Pelvic Prime's Anatomy Academy Series

Degenerative Disc Disease (DDD)

Treat DDD at Pelvic Prime in Aiken, SC. Reduce pain, restore function, and heal effectively.

Relieve Low Back Pain Naturally

Rethinking Degenerative Disc Disease (DDD): A Focus on Healing

Degenerative Disc Disease (DDD) is often misunderstood. Recent research shows that MRI findings like Modic changes and darkened discs may not indicate disease but rather reflect the body's natural healing and repair processes. This challenges the traditional belief that structural changes in the spine automatically mean permanent damage or dysfunction.

MRI scan of lumbar spine showing degenerative changes, right lateral protrusion of L4-5 disc, and L4 nerve root compression in a patient with chronic back pain

What Do MRI Findings Really Tell Us?

Modic Changes

What They Are: Changes in the bone marrow and endplate near the disc.
Old Assumption: Seen as signs of disease or inflammation.
New Understanding: Evidence suggests Modic changes may indicate the body’s efforts to heal, involving new blood vessel growth and repair mechanisms.

Darkened Discs (Low T2 Signal)

What It Means: Often linked to reduced water content in the disc.
Old Assumption: Considered evidence of ongoing degeneration.
New Perspective: May simply reflect a stable state of the disc rather than active damage.

Disc Bulging or Herniation

The Reality: Commonly found in individuals without back pain.
Key Insight: Structural changes on imaging do not always correlate with symptoms, as many people with "abnormal" MRIs have no pain.

Illustration depicting the spread and mutation of a new virus variant, contrasting the processes of disease progression and healing in the human body

What Does This Mean for Patients?

Healing vs. Disease

Many MRI findings, such as Modic changes, reflect natural repair processes, not degeneration.
Discs can stabilize through mechanisms like blood vessel growth and reduced inflammation.

Imaging vs. Symptoms

MRI results often don’t directly correlate with pain or dysfunction.
Some people with minimal imaging changes experience significant symptoms, while others with "abnormal" MRIs feel fine.

Why the Term "Disease" is Misleading

The label "degenerative disc disease" can create unnecessary fear by implying a disease process when, in reality, these changes are part of normal aging and healing.

Historical Context

The term “degenerative” was coined when disc changes were believed to always cause pain or dysfunction.
"Disease" was applied to cases with severe symptoms, even though the underlying changes were often part of the normal aging process.

Addressing Misconceptions

Healing vs. Degeneration: MRI changes often reflect adaptation and repair.
Normal Aging: Disc thinning and reduced hydration are typical with age, not signs of disease.
Pain Factors: Pain is often influenced by muscle tension, movement patterns, and stress, not just spinal structure.

A Better Approach

Using terms like "Disc-Related Back Pain" or "Symptomatic Disc Dysfunction" shifts the focus to symptoms and avoids stigmatizing normal processes.

Young male doctor with a concerned expression, using fear tactics to convince patients with low back pain about the necessity of surgery.

How Physical Therapy Supports Healing

Physical therapy helps patients focus on functional improvement rather than worrying about imaging findings. Treatment strategies include:

Strengthening: Builds core and spinal stability to support the discs.
Movement Training: Improves posture and reduces unnecessary strain on the spine.
Lifestyle Changes: Encourages habits that reduce inflammation and support long-term spinal health.

Physical Therapy Exercises for DDD

Here are a few gentle exercises to improve strength, mobility, and posture:

Pelvic Tilts

Purpose: Strengthen core muscles and improve spinal mobility.
How to Perform:
1. Lie on your back with your knees bent and feet flat on the floor.
2. Gently tilt your pelvis backward, pressing your lower back into the floor.
3. Hold for 5 seconds, then release.
4. Repeat 10-15 times.

Illustration of pelvic tilt exercises designed to relieve back pain, demonstrating proper technique for improving posture and core stability

Cat-Cow Stretch

Purpose: Improve spinal flexibility and relieve tension.
How to Perform:
1. Start on your hands and knees in a tabletop position.
2. Arch your back, tucking your chin to your chest (Cat).
3. Drop your belly and lift your head and tailbone (Cow).
4. Move slowly between positions for 10-15 repetitions.

Bird Dog

Purpose: Build core and spinal stability.
How to Perform:
1. Start on your hands and knees.
2. Extend your right arm and left leg simultaneously, keeping your back flat.
3. Hold for 5 seconds, then return to the starting position.
4. Alternate sides for 10 repetitions per side.

Bridges

Purpose: Strengthen glutes and support the lower back.
How to Perform:
1. Lie on your back with knees bent and feet flat on the floor.
2. Press through your heels to lift your hips off the ground.
3. Hold for 5 seconds, then lower back down slowly.
4. Perform 10-15 repetitions.

Instructional handout demonstrating the glute bridge exercise to strengthen glutes and improve core stability.

Child’s Pose

Purpose: Stretch the lower back and hips.
How to Perform:
1. Start on your hands and knees.
2. Sit your hips back toward your heels and stretch your arms forward.
3. Hold for 20-30 seconds and breathe deeply.
4. Repeat 2-3 times.

Empowering Your Recovery

Your spine is resilient, and your body is capable of healing. Through targeted physical therapy exercises, you can reduce pain, regain function, and feel confident in your recovery—regardless of what an MRI might show!

Why Pelvic Prime Can Help

At Pelvic Prime, we specialize in evidence-based treatments to help you manage and overcome the challenges of degenerative disc disease (DDD) and low back pain. Our approach is tailored to your unique needs, combining the latest research with proven physical therapy techniques to promote healing and restore function.

Personalized Care: We create customized plans to address your specific symptoms and goals.
Evidence-Based Practices: From targeted exercises to postural training, every treatment is grounded in research to ensure the best outcomes.
Holistic Support: We go beyond exercises, offering education and lifestyle guidance to empower you in your recovery journey.
Skilled Expertise: Our team has extensive experience in managing conditions like DDD, helping patients achieve lasting relief and improved quality of life.

With our comprehensive, compassionate care, you can feel confident that your recovery is in good hands. At Pelvic Prime, we don’t just treat symptoms—we support your body’s natural ability to heal, so you can get back to doing what you love.

Start your journey to recovery with Pelvic Prime today!