Degenerative Disc Disease

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DEGENERATIVE DISC DISEASE AND BACK PAIN
Ross Hauser, M.D.
Many patients are distressed at being told that they are suffering from one or more degenerated discs. This suggests an irreversible and crippling phenomenon. The term "degenerated" should be discarded because disc degeneration is universal as age advances, and often causes no symptoms. There must be other structures in the back that are causing the symptoms. The structures causing back pain are most often the ligaments.

The low back is composed of muscles and ligaments. The posture is held erect by four particular sets of muscles. These muscles include the abdominal muscles, the back extensor muscles, and a set of paraspinal muscles that lie to the side of the vertebra. There are also important muscles that control hip, leg, and pelvic motion. The most important of these is the iliopsoas muscle. These muscles have a significant influence on the function of the back. The supraspinatus and interspinatus ligaments go from vertebra to vertebra. There are also strong ligaments that go from the vertebrae to the ilium (iliolumbar ligaments), along with the ilium to sacrum (the sacroiliac ligaments).

Cumulative trauma either by sports participation or heavy labor vocations over the course of years can result in small tears of these ligaments. One major trauma or injury can also be of such severity that healing never occurred. Since the ligaments do not heal, the intervertebral discs do not have the support that they need. This is why there is such a high degree of degenerative disc disease in the lower back, which is essentially 100 percent by age 46. Degenerative discs are the result of Ligament laxity or instability in the lumbar vertebral segments. The instability and ligament laxity cause the chronic low back pain and send athletes by the droves to Chiropractors. Manipulation is helpful to realign the vertebrae, but does nothing to regenerate the damaged ligament. Prolotherapy must be given to repair the ligament tissue to allow the vertebrae to stay in place permanently.

Prolotherapy is the treatment of choice for treating low back pain. Injections are typically given into the ligaments connecting the vertebra, along with injections into the ligaments between the ilium and sacrum. This helps to tighten the connections between the pelvis and lumbar spine and assists the muscles in providing stability to the back. It is amazing how many people end up avoiding surgery once they have Prolotherapy because Prolotherapy gets rid of the pain and stabilizes the back. Unfortunately, back surgery usually causes the muscles and ligaments to become even weaker. A surgery that was supposed to strengthen the area actually ends up weakening it to the point that the non-surgerized back is stronger than the back that was surgically repaired.

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