Degenerative Disc Disease (DDD) is one of the most common causes of back pain, and also one of the most misunderstood. Many patients diagnosed with low back pain caused by degenerative disc disease are left wondering exactly what this diagnosis means for them.
In the majority of cases, (DDD) is caused by irregular oblique and torsion constraints of pressure on the intervertebreal discs.
An intervertebral disc has a
lamellar structure, and is a super shock absorber that permits to
absorb shock in every direction of space. However it does not perform well when in “torsion”.
So what causes a disk to be in torsion? Postural Imbalance. Researches made on posture since more than one hundred of years ago bring us to consider the postural system as a whole.
In normal orthostatic posture from the side view (sagittal), the scapular and gluteal planes should be aligned. From the front (frontal plane) , the thoracic and pelvic girdle, should be perfectly horizontal. From the top (transverse plane), there should be no rotation of the scapular and pelvic girdle.
If any of these landmarks are not respected, there will hyperconstraints of joints, ligaments and muscles of spine and the intervertebreal disk will be under oblique and torsion pressures.
The first stage of Degenerative disk disease (DDD) consists of the protrusion of the nucleus pulpous. At that point, the yellow ligament and the membrane and are still present. If unaddressed, the second stage of Degenerative disk disease (DDD) is a rupture of the membrane causing the disk to protrude; causing disk herniation.
So what now? If we remove the disk, it will take care of the problem between the vertebra and the pinch on the root nerve, so sciatica or whatever issue will disappear. However, the surgeon will have removed the last shock absorber of the spine (although the disk is degenerated, it still useful as a shock absorber).
Over time, the vertebra on top and below will get closer and put posterior pressure on the facet joints that will eventually provoke arthrosis, inflammation, and epiduritis. The facet joint that are suffering will contract the muscles to prevent movement which will lead to tightness and this tightness increases the constraint, and these constraints will go to the higher and lower level of the spine.
It is difficult to consider subjects that present a postural clinical imbalance as normal subjects, for several reasons:
- The subjects having a posture clinically well balanced do not suffer from low backpain;
- The patients who are suffering always present an obvious postural imbalance;
- When postural system inputs are out of order that brings about postural imbalance, the body never cures itself, on the contrary it integrates the new postural scheme and considers it as normal;
So when we a surgeon operates a discal herniation, (and I am not implying that it should never be done), is he treating the symptom or the cause?