Can exercise promote healing in patients with degenerative disc disease? A study reported October 1, 2015, in Spine Journal looks at the regenerative potential of a particular type of exercise for patients suffering from degenerative disc disease.

Disc degeneration in the spine is a normal part of aging, like gray hair and wrinkles. Some people experience more disc degeneration, and this is what is referred to as degenerative disc disease. The discs are the shock absorbers between the vertebrae, and they allow the spine to remain flexible through a normal range of motion. Each disc has a tough outer covering, the annulous fibrosus, and a gel-like center called the nucleus pulposus. In degenerative disc disease, the inner gel-like material often loses its ability to hold water and becomes dried out, and the tough outer covering becomes damaged due to wear and tear. The disc begins to collapse, causing more pressure on the bones, and this in turn leads to bone spurs. At the same time, the spinal segment around the disc becomes unstable and moves too much, which causes instability and accelerates the bone spurs. This then can cause the ligament inside the spinal canal, the ligamentum flavum, to enlarge, compressing nerves and causing spinal stenosis. All of this can be painful.

Lower back pain is epidemic, accounting for the largest percentage of missed work. Stabilizing exercises, like axial loading exercise, place compressive emphasis on the spine, pelvis and hips, forcing many muscle groups to engage. Greater stability tends to equal less pain. The study in Spine Journal looks at the regenerative potential of specific types of loading exercises for the intervertebral disc. They found that low-dose (low-frequency, high-volume, high-load) types of extension-loading exercises appeared to induce some basic regenerative mechanisms. Inversely, high-frequency exercises of the same type increased disc degeneration.

Exercise can be a good tool in working to manage degenerative disc disease pain. If the degenerative damage is too great, such exercise may not significantly decrease pain. In such cases, using a patient’s own platelets and stem cells has shown good results in addressing the physiopathology involved in degenerative disc disease—bulging discs that irritate nerves, instability that leads to bone spurs, and painful facet joints.

 

“DDD and Exercise” first appeared as a post on the Regenexx blog.

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