Unlike the muscles in the back, the discs of the lumbar spine do not have a natural blood supply and therefore cannot heal themselves; the painful symptoms of DDD can therefore become chronic.
Degenerative disc disease (DDD) tends to be linked to the ageing process and refers to a syndrome in which a painful disc can cause associated chronic lower back pain, which can radiate to the hip region.
The condition generally occurs as a consequence of some form of injury to the lower back and the associated structures, such as the intervertebral discs. A sustained injury can cause an inflammatory process and subsequent weakness of the outer substance of the disc (annulus brosus), which will then have a pronounced effect on the inner nucleus pulposus.
This reactive mechanism will create excessive movement because the disc can no longer control the motion of the vertebral bodies that are located above and below the disc. This excessive movement, combined with the natural inflammatory response, will produce chemicals that will irritate the local area, which will commonly produce symptoms of chronic lower back pain.
Degenerative Disc Disease - Trigger Point Therapy Protocols are often used effectively to treat the pain
Chronic Lower Back Pain
DDD has been shown to cause an increase in the number of clusters of chondrocytes (cells that form the cartilaginous matrix and consist mainly of collagen) in the annulus brosus (consisting of brocartilage).
Over a prolonged period of time the inner gelatinous nucleus pulposus can change to brocartilage, and it has been shown that the outer annulus can become damaged in areas that allow some of the nucleus material to herniate through, causing the disc to shrink and eventually leading to the formation of bony spurs called osteophytes.
Unlike the muscles in the back, the discs of the lumbar spine do not have a natural blood supply and therefore cannot heal themselves; the painful symptoms of DDD can therefore become chronic, eventually leading to further problems, such as discal herniation, facet joint pain, nerve root compression, spondylolysis, and spinal stenosis.
Myofascial Pain and Trigger Point Therapy
Pain is often caused by myofascial tightness within the fascial system (the web of connective tissue that spreads throughout the body and surrounds every muscle, bone, nerve blood vessel, and organ to the cellular level). Diagnosis is typically more difficult, as fascia restrictions do not show up on MRI scans or X-rays. Yet, those restrictions can play a significant role in creating pain and malfunction in the structure of the spine, extremities and organs.
DDD is commonly associated with trigger point activity and there are a number of well established trigger point treatment protocols that your therapist may be able to apply to help manage the symptoms.
Trigger point treatment protocols will typically include deep stroking massage and compression techniques applied to trigger points, combined with prescribed stretching and strengthening exercises.
About the author
John Gibbons is a qualified and registered osteopath with the General Osteopathic Council, specialising in the assessment, treatment, and rehabilitation of sport-related injuries. Having lectured in the field of sports medicine and physical therapy for over 12 years, John delivers advanced therapy training to qualified professionals within a variety of sports.
This trigger point blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell.
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