Q: I have neck pain. Should I seek the help of a physical therapist?
A: Yes. It's estimated that as many as 75 percent of us will have some form of back or neck pain at some point in our lifetime. The good news is that most of us will recover without the need for surgery and conservative care such as physical therapy usually gets better results than surgery. Degenerative disk disease (DDD) is one cause of back and neck pain. Usually the result of the natural aging process, degenerative disk disease (DDD) is a type of osteoarthritis of the spine.
Q: Who might develop DDD?
A: Disk degeneration might occur throughout several regions of the spine, or it might be limited to one disk. When it's part of the natural aging process, the degeneration does not always lead to pain. For some people, however, it can cause a great deal of pain and disability.
You are more likely to develop DDD if you: smoke, are obese, do heavy physical work or don't get very much exercise.
Q: How Is DDD Diagnosed?
A: Your physical therapist will conduct a thorough evaluation that includes a review of your medical history and will use screening tools to determine the likelihood of DDD. For example, the therapist may:
Ask you very specific questions about the location and behavior of your pain, weakness and other symptoms
Ask you to fill out a body diagram to indicate specific areas of pain, numbness and tingling
Perform tests of muscle strength and sensation to determine the severity of the pressure on your nerves
Examine your posture and observe how you walk and perform other activities
Measure the range of motion of your spine and your arms and legs
Use manual therapy to evaluate the mobility of the joints and muscles in your spine
Test the strength of important muscle groups
If you have muscle weakness and loss of sensation or very severe pain, special diagnostic tests, such as x-rays, may be needed. Physical therapists work closely with physicians and other health care providers to make certain that an accurate diagnosis is made and the appropriate treatment is provided.
Research shows that in all but the most extreme cases (usually involving muscle weakness or high levels of pain), conservative care, such as physical therapy, has better results than surgery.
After the evaluation, if your therapist suspects you have DDD and there are no major medical problems, treatment can begin right away.
Q: How can a physical therapist help?
A: Your physical therapist's overall purpose is to help you continue to participate in your daily activities and life roles. The therapist will design a treatment program based on both the findings of the evaluation and your personal goals. The treatment program likely will be a combination of exercises.
RELIEVE PAIN AND INCREASE MOVEMENT
Your therapist will design:
Stretching and flexibility exercises to improve mobility in the joints and muscles of your spine and your extremities - improving motion in a joint is often the key to pain relief
Strengthening exercises - strong trunk muscles provide support for your spinal joints, and strong arm and leg muscles help take some of the workload off your spinal joints
Aerobic exercise, which has been shown to be helpful in relieving pain, promoting a healthy body weight, and improving overall strength and mobility - all important factors in managing DDD
This might sound like a lot of exercise, but don't worry: research shows that the more exercise you can handle, the quicker you'll get rid of your pain and other symptoms.
Your physical therapist also might decide to use a combination of treatments:
Manual therapy to improve the mobility of stiff joints and tight muscles that may be contributing to your symptoms
Posture and movement education to show you how to make small changes in how you sit, stand, bend and lift - even in how you sleep - to help relieve your pain and help you manage your condition on your own
Special pain treatments - such as ice, electrical stimulation or a short course of traction, for pain that is severe and not relieved by exercise or manual therapy
Once your pain is gone, it will be important for you to continue your new posture and movement habits to keep your back healthy.
Q: Can DDD be prevented?
A: DDD usually is a natural result of aging. Research has not yet shown how to prevent it, but you can make choices that lessen its impact on your life and slow its progression. Many physical therapy clinics conduct regular educational seminars to help people in the community learn to take care of their backs and necks. These seminars often are free and provide demonstrations along with written information about exercises for the back and neck, instruction on proper lifting and sitting postures, and other tips to keep your back healthy.
Your physical therapist can help you develop a fitness program that takes into account your DDD. There are some exercises that are better than others for people with DDD, and your therapist will educate you about them. For instance:
Exercising in water can often be a great way to stay physically active when other forms of exercise are painful.
Exercises involving lots of twisting and bending need to be avoided in some individuals.
Weight training exercises, though very important, need to be done with proper form to avoid stress to the back and neck.
General tips when you're looking for a physical therapist:
Get recommendations from family and friends or from other health care providers.
During your first visit with the physical therapist, be prepared to describe your symptoms in as much detail as possible, and say what makes your symptoms worse.
Chautauqua Physical & Occupational Therapy is celebrating 17 years of serving our community. We are located in the Riverwalk Center, are therapist owned and are the only outpatient clinic in the area to offer free consultations. Call us at 488-2322 or visit www.chautauquapt.com.