As many of you know, I was diagnosed with degenerative disc disease (DDD) in 2017. (See that post here.) The disc that is degenerating (drying up and shrinking) is one of the most common to degenerate – between lumbar spine #5 (L5) and sacral spine #1 (S1). This shrinking of the disc is causing me lower back pain that’s aggravated by bending, lifting, and most general movements I make.
For me, every day brings a different level of pain. Some days are better than others, but even on a great day, there is always some discomfort in my lower back.
Since it had been three years since my first diagnosis, I figured it was time to go back to an orthopedic doctor (who specializes in the spine) and see how my DDD is fairing. This time, I tried a new doctor since the first one, who diagnosed me with DDD, basically left me, without addressing any questions and concerns.
After a few x-rays, this new doctor compared my old images with the new and stated that my DDD has remained the same. I was actually worried that it was worse, as my pain is more frequent now.
However, this orthopedic doctor actually explained to me what exactly is causing all of the pain in my back. This is the new information I wanted to share with you.
The last few bones of the lumbar spine (L4-L5) have the extraordinary task of keeping our upper half mobile, as well as supporting everything above it. This is why it’s very common to have an injury or degenerative disc in this area. L5 is the largest vertebra in the spine and has great range of motion. Add to this the extreme weight-bearing on this bone, and it’s obvious why the discs in-between the vertebrae may shrink and facet (spinal) joints wear down over time. Here’s how that happens:
For all people, every night during sleep, fluid fills the middle of the spinal discs and the during the day, body movements push the fluid out. It’s natural for these cushioning discs to lose fluid over time, causing shrinkage as we age. This is why most older people (60 years +) have some form of degeneration in their spine, although it may not cause any pain.
As these discs degenerate and shrink, the vertebrae get shoved closer together and get irritated. In addition, the facet joints of the vertebral bones are affected. This is where we feel the pain. The pain is coming from the worn and damaged cartilage of the joint, poor joint alignment, and the inflammation of these facet joints in the spine. Bone spurs commonly occur on the vertebrae with shrinking discs; these bony growths can irritate nerves and possibly cause inflammation of the facet joints, muscles, and ligaments of the spine. This is our source of pain. See the photos below.
As you can see in the photos above, the back of each vertebrae contains facet joints. These facet joints are on the top and bottom of each vertebrae and only allow gliding movements of flexion and extension and limit the spine’s rotation. (wikipedia.org) When a disc shrinks, it isn’t able to provide the cushioning and stability to the spine that it’s supposed to. The shrinkage also pushes the facet joints closer together which can limit movement and increase stress on the spinal column.
Just as your knee joint works in only one direction and limits side to side movement, the facet joints of the spine work in the same way. As you age, the cushioning cartilage discs of the spine get thinner and degenerate, which leads to the joints to be pushed closer together. This can eventually result in inflammation, irritation, and can lead to bone-on-bone grinding within the joint. Ouch!
So the pain that we experience with degenerative disc disease is not from the disc itself, but rather the joints behind it. As with most things in the body, there is often a domino effect with injury. Because the entire spine is working together in so many different ways, if one part isn’t working right, it’s going to affect another. In fact, it’s common to see facet joint arthritis along with other back problems or conditions like DDD.
So what is exactly happening within the joint for this pain to occur?
Usually, there is one of three reasons why we have pain. First, there is damage to the protective cartilage that covers the facet joints of the spine. This is similar to an overworked knee joint that has worn down much of its cartilage and is grinding bone-on-bone. Second, there could be less synovial fluid (a lubricant) in the joint. And lastly, there could be bone spurs forming on the joint, our body’s way of fixing the damage of the facet joint. When bone spurs rub up against a nerve, you could get shooting pains in your buttocks and legs.
Whether it’s from trauma or a natural degeneration of the disc, these damaged facet joints can become unstable, affecting the nerves, connective tissues, and muscles around it. This can result in an incredibly sore lower back.
When it comes to living with facet joint arthritis and degenerative disc disease, my doctor explained that there are a few steps to take to keep my spine healthy and minimize pain.
If there is no pain relief, start with:
The last hope for treatment is spinal fusion. My doctor explained that spinal fusion (the joining of two vertebrae) is not guaranteed to take away back pain and it may cause more pressure and inflammation on the bones and discs around the site of fusion. This is more of a ‘last resort’ treatment.
In terms of using an inversion table, my doctor expressed that it’s not going to do much for my pain. He told me that inversion tables work better for patients with sciatica, opening up the joints and stretching enough to relieve pressure off a pinched nerve. Because I have a drying, thin disc, the inversion table may relieve some pain in the facet joints while I’m upside down, but it’ll return as soon as I’m upright. He stated it’s not going to bring about lasting change.
So again, with no medication, no recommended physical therapy, no MRI, and no future appointment, I was sent home.
Needless to say, all of this has been a struggle for me. There are times I find myself sobbing because I will be dealing with this pain for the rest of my life, upset my daily activities are often limited, and afraid of what’s to come in the future.
I still work out regularly, try to garden once a week (with much soreness afterwards), and keep my core strong. I’m going to try to focus more on proper body mechanics, continue core strengthening, add more back stretches, and supplement with tumeric for now.
It’s so isolating when you don’t hear about many middle aged people dealing with DDD, but I’ve been comforted by the comments many of you have made. I hope this update has been as helpful to you as it was to me. Take care of your spines!
Here’s to your health,
Medical Disclaimer: The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Information provided on this web site is for general information purposes only.
Jamie | 11th Oct 20
I had my first x-ray at 27 when I got diagnosed DDD. Due to my young age it’s considered a congenital form of DDD. Last January during one of my four older boys hockey games I started to have pain that would drop me to my knees at times. I am now 35, a mother of five boys & a nurse. After 10 months of this pain I decided to see my PCP (primary care provider). We did an X-ray again this Wednesday 10/07/2020. Things look a lot worse with many lumbar and thoracic areas having no disc and bone on bone. My spine has shifted, L3 has slid forward, I now have stenosis going on and few disc are rotating. I also have bone spurs on L3,L4 & L5. I’ve already done the steroids and muscle relaxers, the PT (physical therapy) and the Chiropractor. It isn’t getting better. I have an appointment on Wednesday and I know we will be doing an MRI and consult with the Neurosurgeon. Definitely take of your backs!
Julie | 12th Oct 20
Thanks for your comments Jamie. I definitely empathize with you! I can’t imagine the pain and frustration you are going through, being so young, a busy mom and nurse, with such an uncooperative spine. Let us know how your treatment progresses! I really hope you get the relief you deserve. You’re definitely right – we all need to take care of our backs! Best of luck 🙂
Andrea | 13th Oct 20
Was diagnosed with DDD in my 30’s unfortunately have had 6 spinal surgeries most recently 2 this past July, I am now 53. My lumbar is fully fused l1-s1 and I also have a fusion 2 levels in my cervical c5-c7.
I have had to have surgery no other treatments worked for me as I have very bad cartilage, spinal stenosis and arthritis. I am determined with my wonderful Orthopedic Spinal Surgeon Dr in Boston to continue to live my life. I wish I could say no more surgeries but I cannot. I have “iron will” and refuse to let this get the best of me and will go down in flames before I subject myself to
needing medical equipment to walk. My problems are a lot smaller than others.
Best of luck to you.
Julie | 14th Oct 20
Thanks for sharing your story Andrea. Despite your DDD, it sounds like you have a supportive doctor and an amazing attitude for dealing with the disease. I hope your treatments/surgeries continue to provide you with some relief. We all need to be grateful for our spines, especially when they’re healthy and pain free. Best of luck to you! 🙂
Tasha | 9th Jan 21
Hi Julie I was just reading your post I was diagnosed with DDD Thursday morning and walking to my car was the same feelings you had after finding out . I have cried so much I have been dealing with the pain for about 3 years now but just in the past few months the pain is worse keeping me up at night and the pain is all day long . I have been to 5 different dr 3 chiropractors all saying different things . One saying my right leg was shorter then the other to the other one saying I had hip dysplasia so after that being said I went to orthopedic dr and that did MRI he said that it was inflamed nerve put me on prednisone and did physical therapy with no relief so i went back to him for follow up and he wanted to do epidural injection but he was booked out till February so he referred me to another dr Thursday morning I went in and that dr actually showed me the images or MRI and told me it was DDD . I just broke down and cried not knowing what to do the only option he gave me was the injection which I’m so scared of doing I just don’t think I can go through that and they will not put me under to do the procedure . So I just eel broken am I going to have to live with this pain for the rest of my life . I schedule appt with my primary for Tuesday he originally told me it was a slipped disk and sent me to physical therapy so not really for sure if I trust what he has to say either but I don’t want to do the injection and hoping he can offer some advice for relief . I did read that yoga and swimming could help with the pain . Im going to be strong and fight this and just keep going and have hope that things will get better . I just wanted to reach out to you and thank you so much for sharing i wish you all the luck and please keep me posted on any changes
Julie | 9th Jan 21
Thank you for sharing your story with us. I can understand your complete frustration. After going to so many doctors, who wanted to treat you in so many different ways….I would be exhausted if I were you. All anyone wants is to be free of pain. Getting thrown a diagnosis without a cure or quick fix is so incredibly heartbreaking.
If you’re still concerned about an accurate diagnosis, I would most trust the physician that read the MRI. Or better yet, take that MRI and show it to another doctor to get his/her opinion.
Find activities that don’t aggravate your back and be sure to stretch or even get massages. I’m currently rowing (on a rowing machine) these days for exercise, and if I row for too long, it bothers my back. Yoga helps me as well. I’m glad that you were able to find my post and find some comfort in it. Be sure to find a good orthopedic doctor that you trust and that understands the pain you’re going through (I’m still searching for one myself). Best of luck to you and I hope you find the much needed relief that you deserve!
Kate | 12th May 21
Thanks for sharing. Had also aches the past year, on and off but not terrible, thinking it was the piriformis muscle or done something with a muscle. No big dealio.
This year in April, I all the SUDDEN had the worst excruciating lower back pain for 4 weeks where I couldnt bend more than a few inches (couldnt bend forward to pump soap in bathtub without bending knees). I couldnt sit for more than a minute, I was limping at work with bad pain like someone wacked my lower back horizontally with a metal bat. Walking after a few hours helped though. I needed ibuprofen, there was literally no way I could go without it at the time. Laying down was the only thing to cope with the sharp pain.
Had aches/burning/cramping shoot down my right leg, same side I had that “piriformis” muscle pain feeling. I looked up nerve pathways for lower lumbar/sacral joints and it matched closely to the side of my leg I was feeling.
I had to wait 2 weeks to see a spine specialist, only to see the pain was slowly diminishing, but by then, the right side pain moved to the left side, so I felt it going down left my thighs and lower back. Had xray at doctors and he informed it was DDD, exact same xray as yours with the very little spacing between L5 and S1. I was prescribed steroids but I refused. He said walking would help as well as physical therapy. I feel slightly better now, some aches here and there but nowhere near I was last month.
I am currently doing physical therapy exercises at home as well as having acupunctures and chiropractic sessions to help. I refuse to have any back surgery in the future, thinking itd make it worse.
I am only 27 years old. I did a lot of bending with my back in the pharmacy for 4 years without bending my knees and standing/walking all day for 8 hours. I now have to make sure I do not twist my torso much anymore, and to make sure I wound bend at the knees more.
Glad I found this post, thank you. Wish I can share my xray on here as well haha. Take care of yourself!!
Julie | 12th May 21
Thanks for sharing your story Kate. Your thinking about treatment is similar to mine, wanting to avoid surgery and focus on more natural methods of healing. My spine doctor even told me that surgery doesn’t always work. Many times, he said, someone will get L5-S1 fused due to a degenerative disc, but then has a new problem with a degenerative disc between L4-L5…meaning the problem keeps working its way up. That scared me.
Best of luck to you with your spinal health. You’re so young to have this issue now, but it sounds like you’ve got a great treatment plan! Stay well! 🙂
Beth | 28th May 21
Hi. Feeling empathetic after reading the post and all of the comments. I was diagnosed with DDD and osteoarthritis. Was bedridden for most of 2020, then my physician referred me to a specialist who then prescribed spinal shots. My first two shots were in October & November of 2020. They helped me get back onto my feet again with lesser pain. Afterwards, I still couldn’t lift anything with any weight; after a few months, had good days where I could cook, bake, sew, do light house cleaning & bad days that put me back into the bed for 1-3 or 4 days. Just received shots again on April 27, 2021; the last set was scheduled for May 18th….however, it was cancelled bc its being reviewed by the insurance agency. Ugh! I’m a very hard-core worker who refuses to sit still or stop, so needless to say I am extremely frustrated as I have been stuck in bed the past 2 days bc I overdid it earlier this week. Pacing myself is as difficult as it is to push a rope. Idk how I’m going to get through the rest of my life, but I will die trying. Its really aggravating whenever insurance companies drag their feet bc there are so many things I NEED to do as well as want to do. I’m used to helping everyone else and not the one being helped. I pray that insurance companies will trust the doctor’s recommendations and referrals without hesitation! Everyone’s lives matter. Period.
Julie | 29th May 21
Everyday is certainly a struggle. Thanks for sharing your story of DDD with us. Glad you found relief with the shots! Best of luck to you 🙂
Michelle | 3rd Apr 22
Hello; I experienced the same frustration with my DDD diagnosis. I asked if PT or Chiropractic or inversion would help and was told it might, but it could make it worse. I was told to do what reduces pain and limit doing what makes it hurt. Going to work all day, playing with my grandkids, gardening, hiking, etc make it worse! Basically everything I love. Going to work is all I can manage and then I have to lay flat every evening and every weekend to recover! I am so sad, I cannot accept that this will be my life.
Julie | 3rd Apr 22
I have to lay flat on a regular basis too! It’s so frustrating. Thanks for sharing your comments. Best of luck!
Pat | 21st Aug 22
I would recommend looking at Dr Alyssa Kuhn/Keep the Adventure Alive on YouTube. She is a PT who addresses degenerative disc disease as well as osteoarthritis.
Pam | 25th Sep 22
Hi Julie, Just read this blog. Yes like you I too have DDD. I was first diagnosed 14 months ago, after several years of pain, via an MRI which I had to fight for with the insurance company for over a year. Also like you, the doctor did not really provide great education about what was wrong with me. I did do physical therapy which helped for awhile. The problem is you always have to be monitoring DDD and keeping thoses muscles in your core stronge which is a challenge for me. My condition is slightly different because my DDD occurs at the L4 and L4/5 disc.
Now my reason for writing, I just wanted to share….since I believe knowledge is best I received two steroid injections this past year. The first seem to really help with pain and back stiffness but two months later I developed extreme pain on the opposit side of the body. Since the first shot seemed to work and this pain was on the opposit the Doctor (pain management) suggested a 2nd injection on the newly effected side. What happened after, was horrible. It actually caused more intense pain which did not resolve at 4 weeks. Had a new set of images which showed my condition had advanced. I believe the steroid injection contributed to it. I’m missing the endcap on L4 vertebrae and I think this caused the bone to deteriorate more causing more Disc. shrinkage. When asking Doctor if the shots could cause this to happen, he said not…..I’m in disagreement since the pain increase substantially within a few days of injection and the imagines (MRI) were only 14 months apart…. a bit scary and yes I cried… Its just a warning to beware, everthing can have complications.
Lastly, heres a bit of hope, there maybe on the horizon a new therapy for DDD, since most everything does not work, it’s a HydroGel. It’s not approved as of yet. Just remember to move with cautious with new technology when approved.
Oh….I also have been taking a supplement called Alpha Lipoic Acid….it’s suppose to help with never pain. Don’t know if it works yet since you should give supplements 3 months but thought Id share. Its generally very safe. THANK YOU FOR THE BLOG! God Bless.
Julie | 26th Sep 22
Thanks for sharing your story Pam. Steroid injections were suggested to me, as they are to most patients. My pain has always wavered on a weekly basis so I held off on injections. Hearing what happened to you is so disheartening. I’ve heard too many stories about people getting surgery or treatments that don’t help their pain. I’m so sorry this happened to you. Maybe switching to another doctor (or finding a more compassionate one) is a good idea. I’m a firm believer in second (and third!) opinions. No one can truly understand the daily pain we deal with unless you suffer from it. And I have yet to find a compassionate spine doctor myself (although I’ve only been to 2 in the last five years). Thank you for sharing with us and for your links to articles. Best of luck to you in the future! Julie 🙂
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