Degenerative disc disease is a common condition that affects many people, but not everyone experiences symptoms or pain.
In this article, we’ll explore what degenerative disc disease is, why some cases can cause pain, benefits of massage for back pain, and how you can take preventive measures to maintain good spinal health.
What is Degenerative Disc Disease?
Degenerative disc disease refers to the natural wear and tear of spinal discs, which are the cushion-like structures between the vertebrae (bones) in the spine.
According to studies, about 37% of people in their 20s have some degree of degenerative disc disease, and by the time they reach their 80s, this number rises to 96%.
It’s important to note that not everyone with degenerative disc disease experiences symptoms or pain.
Massage Therapy as a Complementary Treatment
While massage therapy cannot reverse or halt the progression of degenerative disc disease, it can help manage symptoms and improve overall well-being. Some benefits of massage therapy for individuals with Degenerative Disc Disease include:
- Pain relief: Massage can help alleviate muscle tension and spasms associated with DDD, providing short-term pain relief.
- Improved circulation: Massage promotes increased blood flow, delivering oxygen and nutrients to affected areas while promoting the removal of waste products and inflammation.
- Increased flexibility and range of motion: By targeting surrounding muscles and connective tissue, massage can help improve mobility in the spine and reduce stiffness.
- Stress reduction: Massage can promote relaxation and reduce stress levels, which may contribute to overall pain management.
Understanding Spinal Anatomy and Disc Degeneration
To better understand degenerative disc disease, let’s first look at the normal structure of the spine. The vertebrae are the white bones, and in between them are the tan-colored discs. In a healthy spine, the discs are thick and plump, providing adequate spacing for the nerves that exit the spine.
A spinal disc can be likened to a jelly donut, with a firm outer ring and a soft, jelly-like material in the center. When pressure is applied to a disc, it can bulge or compress, leading to changes in its shape.
Over time, the wear and tear on the discs can cause them to flatten, narrowing the space between vertebrae. This is known as degenerative disc disease. If the hole on the side, called the foramen, where nerves exit the spine, becomes smaller, it can cause pain or other symptoms, such as numbness or tingling.
Stages of Degenerative Disc Disease
There are several stages of degenerative disc disease:
- Healthy Spine: In a healthy spine, the discs are thick, plump, and well-spaced, allowing the nerves to exit without any issues.
- Early Degeneration: The first stage of degeneration is characterized by a decrease in disc height, which can lead to a smaller foramen and potential nerve irritation.
- Advanced Degeneration: In this stage, there is a significant loss of disc height, jagged bone edges, and the development of osteophytes or bone spurs. This is known as degenerative joint disease and typically occurs alongside degenerative disc disease.
Preventing and Managing Degenerative Disc Disease
The most common treatments recommended for degenerative disc disease include pain medications, injections, and in some cases, surgery. However, surgeries carry risks, such as infections and the possibility of not resolving the issue. Other recommendations include weight loss, especially for those who are overweight.
While degenerative disc and joint diseases are natural occurrences that come with aging, there are ways to slow their progression and manage any symptoms that may arise.
Manual Therapy for Back Pain – Degenerative Disc Disease
- Pillow Positioning
A simple and effective modification for clients with low back pain is to provide a pillow for their lower abdomen when lying face down. This offers support and maintains the natural curvature of their back, reducing the likelihood of discomfort or spasm upon standing.
- Think Hips and Pelvis, Not Just Lumbar Region
When addressing low back pain, it is essential to focus on the hips and pelvis rather than only the lumbar region. By extending massage techniques into the posterior and lateral pelvis, you can provide more comprehensive relief to clients experiencing low back pain.
- Broad Techniques for Quadratus Lumborum (QL)
When working with the QL, avoid hyper-focusing on trigger points or direct pressure in the first session. Instead, use broader techniques such as soft fists that conform to the shape of the lumbar region, and tractioning the tissue away from the spine. This reduces the risk of soreness or stiffness following the massage.
- Work with Related Structures
Massage therapists should address related structures such as the lateral pelvis, gluteus medius, and minimus when treating low back pain. By doing so, clients may feel a reduction in pain or referral to other locations in their low back or near the sacroiliac (SI) joint.
- Addressing Hamstrings and Quadriceps
Take the time to work with the hamstrings and quadriceps, as tension in these muscles can affect the hips and low back. Long, slow compressions can have a positive impact on these areas, especially when working from both the top down and leg up.
- Bolster Support for Supine Position
When a client is in a supine position, use a large bolster under their knees to alleviate pressure on the low back. This allows for a more comfortable experience and can prevent discomfort during the massage.
Remember that massage therapy is most effective when combined with other forms of care and lifestyle adjustments.
Precautions and Best Practices
Before seeking massage therapy for Degenerative Disc Disease, consult with a healthcare professional to determine if it is appropriate for your condition.
Keep the following precautions and best practices in mind:
- Choose a qualified therapist: Work with a licensed massage therapist who has experience in treating clients with DDD or similar conditions.
- Communicate openly: Discuss your symptoms, limitations, and expectations with your therapist to ensure a safe and effective treatment plan.
- Avoid direct pressure on the spine: Massage techniques should focus on the surrounding muscles and soft tissue, rather than applying direct pressure to the spine or affected discs.
- Consider a gentle approach: Deep tissue massage may not be appropriate for individuals with DDD. Instead, opt for gentler techniques such as Swedish massage, myofascial release, or craniosacral therapy.
- Combine with other treatments: Massage therapy is most effective when used in conjunction with other treatments, such as physical therapy, medication, and lifestyle changes.
Diagnostic Findings
Individuals diagnosed with degenerative disc disease through X-rays or MRIs may have decreased disc height, bone spurs, disc herniations, and stenosis (narrowing of spaces for nerves to travel through the spine).
They may also experience arthritis or facet arthropathy, indicating joint disease in the facets of the spine.
Signs and Symptoms
Degenerative disc disease usually affects people in their later years, as it involves an accumulation of problems such as arthritis, bone spurs, disc problems, shrinking disc height, and pinched nerves.
The condition develops gradually over time, leading to back pain and stiffness, particularly upon waking up.
Pain and stiffness may last anywhere from 20 minutes to an hour before the person starts feeling better. Other symptoms include pain when lifting heavy objects, carrying things for extended periods, or standing for long durations.
As the condition worsens, flare-ups can last longer, and affected individuals may experience losses of balance. This occurs when the nerves in the lower back, responsible for supplying muscles and balance systems in the legs, become affected over time.
Conclusion
Massage therapy can be a valuable complementary treatment for individuals with Degenerative Disc Disease. By alleviating pain, improving circulation, and increasing flexibility, massage may improve the quality of life for those living with this condition.
Degenerative Disc Disease can be a challenging condition to live with, but it is possible to improve your symptoms and overall quality of life through natural treatment options.
By understanding the signs, symptoms, and causes of DDD and working with a specialist physical therapist, you can develop a treatment plan that addresses the root causes of your pain and helps you regain your mobility and independence.
Diene Oliveira Cruz
Physiotherapist, with specialization in Orthopedics and Traumatology by Santa Casa de São Paulo. Pain and Rehabilitation Specialist.