Chiropractic Continuing Education

Success with Chiropractic for Degenerative Disc Disease

            Degenerative disc disease is amongst the most treated conditions in chiropractic, low back pain encompassing 46% of chiropractic patients. The trouble with degenerative disc disease is that it is very common, and progressive. About 40% of adults over the age of 40 have one degenerate disc in the vertebrae at a minimum, and unfortunately, by age 80, 80% of adults have one or more degenerated disc. There are a multitude of treatment options, but chiropractic treatment has been shown to be not only safe but effective without the side effects on degenerative disc disease.


Degenerative Disc Disease Basics


            Although degenerative disc disease is normal degeneration of the discs in the spine, that does not make it any less painful for the patient. Considered to be the shock absorbers of the spine, the spinal discs help to keep the back flexible, but as a patient gets older, wear and tear gets to be inevitable. That being said, not everyone feels pain from the degeneration. There are some tell-tale signs that a patient has degenerative disc disease, aside from their age.


Degenerative Disc Disease Symptoms:


  • Pain in the lower back, buttocks, and upper thighs
  • The pain feels worse sitting, and better when moving around
  • The pain feels better when changing positions or lying down
  • The pain feels worse when bending, twisting, or lifting
  • The pain comes and goes, and can be either severe or nagging lasting anywhere from a few days to a few months.
There are also times where degenerative disc disease can give rise to tingling and numbness in the legs and arms. In traditional treatment, degenerative disc disease is normally managed with NSAIDs like ibuprofen, or with steroid shots in order to combat the inflammation, and reduce pain and swelling. If medications don’t work, a patient may be recommended for surgery such as a discectomy to remove the injured part of the disc taking the pressure off the nerves, or remove the whole disc to input an artificial one. In the worst-case scenario, the patient will have surgery and the doctor will fuse the vertebrae after removing the disc.
Causes of degenerative disc disease is a natural part of aging being that when humans are born the discs are 80% water and absorb shocks well, but as we age, the discs dry out making the shocks more painful. Other things like daily activity and sports injuries can cause tears in the disc, or even just performing those tasks on a daily basis can wear down the discs more rapidly. Traditional medical treatment for degenerative disc disease includes surgery, artificial disc replacement, and back braces along with pain management medications.


Chiropractic Works for Degenerative Disc Disease


            Treating degenerative disc disease with chiropractic is extremely helpful in decreasing inflammation within the spinal tissues as well as improving joint mechanics by increasing spinal motion. There are a multitude of treatment protocols that could take place with a degenerative disc disease patient, but most will include some type of spinal manipulation, manual therapy, and additional therapies if necessary.


Spinal Manipulation Treatments for Degenerative Disc Disease:

  • Instrument Assisted Spinal Manipulation – utilizing a hand-held tool applying gentle force without pushing directly on the spine.
    • Although more larger scale research needs to be done, a case study done in 2012 of a veteran with degenerative disc disease showed that there was a positive results with activator assisted spinal manipulative therapy.
  • Area Specific Spinal Manipulation – find the particular joints in the patient which are restricting range of motion, and utilizes a gentle thrust technique.
  • Flexion-Distraction Technique – also known as Cox technique, it utilizes a non-thrusting and gentle motion.

Manual Therapy Treatments for Degenerative Disc Disease:

  • Soft Tissue Therapy w/an Instrument – Graston technique is most utilized here, and the instrument allows for pain relief as well as many other symptoms.
  • Trigger Point Therapy – Identify tight points on the muscle of a patient, and place direct pressure on these areas to relieve tension.
  • Therapeutic Massage – used for decreasing muscle tension
  • Manual Joint Resistance & Stretching – also utilized for pain relief and promotes imbibition which is usually lost in degenerative disc disease.

Reducing Inflammation Treatments:

  • Ultrasound – sends sound waves into the muscles tissues to decrease muscle spasms, pain, and stiffness.
  • Electrical Stimulation – an electrical current used at a low frequency to stimulate the muscles to decrease inflammation.


In addition to these treatments, like with most conditions being treated by chiropractic, therapeutic exercises are often given to be done at home to maximize results and prevent degenerative disc disease from getting worse.


Basic Chiropractic Treatment Protocol for Degenerative Disc Disease:

  • Initial Treatment Phase – the goal in the beginning of the treatment plan is imbibing the spinal discs, and reestablish structural support within the spine. It is important to advise patients that even if they achieve pain relief within a few treatments, it is vital to stay on the course of the treatment plan to keep the spine healthy. This will allow the patient to fully return to their normal day-to-day life, and in so doing, will let the patient have more muscle activity which will support the spine.
  • Second Treatment Phase – the goal of this stage is to stabilize the spine as those with degenerative disc disease have decreased spine flexibility as well as poor muscle control. There should be a focus on rehabilitative exercises as well as additional pain-free therapies such as biofeedback to control and keep an eye on spinal motion. Nutritional and lifestyle advice to be done at home being added to the treatment plan at this point, if not added to begin with, is essential to strengthen the muscles supporting the spine for overall spinal health and success in disc treatment.
  • Re-Evaluation Treatment Phase – the goal of this phase is to check in and re-evaluate the exercises utilized in the treatment plan both in-office and at home. Implement a solid in office and at home exercise program based to help encourage the spine back to optimal health. Consistent and regular exercise is vital for regaining spinal strength and health long-term.


Chiropractic is an effective modality for treating degenerative disc disease, especially considering that most chiropractic patients are being seen for back issues. More than 35 million Americans are treated by a chiropractor each year, and it’s easy to see why. Although there is no cure, and can be a completely natural occurrence, degenerative disc disease can be managed well and sometimes even mostly rectified with chiropractic care.