"You can never be overdressed or over educated." -Oscar Wilde
Lumbar degenerative disc disease (DDD) has nothing to do with being over dressed.. but the better educated we are on disc anatomy and physiology, the better we can understand this pain. Unlike most "diseases", DDD is an anatomic finding that does not always cause symptoms. .
Before we dive deeper into discogenic pain, let's take a step back and discuss the disc itself. The disc sits between the vertebral bodies in the spine and works as a shock absorber. The discs allow movement of the spine and absorb impacts. I always explain that discs are like jelly donuts because there are two parts- the tough outer shell (anulus fibrosis) and the squishy gooey center (nucleus pulposus). The jelly of the donut has many inflammatory markers and can cause significant pain or irritation to surrounding structures. And much like a jelly donut, if you put too much force or pressure in the right (or wrong) locations- the tough outer shell can give way and allow the jelly to leak. .
The discs also have a hydration component that naturally decreases over time. This means that discs get flatter over time. I generally explain this as the grey hair or wrinkles of the spine. .
We should all be so lucky as to develop dehydrated discs.. it means you've been around a while 😉. Stay tuned as we dive deeper into discogenic pain...