Degenerative Disk Disease
Dr. Marc Darrow, M.D.

The aging process brings about degenerative changes to our ligaments, tendons, and cartilage through the desiccation (the drying out) of collagen. Degenerative Disc Disease (DDD) refers to this process occurring in the vertebral discs. It just so happens that the vertebral discs suffers through the most dramatic of age-related changes of all connective tissue related to this process. In DDD, the discs will shrink and collapse bringing the vertebrae closer together and causing greater risk of disc herniation and assorted pain problems.

The typical treatment for Degenerative Disc Disease is heat, rest, physical therapy, and of course, medications—pain relievers and anti-inflammatories. These treatments can not solve the problem of ligament laxity as we have seen Prolotherapy do. Injections to the ligament area, can help restore, tighten, and thicken the ligaments that will stabilize the spine in Degenerative Disc Disease.

The Problem With The Diagnosis
We typically have patients come into our office with big stacks of MRIs, CT Scans and x-rays to confirm the label of Degenerative Disc Disease placed on them by other medical professionals. For example, a woman once came into our office. She had in essence become the living, breathing “embodiment,” of the problem that showed up on her film. When she came in, all she could do was talk about her degenerative disc disease at the L-5, S-1 discs.

This woman had pain in her groin and her back. When we told her we were going to examine her to determine if this was indeed her problem, she had a lot of difficulty comprehending that her pain may not come from her Degenerative Disc Disease at L-5, S-1 because she had already been diagnosed as needing surgery on these two discs. There have been many studies and papers written on the accuracy or correctness of diagnosis based on an MRI reading.

We know from studies that half the people after a certain age show disc problems on film but they reported they had no pain.

So if someone has a diagnosis from an MRI the first thing we do is see if that is REALLY where the pain is coming from. To practice good medicine you need to rely on MRI and X-Rays and scans but you also need to use your hands to find out where the pain is coming from, being careful to gently press on the suspect area causing pain. When the physician's touch elicits an intense pain spot, known as a trigger point or tender point, then we know this is the spot (to do Prolotherapy).

Disc Herniation
As Degenerative Disc Disease progresses, the pressure exerted on the discs by the squeezing together of the vertebrae can cause the disc's inner fluid the "nucleus pulposis" to bulge (or herniate) out and through the disc’s outer layer (the annulus fibrosus) and press down on the nerve.

It is estimated that nearly 90% of disc herniations occur in the lower back and in connection with the L5-vertabrae, either between L4 and L5, or, L5 and S1.
 

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