disc Starts to Wear

Remember, the disc does not have any nerve supply. You just have to shut down the psoas, turn on the gluteal muscles, restore balance to the entire spine and pelvic area. If you fix the imbalance and any weaknesses in these muscles, you’ll restore balance and alignment into the spine. The numbness, tingling and things leading to other kinds of issues such as sciatica will be alleviated.

Too often patients come in to see me, they are fully focused on the disc and what’s wrong with the disc. That is not the problem. The root cause of the condition is everything that’s led up to it and the imbalances.

Folks that have these issue have a hard time standing upright because they’re so tight with spasms in their hip flexors. The glute muscles are so weak their spine starts to become very painful and irritated. The back muscles become really tight and stiffens their ability to move. Now they can’t twist or rotate. This leads from degenerative disc disease onto the next step, which is often spinal arthritis or spinal stenosis.

If you want your back healthy and avoid going down the road where you’re having chronic inflammation, gluteal pain, and buttock pain that prevents you from sleeping at night; You’ve got to focus on fixing those imbalances. I can’t say that enough. I know it starts to sound a little bit like a broken record, but that’s the truth. That’s how you can correct those kinds of issues. I’ve seen it time and time again.

I’ve seen it in my own patients and with my wife’s back. She has had issues with her back for a number of years stemming from degenerative disc disease and a couple of disc herniations. Correcting the spasm hypertonic hip flexors along with building and strengthening her glutes has kept her from having to get injections and avoid surgery altogether. Those things are key.

What Can You Do?Healthy food to prevent degeneration of discs

You address the nutritional side, make sure you’re getting enough sleep, and maintain enough water to stay hydrated. All of those things are keys, but going in and really addressing those true imbalances is number one. That’s the number one secret of anything when you’re dealing with these kinds of back issues.

That’s about all I had for today. It’s so great and I am glad to be back with you guys again. I’m so passionate. I love talking about spine issues. I have a new eBook out, The Five Best Kept Secrets to Fast Back Pain Relief. There’s a lot of really good stuff in there. Things that you can put into practice right now, which will help you immediately. If you want to get a copy of that just shoot me a Facebook message, say, “Hey, I want my free back report,” or shoot me an email at mike@flex-pt.com. I’ll make sure you get that free copy.

Next time, we will be talking about sciatica, a lot of fun stuff to talk about, I can’t wait!

Until then, Power Your Life and keep moving forward.

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Filed Under: Physical Therapy Tagged With: anterior pelvic tilt, Degenerative Disc, hip flexors, imbalances, nutrition, Psoas, Spine, vertebrae

About Mike Uhrlaub

Head physical therapist and leader of Flex PT in Council Bluffs, Iowa. Mike's a unique kind of therapist that believes everyone should be treated like they are a VIP regardless of insurance or financial status.

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