Rehabilitation Low Back Pain and Lumbar Disc Degeneration By Physical Medicine and Rehabilitation, November 7, 2016 If your lower back hurts, you might wonder if muscle strain or another injury is to blame. For many people, however, low back pain is the result of lumbar disc degeneration, a condition that occurs over time. Although this breakdown of spinal discs is a normal consequence of aging, it can cause pain, discomfort, and other symptoms in some people. What Is Lumbar Disc Degeneration? The discs of your spine cushion the interlocking vertebrae and act as shock absorbers for your back, allowing it to bend, flex, and twist. These discs are composed of two layers: A tough, firm outer layer A soft, jelly-like core that’s made up largely of water As we get older, the inner core cushion loses some of its water content and becomes drier. Consequently, the discs’ outer layers can crack or tear. Eventually, the disc can lose height, which leads to changes in your vertebrae, joints, ligaments, and other soft tissue, a condition known as disc degeneration. When this occurs in your lower back, it’s called lumbar disc degeneration. Lumbar disc degeneration is common among people over 30 and has been associated with low back pain. However, it is commonly present in asymptomatic individuals as well. Your doctor can help determine if the disc degeneration is a cause of your pain. Disc Degeneration Symptoms When present, it can contribute to symptoms such as: Back pain that worsens when sitting, bending, lifting, or twisting. Tenderness or aching in the buttocks, or thighs. Back pain that feels better when walking, changing positions, or lying down. Periods of severe pain that gets better after a few days or months. When the degeneration is associated with pressure on a nerve, it can contribute to: Numbness and tingling into the legs Weakness in the legs How Do You Treat Low Back Pain? If you think you might have lumbar disc degeneration, visit your doctor. He or she will likely perform a physical exam and ask you about your symptoms, previous injury, illness, and physical activities that may be causing pain. Your doctor may test your range of motion in the affected area and nearby areas and look for tender spots, numbness, weakness, tingling, or changes in reflexes. If lumbar disc degeneration has been identified as a contributor to your pain, your doctor will discuss your treatment options. He or she will probably focus on noninvasive approaches to reduce inflammation and relieve pain, such as: Non-steroidal anti-inflammatory drugs like ibuprofen and naproxen, orally or topically Other pain relievers such as acetaminophen Physical therapy Lifestyle modifications Dealing with Chronic Low Back Pain An episode of low back pain doesn’t predict long term, or chronic, back pain. The pain can be improved by making lifestyle changes, such as losing weight, quitting smoking, and reducing stress. You may also be advised to minimize movements that aggravate the problem, such as lifting heavy objects or playing sports (such as golf) that involve twisting the back. At the same time, you should try to remain as active as possible. Your physician or physical therapist can suggest exercises that will strengthen the muscles that support your back, relieve pressure on discs, and help alleviate pain associated with lumbar disc degeneration while modifying movements to maintain your overall fitness level and participation in the activities that you enjoy. If you experience severe weakness in your lower extremities, changes in your bowel or bladder functions, unexplained weight loss, or fever with your low back pain, consult your physician immediately.