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Degenerative Disc Disease

Degenerative Disc Disease

The first thing you notice is a loss of the cervical curve.

Three Phase Process

Spinal degeneration is typically graded by a three phase process. Whether you take three snapshots or twenty-three snapshots, it’s a process. We use the three-phase model based on the book Managing Low Back Pain by W. H. Kirkaldy-Willis and Thomas Bernard, Jr. We find that it makes the differences between each phase great enough so our patients can appreciate what they are seeing.

Text Book Normal

While this process can occur anywhere in the spine, it’s easiest to see in the cervical spine (neck). This is what the side view of the neck should look like. From the side, the neck should have a graceful forward curve. The edges of each bone are well defined. There should be equal disc spacing between each bone and the openings for nerve roots should be clear and unobstructed.

The first thing you notice is a loss of the cervical curve.
  • Phase OneIn Phase One there is a loss of curve and a reduced ability to turn and bend. In some cases, the disc space between adjacent vertebrae may be reduced. Or, discs can become wedge-shaped, risking more serious soft tissue damage. Depending upon your body’s adaptive capacity, pain or other obvious symptoms may not be present. Even the resulting reduced range of motion may be too subtle for some to notice. Adjacent joint surfaces become rough and uneven.
  • Phase TwoIf joint surfaces are neglected, in Phase Two they lose their clearly defined edges as the early signs of bone spurs become visible on X-ray views. Some believe that the body senses the accompanying inflammation as the sign of a broken bone. It begins the process of depositing calcium salts. Without being in a cast to prevent movement the fusion doesn’t occur. The affected bones have lost their individuality and ability to move.
  • Phase ThreeIf still left uncorrected, the problem worsens in Phase Three. Amazingly, pain or other obvious symptoms may not yet show up. But finally, the body successfully “mends the broken bone”.

This process can take years. Its presence calls into question the claim that many patients make that they were…”fine until last week when I bent over to tie my shoes”.

The Prognosis

Some patients begin chiropractic care and discover a restoration of their spinal curves and improved range of motion. Success with Phase Two patients is less predictable and depends on many factors. Primarily, with Phase Two and Phase Three patients, our goal is to eliminate the pain (symptom) and improve range of motion.

It’s impossible to predict what effect, if any, chiropractic care will have on slowing, stopping or reversing this process. Nor can a particular phase be used to predict how much care will be needed.


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