Physical Therapy in Venice for Lower Back

Welcome to FYZICAL Venice's patient resource about Lumbar Degenerative Disc Disease.

The intervertebral discs in the lower spine are commonly blamed for low back pain. Yet low back pain has many possible causes, and doctors aren't always certain why symptoms occur.

During an office visit for low back pain, your doctor may describe how changes in the discs can lead to back pain. When talking about these changes, your doctor may use the terms degeneration or degenerative disc disease. Although the parts of the spine do change with time and in some sense degenerate, this does not mean the spine is deteriorating and that you are headed for future pain and problems. These terms are simply a starting point for describing what occurs in the spine over time, and how the changes may explain the symptoms people feel.

This guide will help you understand:

• how degenerative disc disease develops
• how doctors diagnose the condition
• what treatment options are available

What parts of the spine are involved?

The human spine is made up of 24 spinal bones, called vertebrae. Vertebrae are stacked on top of one another to form the spinal column. The spinal column gives the body its form. It is the body's main upright support. The section of the spine in the lower back is known as the lumbar spine.

Lumbar Spine

An intervertebral disc sits between each pair of vertebrae. The intervertebral disc is made of connective tissue. Connective tissue is the material that holds the living cells of the body together. Most connective tissue is made of fibers of a material called collagen. These fibers help the disc withstand tension and pressure.

Intervertebral Disc

The disc normally works like a shock absorber. It protects the spine against the daily pull of gravity. It also protects the spine during strenuous activities that put strong force on the spine, such as jumping, running, and lifting.

An intervertebral disc is made of two parts. The center, called the nucleus, is spongy. It provides most of the disc's ability to absorb shock. The nucleus is held in place by the annulus, a series of strong ligament rings surrounding it. Ligaments are connective tissues that attach bones to other bones.

Two Parts of Intervertebral Disc

Between the vertebrae of each spinal segment are two facet joints. The facet joints are located on the back of the spinal column. There are two facet joints between each pair of vertebrae, one on each side of the spine. A facet joint is made of small, bony knobs that line up along the back of the spine. Where these knobs meet, they form a joint that connects the two vertebrae. The alignment of the facet joints of the lumbar spine allows freedom of movement as you bend forward and back.

Facet Joints

Related Document: FYZICAL Venice's Guide to Lumbar Spine Anatomy

Why do I have this problem?

Our intervertebral discs change with age, much like our hair turns gray. Conditions such as a major back injury or fracture can affect how the spine works, making the changes happen even faster. Daily wear and tear and certain types of vibration can also speed up degeneration in the spine. In addition, strong evidence suggests that smoking speeds up degeneration of the spine. Scientists have also found links among family members, showing that genetics play a role in how fast these changes occur.

Disc degeneration follows a predictable pattern. First, the nucleus in the center of the disc begins to lose its ability to absorb water. The disc becomes dehydrated. Then the nucleus becomes thick and fibrous, so that it looks much the same as the annulus. As a result, the nucleus isn't able to absorb shock as well. Routine stress and strain begin to take a toll on the structures of the spine. Tears form around the annulus. The disc weakens. It starts to collapse, and the bones of the spine compress.

View animation of degeneration:

Related Document: FYZICAL Venice's Guide to Low Back Pain

This degeneration does not always mean the disc becomes a source of pain. In fact, X-rays and MRI scans show that people with severe disc degeneration don't always feel pain.

Pain caused by degenerative disc disease is mainly mechanical pain, meaning it comes from the parts of the spine that move during activity: the discs, ligaments, and facet joints. Movement within the weakened structures of the spine causes them to become irritated and painful.

What does the condition feel like?

Pain in the center of the low back is often the first symptom patients feel. It usually starts to affect patients in their twenties and thirties. Pain tends to worsen after heavy physical activity or staying in one posture for a long time. The back may also begin to feel stiff. Resting the back eases pain. At first, symptoms only last a few days.

This type of back pain often comes and goes over the years. Doctors call this recurring back pain. Each time it strikes, the pain may seem worse than the time before. Eventually the pain may spread into the buttocks or thighs, and it may take longer for the pain to subside.

How do health care providers diagnose the problem?

Diagnosis begins with a complete history and physical exam. When you visit FYZICAL Venice, we will ask questions about your symptoms and how your problem is affecting your daily activities. Our Physical Therapist will also want to know what positions or activities make your symptoms worse or better.

Our Physical Therapist then does a physical examination by checking your posture and the amount of movement in your low back. We check to see which back movements cause pain or other symptoms. Your skin sensation, muscle strength, and reflexes are also tested.

Some patients may be referred to a doctor for further diagnosis. Once your diagnostic examination is complete, the Physical Therapists at FYZICAL Venice have treatment options that will help speed your recovery, so that you can more quickly return to your active lifestyle.

FYZICAL Venice provides services for Physical Therapy in Venice.

Non-surgical Rehabilitation

Whenever possible, nonsurgical treatment of lumbar degenerative disc disease is preferred. The first goal of nonsurgical treatment is to ease pain and other symptoms so the patient can resume normal activities as soon as possible.

We rarely prescribe bed rest for patients with degenerative disc problems. Instead, patients are encouraged to do their normal activities using pain as a gauge for how much is too much. If symptoms are severe, a maximum of typically two days of bed rest may be prescribed.

After evaluating your condition, your Physical Therapist at FYZICAL Venice can assign positions and exercises to ease symptoms. Our Physical Therapist can design a personalized exercise program to improve flexibility of tight muscles, to strengthen the back and abdominal muscles, and to help you move safely and with less pain. Although recovery time varies among patients, as a guideline you may expect to work with our Physical Therapist a few times each week for four to six weeks. In some cases, patients may need a few additional weeks of care.

Our first goal of treatment is to control symptoms. Your Physical Therapist will work with you to find positions and movements that ease pain. We may use heat, cold, ultrasound, and electrical stimulation to calm pain and muscle spasm.

Our Physical Therapist may perform hands-on treatments such as massage and specialized forms of soft-tissue mobilization. These can help a patient begin moving with less pain and greater ease. Traction is also a common treatment for degenerative disc problems. Traction gently stretches the low back joints and muscles. Our Physical Therapist will instruct you on stretches that will help you move easier and with less pain.

As you recover, we will gradually advance you in a series of strengthening exercises for the abdominal and low back muscles. Working these core muscles helps patients move more easily and lessens the chances of future pain and problems.

A primary purpose of Physical Therapy is to help you learn how to take care of your symptoms and prevent future problems. We’ll give you a home program of exercises to continue improve flexibility, posture, endurance, and low back and abdominal strength. Our Physical Therapist will also discuss strategies you can use if your symptoms flare up.

Post-surgical Rehabilitation

Rehabilitation after surgery is more complex. Some patients leave the hospital shortly after surgery. However, some surgeries require patients to stay in the hospital for a few days. 

During recovery from surgery, patients should follow their surgeon's instructions about wearing a back brace or support belt. You should be cautious about overdoing activities in the first few weeks after surgery.

Many surgical patients need Physical Therapy outside of the hospital. Patients who've had lumbar fusion surgery normally need to wait up to three months before beginning a rehabilitation program. Our treatment sessions help patients build strength and learn to move and do routine activities without putting extra strain on their backs.

Although the length of FYZICAL Venice rehabilitation programs vary based on an individual patient’s rate of recovery, as a guideline you can expect to attend Physical Therapy sessions for eight to 12 weeks and should expect full recovery to take up to six months.

As your Physical Therapy sessions come to an end, our Physical Therapist will help you get back to the activities you enjoy.  You may need guidance on which activities are safe or how to change the way you go about your activities. Ideally, patients are able to resume normal activities.

When recovery is well under way, regular visits to FYZICAL Venice will end. Although we will continue to be a resource, you will be are in charge of doing your exercises as part of an ongoing home program.

FYZICAL Venice provides services for Physical Therapy in Venice.