The pdf describes the different treatment modalities for low back pain arising from degenerative disc disease (DDD).

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Treating Degenerative Disc Disease to Resolve Low Back Pain
Low back pain is a common problem that affects millions of Americans, with reports
suggesting that about 85% of Americans are affected by it at some point in their lives. The
intensity of pain can range from mild to severe and it can be short lived or chronic. Such
back pain can significantly affect a person’s ability to perform day-to-day activities. There
are many causes of low back pain and degenerative disc disease (DDD) is the most
common one.
Generally, disc degeneration is an age-related disease that
occurs due to the deterioration of the intervertebral discs.
These are the pillow-like cushions between vertebrae in your
spine that help your back carry weight and allow complex
motions of the spine while maintaining stability. As we age,
the discs may lose flexibility, elasticity and shock absorbing
characteristics. This will cause them to become thinner as
they dehydrate and change from a supple state (that allows
fluid movement) to a rigid state (that restricts movement).
This leads to back pain.
Common Signs and Symptoms
In certain cases, people with disc deterioration experience
zero pain, while others may experience chronic pain that
directly interferes with daily activities.
DDD mostly affects young adults or middle-aged people who lead an active lifestyle. People
who smoke are at greater risk of developing the condition. Usually, the pain starts in the
lower back area and may be felt in one or both of your legs and buttocks. The symptoms
start in any of the three ways -

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 A major injury followed by sudden and unexpected pain
 A trivial injury followed by sudden back pain
 Pain that starts gradually and gets progressively worse
Generally, the most severe symptoms are experienced when sitting because in this position,
the discs bear more weight. Activities such as bending or twisting make the pain worse, but
activities such as walking, running and even lying down may help manage pain.
Treatment Options
The main treatment methods for degenerative disc disease are
 Chiropractic manipulation – The treatment involves applying pressure to the area
that is immobile or not moving properly. This allows the joints to return to a more
normal motion by lowering aches, muscle spasms or imbalance, thereby improving
overall function.
 Self care – Maintaining correct posture and keeping your spine in alignment can
help to reduce back pain. It is essential to make adjustments to sitting, standing and
sleeping habits. In addition, workspace must be rearranged to reduce stress to spine.
 Physical therapy (PT) – PT exercises helps to reduce pain and stiffness of the disc
and helps faster healing. The therapist may recommend proper lifting and walking
techniques to strengthen and stretch the muscles of the lower back, leg and
stomach. TENS, ice or heat application, ultrasound, massage, and myofacial release
are other methods in physical therapy.
 Medications – Non-steroidal anti-inflammatory medications (NSAIDs),
acetaminophen, oral steroids, narcotic drugs, and muscle relaxants may be
prescribed to reduce inflammation and relieve pain.
 Epidural injections – Epidural steroid injections relieve pain by decreasing swelling
and inflammation.
 Exercise – This includes a combination of strengthening, stretching and low-impact
aerobic exercises.
 Weight loss – Cutting pounds helps reduce the amount of stress on the low back
muscles and ligaments.
Generally, non-surgical treatment is the first option for low back pain arising from DDD. If
the patient does not respond well to the above-mentioned treatment approaches, surgery
may be recommended.