Pain That Wakes Us Up At Night

Welcome to the Stay Healthy El Paso Podcast. My name is Dr. David Middaugh, I'm a specialist physical therapist over at El Paso Manual Physical Therapy, and today we're going to be talking about degenerative disc disease and what to do about it.

The reality is that most people don't really know what it is or what it means. And a lot of people in the medical field don't even really know what it is and what it means either. They just know how to diagnose it and help patients that they have it. They will often do an MRI or an X-ray, or some other imaging study, and tell patients that they have degenerative disc disease. Or otherwise known as DDD for short.

Aside from medications and surgery, there isn't a whole lot of other treatment for this. But the good news is that we have a lot of great help that we can give patients that is natural, and they can really have long lasting benefits for the patient, and definite benefits as long as they can keep up a few things.

I'm going to tell you exactly what it's about and what to do about it through this podcast today.

The cool thing about this problem is that it can get better naturally, without having to rely on medications, injections, or surgery. And we help people do this all the time.

Now, there are a lot of facets to a degenerative disc disease problem. It's kind of an accumulation of several different little causes that all come together to form degenerative disc disease. I'm going to go through all that with you, so that you can have a better understanding of what it is and what to do about it.

First off, let me tell you about the signs and symptoms of this. That way you can see if this is what you have or not. And most people with a degenerative disc disease are 50 and up. It tends to affect people later in life. And it's a combination of arthritis, bone spurs, disc problems, shrinking disc height, and pinched nerves all coming together at the same time.

Now the process of accumulating all these problems happens gradually over time. So it's not like it all happens all of a sudden, it's slowly over years and that's why this tends to affect people later in life.

One of the biggest complaints of this is back pain, stiffness, especially in the morning when waking up, they have stiffness when getting up and moving around. It commonly takes people 20 minutes, 30 minutes, sometimes even up to 60 minutes to free the back up and get to a working place, where it's not that bad, and they can move around.

Oftentimes, the back pain gets worse whenever they're lifting something heavy or carrying something for a long period of time. Even just standing for long periods of time can affect the problem and make it worse. Many times, people with degenerative disc disease get the sensation of their back gives out, or they just all of a sudden get a bunch of back pain and are kind of out of commission for at least a few hours, sometimes as long as a few days. In worst cases, it can take weeks or even months to get better from a flare up like that.

They would have overdone it somehow, typically they would have walked too much, or stood too much or picked up some heavy stuff. Oftentimes when we get patients here in the clinic, they're doing housework and they just overdid it. Or they went on a trip and were on their feet too much. And when they returned from their trip, or finished with their housework, their yard work, then they paid for it as well. They often say I knew I was going to do all that stuff and would have to pay for it the next day.

But as the degenerative disc disease gets worse, the length of time of the flare ups tends to get longer and longer and longer. Usually when they are in their 50s, they say, “Well, you know what I can deal with the flare up that lasts just a day or two, I take some pain medication, and I'm good. I can get on with my life. There's always that low level of back pain, but nothing that stops me from being able to work and take care of my home and my family and do everything that I need to do.“

But as the years go by, it worsens and worsens and what was a one or two day flare up, now turns into a five to seven day flare up, and they are out for a while, they are moving a lot less. They're usually getting less healthy on other fronts, because they can't exercise as much as they like to, they can't walk as much as they like to. They're just not as active as they were in younger years. Because the back pain is just debilitating them slowly over time.

And if it's bad enough and goes on long enough, people often experience losses of balance, they begin to feel like they need to hold on to walls to walk around or furniture people, they need to have a hold of somebody's arm, just to make sure that their balance is okay. And this tends to happen because if the problem goes on long enough, it can begin to affect the nerves that come out of the low back, that go into the legs and provide the nerve supply to the muscles of the legs.

It also helps with the balance systems within the legs. So if that begins to get affected over time, then you start to have some balance issues and that sets you up for some other potential problems, falls, fractures, those kinds of things. The people that go get x rays or MRIs, or other imaging studies are often told that they have decreased disc height. The discs that are between the bones of the spine are shorter than they should be. They also find bone spurs on the vertebrae on the bones in the spine. And they'll often find disc herniations as well.

There are parts of the disc that might be bulging out. And oftentimes there might be stenosis, as well as. Stenosis is where there's a narrowing of the spaces for the nerves to travel through the spine. And sometimes they'll say that they've got a pinched nerve sensation. And sometimes off the imaging, they'll tell the patient that they've got a pinched nerve in an area of the spine, and the patients often feel it, they'll feel that back pain or that radiating pain.

Oftentimes, it can feel like sciatica, where there's pain going down the leg from the back. In rare cases, there isn't much back pain, maybe a low level of it, but the pain going down into the legs is much more severe and stops people from being able to do what they want to do. But when they do the imaging studies on their lower back, they'll find that they've got this degenerative disc disease like we're talking about.

Some other findings that will be on the imaging will be arthritis, osteoarthritis, and then they'll talk about facettes arthropathy which just means the facettes, so arth arthropathy. arth means joint, pathi means disease. So there's some joint disease in the facettes. It's usually arthritis that they're talking about.

If you have had an X-ray or an MRI that talks about all this stuff that I'm discussing, it can be overwhelming, and you hear all these big medical terms. I wouldn't get too concerned about it. It's just a lot of medical jargon. The reality is we've had people in here that have some terrible looking MRIs and x rays, and through our treatments here as specialist, we can actually get them to balance better, to walk better, to have less back pain and be able to live a life without constantly worrying or thinking or stopping or adjusting their schedule to their back problem.

We help people do that all the time, even with severe degenerative disc disease, that the most common treatments. People with degenerative disc disease get recommended is of course pain medications. They will start some sort of oral pain medication. They might also do injections where they stick pain medication into the spine using a needle. And then in some cases, doctors might recommend surgery to open up the holes for nerves and put space in more discs they can replace discs now these days.

They look to do that, and the surgery is dependent on age and strength and other health factors that that the surgeons have to take into consideration. But what you have to realize with surgery is, once they go in and do that, they can't really undo it and there's risks with surgeries, infection, the surgery not even working oftentimes with degenerative disc disease. There are so many components to this.

Like I described that when a surgeon goes in there fixing one of those components, usually maybe two, if they can wing it, but to fix arthritis, the disc problem the pinched nerve, the stenosis, all these issues that I talked about, it's really challenging to fix with surgery.

The other recommendations that are out there are weight loss sometimes. If the individual with a disc problem is a little bigger and could stand to lose some weight that can help. Oftentimes, it does help to some degree. But what needs to be addressed even in people that are heavier is the strength. Because we get people in here all the time that are not obese or not heavy, they really don't need to lose any weight, but they're still dealing with a degenerative disc problem.

And what we find the root is oftentimes is a muscle imbalance, the way that they're moving, some strength issue, some joint that is stuck, some muscles that are stuck as well. And that's something that needs to be checked hands on in the clinic, and talked about with the patient, and a plan needs to be formed so that we can have a process to fix this degenerative disc problem gradually over time, for the long term.

That's exactly what we do here at El Paso Manual Physical Therapy.

Thanks for listening to this podcast, I hope that it was helpful for you. If you'd like to learn more about how we might help you in your back problem, you can visit our website at www.EPmanualPT.com or you can just google El Paso Manual Physical Therapy, that tends to work pretty well as well.

You'll find more helpful videos in our blog, or you can look into the podcast. We have tons of videos on YouTube as well, just hit subscribe to our YouTube channel, you can follow us on Facebook.

And if you want to get direct help, if you're interested in hiring us, and you're in the El Paso area, and you want us to take a look at you and see if it's possible for us to help you directly, then give us a call at 915-503-1314 so that we might begin to help you out. Thanks, and have a wonderful day. Thanks for listening to the stay healthier pestle podcast. Bye.

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