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Degenerative
changes in the spine are often referred to those that cause
the loss of normal structure and/or function. The intervertebral
disc is one structure prone to the degenerative changes
associated with wear and tear aging, even misuse (e.g. smoking).
Long
before Degenerative Disc Disease can be seen radiographically,
biochemical and histological (structural) changes occur.
Some of these changes are not unlike those associated with
osteoarthritis.
Over
time the collagen structure of the annulus fibrosus weakens
and may become structurally unsound. Additionally, the water
content decreases. These changes are linked and may lead
to the disc’s inability to handle mechanical stress. Also,
since the lumbar spine carries a large portion of the body’s
weight; the stress from motion may result in disc degeneration.
Non-Operative
Treatment: Yesterday vs. Today:
It
is interesting to note that although 80% of adults will
experience back pain, only 1-2% will need lumbar spine surgery!
In the past some physicians prescribed long courses of bed
rest and/or lumbar traction for their patients with low
back pain. However, that is not the attitude today. During
the acute phase, bed rest may be recommended for a few days,
but beyond that experts like Dr. Cady advocate stretching,
flexion and extension exercises, and low impact exercise.
Of course, each patient is different and so is their treatment
plan.
Therapeutic
Exercise:
In
some patients, the pain response may limit their flexibility.
Prescribed stretching exercises can improve flexibility
of the trunk muscles. Flexion exercises may help to decrease
inflammation in the intervertebral foramen, which improves
the pain. The intervertebral foramen are small canals through
which the nerve roots exit the spinal cord. The intervertebral
foramen are located on the left and right sides of the spinal
column.
Extension
exercises, such as McKenzie exercises, focuses on the muscles
and ligaments. These exercises help maintain the spine’s
natural lordotic curve, important to spinal health.
Aerobic
exercises offer many benefits including improved muscular
endurance, coordination, strength, strong abdominal muscles,
and weight loss. Strong abdominal muscles work like a brace
(or corset) to reduce the load to the lumbar spine. It is
also known that proper exercise helps to combat anxiety
and depression. The load on the discs during walking is
only slightly greater than when lying down. Using an elliptical
trainer, walking, and swimming are forms of aerobic exercise
which Dr. Cady may suggest.
Acupuncture:
Acupuncture,
a type of alternative medicine, has been shown to control
pain. It has been suggested that acupuncture stimulates
the production of endorphins, acetylcholine, and serotonin.
However, acupuncture should be combined with an exercise
program for many of the reasons outlined in prior paragraphs.
Dr. Karen Li has worked closely on cases with Dr. Cady for
the past 10 years.
Manipulation:
Today
manipulation is performed by Chiropractors such as Dr. Cady.
Manipulation is believed to be effective because of its
effect on spinal mobility. Acute low back pain, chronic
low back pain, and Degenerative Disc Disease (DDD) may respond
to manipulation.
Call
us today at 408-739-2273 to make an appointment.
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