Conditions Related to Degenerative Disc Disease

Around 5 million Canadians seek care from a chiropractor each year which is about 12% of the population. It always amazes Dr. Horowitz so many people have never experienced the amazing relief and benefits of chiropractic care. Dr. Horowitz believes this has to do with people not realizing:

• How important preventive spinal care
• You only have one spine, that will degenerate with age
• There are preventive measures you can take so slow down the degenerative process and to reduce episodes of back pain
• The safety of chiropractic manual manipulation, even when performed in the neck
• Injuries to the spine may feel better in time, but often leave deficits behind, such as reduced segmental spinal motion, postural changes that become permanent and muscle spasms

Every person’s spine will degenerate over their lifetime and 80% of people experience at least one episode of low back pain.

In some people, the amount of spine degeneration is mild and in others, it is severe.

As the spine degenerates, the spine becomes more disorganized in appearance and function. As a result, you may develop one or more than one spinal disease at the same time.

Chronic pain, nerve and muscle damage may result.

Sciatica

Sciatica is a type of radicular pain that is sharp, electric and shooting that travels into the leg.  

The term sciatica is usually used when it is caused by a disc that has herniated or bulged out of place. The disc material and accompanying inflammation compresses and irritates a nearby nerve.

The term sciatic radiculopathy refers to when the pain is accompanied by progressive numbness, tingling, leg weakness, reduced deep tendon reflexes as well as reduced muscle mass.

If you are older than 60 years of age and experiencing sciatic pain, it is likely due to pressure and inflammation on nerves due to degenerative changes in the spine, rather than from a disc herniation. This is because discs become dehydrated as we age and they do not herniate the way they can in younger people.

Disc Herniation

Disc herniations usually occur following a sudden trauma and in people under 60 years of age.  Early degenerative changes in the spine make lumbar disc herniations occur more easily and most commonly occur at L4-5 or L5-S1 in the low back. This can occur if you place high contact or competitive sports, have been in a motor vehicle accident or have experienced a significant fall or injury earlier on in life.

Spinal Segmental Restrictions

Chiropractors specialize in examining the spine and using their hands to feel for areas where the spine has lost it’s normal segmental motion. These areas of restriction cause pain, reduced motion and altered posture. Spinal restrictions likely occur in the beginning stages of spinal degeneration, which is why it is so important to have your spine checked on a yearly bases.

While research and long-term studies are lacking on spinal manipulation for degenerative disc disease and spinal arthritis, Dr. Horowitz and other manual practitioners believe that it is possible to slow down the degenerative process with Chiropractic care.

Spondylolisthesis: As spinal degeneration advances, a vertebra can become hypermobile (too much movement) and even move out of place.

A vertebral bone can move forward (anterolisthesis) or backwards (retrolisthesis).  As a result, the spaces and pathways (foramen and lateral recesses) where the nerves exit from the spine is reduced, which affects nerve signals that travel to organs and muscles.  This is called stenosis.

It is not possible to predict the degree of degeneration (mild moderate and severe) and how quickly your spine will degenerate.

Signs and Symptoms of Segmental Restriction, Instability and Degeneration

• You may feel a sensation that part of your spine is unstable or on the verge of giving way
• Severe, radiating pain, numbness or weakness in your arms/legs
• Your balance may become affected which places you at higher risk of falling

In rare cases, retrolisthesis that is moderate to severe and unstable can lead to a medical emergency.

Seek emergency care if you experience:

• Loss of bowel or bladder control (retaining urine or incontinence)
• Numbness in your inner thighs, anal area or groin
• Severe back or leg pain
• Leg weakness that is sudden and profound

Lumbar Spinal Stenosis – Neurogenic Claudication

Lumbar spinal stenosis involves the narrowing of the central spinal canal, which may compress the spinal cord and nerves.

Neurogenic claudication is the compression or irritation of spinal nerves due to lumbar spinal stenosis.  Sitting, lying down, bending forward, and walking uphill relieves the leg pain and foot pulses are normal.

If you develop lumbar spinal stenosis before age 50, it is usually due to being born with a congenital anomaly such as short pedicles. Rarely, a middle-aged person can experience both lumbar spinal stenosis and a disc herniation simultaneously.

More commonly, lumbar spinal stenosis develops in the later stages of spinal degenerative. Ligaments deep within the spine may thicken and enlarged bone structures reduce the space within the spinal canal.

This is different than vascular claudication, which is a peripheral artery disease where blood flow is reduced when walking or climbing stairs and your foot pulses are reduced. Vascular claudication can occur in if you smoke, are diabetic, or if you have heart disease or high cholesterol.