Why I believe disc degeneration has very little to do with chronic low back pain
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Why I believe disc degeneration has very little to do with chronic low back pain Ross A. Hauser, M.D.
A patient asked, "will my disc always be degenerated?" You might say the question was legitimate but what you don't know is I spent 10 minutes explaining why the MRI finding of lumbar disc degeneration is a nothing (usually).
As I explained to the patient "Do you want to replace the disc or do you want to correct the reason the disc became degenerated?" In other words is it better to just replace the disc (because surgeons can do this now) or correct the underlying problem that led to the disc degeneration?
Disc degeneration is not the cause of your pain
Very seldom is there just one disc that is degenerated, the condition often affects many discs. Another issue is the underlying problem that caused the disc degeneration is not fixed by disc replacement or other surgical procedures. Even spinal fusion does not fix the underlying problem. Prolotherapy can fix it.
The underlying problem typically when someone has disc degeneration is spinal ligament weakness. When the ligaments allow excessive movement of the vertebrae, subluxations, disc herniations, and disc degeneration begin to occur. Anyone who has a vertebrae that keeps slipping out of place has vertebral ligament laxity may consider Prolotherapy.
Is my MRI wrong?
Most folks who come to Caring Medical with low back pain, thoracic or neck pain have MRI's that show disc degeneration but seldom is that what is causing their pain. Here are some signs/symptoms that allow you to know that your pain is not coming from the disc problem (none of these is absolute, but give a good idea):
Pain on either side of the spine not on the midline
Sensation is intact
Muscle strength is fine
Pain upon lying down
Pain is not worse with sitting
Pain is not worse with bending over
Numbiness (tingling down the arm, but sensation is ok)
Cracking
All of the above symptoms suggest ligament laxity of spine or sacroiliac ligament problems. Disc problems are more indicative if the person has low back pain for instance that is:
Central
Sitting makes it worse
Standing (compared to lying) makes it worse
Bending over while standing increases the central pain.
Realize the only way to truly get out of pain is to stop the process that is causing the body injury. This process for those in chronic pain is typically either ligament laxity or what we call "connective tissue deficiency." The latter involves the breakdown of collagen in the body. This often occurs because the body is in a catabolic state because anabolic hormones are low. Correction of this through natural hormone replacement, diet, and supplements can relieve some of the pain, but typically Prolotherapy also has to be done.
Prolotherapy for a Degenerative Disc or a Herniated Disc
Prolotherapy to the back, specifically the supraspinatous, interspinus and lumbosacral ligaments is what the person with chronic low back needs, regardless if disc degeneration shows up on the MRI. For such a person "yes, after Prolotherapy it is possible for the MRI to look the same, but I suspect your back pain won't be... you'll have a hard time finding it!"
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