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Degernarive DISC disease

  • What is the DDD ( Degenerative Disc Disease)
    • It is degeneration of the annular fibres of the intervertebral disc.
  • Causes
    • Drying out of the disc with age.
    • Chronic overloading of the disc leading to annular fibre microtearing and migration of the nucleus
    •  Injury
  • Types
    • Cervical DDD
    • Thoracic DDD
    • Lumbar DDD
  • Stages and Symptoms of DDD
    1. Stages
      1. Dysfunction stage
        1. There are wakness, bulging and minor tears in the annulus which heal slowly(due to the hypovascular nature of the disc) over many years.
        2. Disc protrusions
        3. This stage is considered reversible
      2. Instability stage
        1. The posterior annular fibres and joint capsules become lax.
        2. Nerve entrapment may occur.
        3. Spondylolisthesis may occur.
      3. Stablization stage
        1. There is loss of disc material and decreased disc height.
        2. Stenosis or narrowing of the spinal canal may occur.
        3. Degeneration may spread to other vetebral levels.
    3. Symptoms
      1. Pain and other symptoms may occur at any stage.
      2. The person may remain asymptomatic if a threshold of tissue damage is not reached.
      3. This threshold varies from person to person.
  • Acute Disc herniation
    1. Acute herniation can occur at any stage, but is more common at the end of the dysfunction or beginning of the instability stage.
    2. It is common between 30 and 45 years age.
    3. posterolateral protrusion is most common.
    4. Symptoms
      • Severe low back pain, radiating pain.
      • Walking can be painful and difficult.
      • Acute scoliosis
      • Neurological sign
        • Muscle weakness
        • demaromal sensory chagnes
        • Bladder or bowel dysfunction
  • SOAP
    1. Subjective information
    2. Objective information
      1. Observation , Palpation
      2. ROM
        1. Degenerative Disc Disease
          1. AF/PR ROM : Cervical and lumbar spine extension is most restricted.
          2. AR ROM : weakness in affected muscles, depending on the stage of degeneration
        2. Acute herniation
          1. AF/PR ROM : flexion and extension are limited by pain and muscle spasm
            • AF : flexion in the lumbar spine may have a deviation to one side.
      3. Special test
        1. For Cervical
          1. Upper limb tension tests
          2. Neurological test : dermatome, myotome
          3. DTR
          4. Spurling’s test
          5. Valsalva’s test
        2. For lumbar
          1. Straight Leg Raise test
          2. Neurological test : dermatome, myotome
          3. DTR
          4. Slump test
          5. Valsalva’s test
          6. Kemp’s test
          7. Kernig’s test
    3. Treatment Plan
      1. Degenerative Disc Disease
        1. Treatment goal for degenerative disc disease depend on the presenting symptoms and stage of degeneration.
        2. If client has a head-forward posture : treat same as hyperkyphosis
        3. IF Client has flat back, or posterior pelvic tilt, treat same as flatback
        4. Remedial exercise : Mckenzie exercise
      2. Acute disc herniation
        • The treatment is a half-hour
        • Ice pack to decrease spasm and pain
      3. Contraindication
        • Saddle anesthesia and bladder weakness
        • If no position can be found that relieves the pain, treatment is contraindicated
        • Position that aggravate symptoms are avoided

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Spine and Thorax Trail Guide - Test for Massage Therapist
3 years ago

[…] Degenerative disc disease […]

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