Degenerative Disc Disease (DDD) is a gradual process that may compromise the spine and cause back pain. DDD is relatively common and as a Chiropractor serving Anglesey, Gwynedd and Conwy I find it’s a common diagnosis amongst people in North Wales. In this discussion our North Wales Chiropractor addresses one of the causes of back pain – Degenerative Disc Disease in the lumbar (low back) spine.

Degenerative Changes to a Disc

Degenerative changes in the spine are often referred to those that cause the loss of normal structure and/or function. The intervertebral disc is one structure prone to the degenerative changes associated with wear and tear aging, even misuse (e.g. smoking).

Long before degenerative disc disease can be seen on an x-ray, biochemical and histologic (structural) changes occur. Some of these changes are similar to those associated with osteoarthritis. Back pain is the first indicator we have that something is wrong, in the majority of cases.  By this stage much of the degeneration has occurred as our body tries to adapt.

Over time the collagen (protein) structure of the annulus fibrosus weakens and may become structurally unsound. Additionally, water and proteoglycan (PG) content decreases. PGs are molecules that attract water. These changes are linked and may lead to the disc’s inability to handle mechanical stress. Understanding the lumbar spine carries a large portion of the body’s weight; the stress from motion may result in a disc problem (e.g. herniation) and back pain.

Non-Operative Treatment: Yesterday vs. Today

DDD is a disorder that causes back pain. It is interesting to note that although 80% of adults will experience back pain, only 1-2% will need lumbar spine surgery!

In the past some physicians prescribed long courses of bed rest and/or lumbar (low back) traction for their patients with low back pain. However, that is not the attitude today. At The North Wales Spine Clinic we believe movement is a nutrient and we try to get patients moving as soon as possible.  This is following by other interventions such as Chiropractic, Muscle release, Acupuncture and for the long term solution we all need – rehabilitation work in our fully equipped rehabilitation gym. Of course, each patient is different and therefore so is their treatment plan.

Therapeutic Exercise

In some patients, the pain response may limit flexibility. Prescribed stretching exercises can improve flexibility of the trunk muscles. Flexion exercises may help to widen the intervertebral foramen. The intervertebral (between the vertebrae) foramen are small canals through which the nerve roots exit the spinal cord. The intervertebral foramen are located on the left and right sides of the spinal column.

Extension exercises, such as the McKenzie method, focuses on the muscles and ligaments. These exercises help maintain the spine’s natural lordotic curve, important to good posture.

Specific tailored rehabilitation exercises at our rehabilitation gym will help to improve muscular endurance, coordination, strength, strong abdominal muscles, and weight loss. Strong abdominal muscles work like a brace (or corset) to reduce the loads to the lumbar spine. It is also known that exercise help to combat anxiety and depression. The loads on the discs during walking are only slightly greater than when lying down. Walking, bicycling, and swimming are forms of aerobic exercise our Chiropractor may suggest to patients from Gwynedd, Anglesey and Conwy.


Acupuncture has been shown to help control back pain. It has been suggested that acupuncture stimulates the production of endorphins, acetylcholine, and serotonin. At The North Wales Spine Clinic we use Acupuncture for pain relief, which speeds up the time scale that we can get patients on an exercise program for many of the reasons outlined in prior paragraphs.

Drug Therapy

During the acute phase of low back pain, drugs may be prescribed. Some may include acetaminophen, anti-inflammatory agents, muscle relaxants, narcotics, and anti-depressants. Narcotics are used on a short-term basis partly due to their addiction potential. When back pain is caused by muscle spasm, a muscle relaxant may be prescribed. These drugs have sedative effects. Depression can be a factor in chronic back pain. Anti-depressant drugs have analgesic properties and may improve sleep.


Today manipulation is performed by registered Chiropractors. Manipulation of spinal joints creates an analgesic effect reducing pain in the initial stages of the complaint.  However the over the long term we really see the benefits as posture is affected and the body begins to move more efficiently thus reducing the probability of further tissue damage.

Why do we get damaged tissue in the human body causing back pain?

In the majority of cases its errors in control.  Your neurological system must orchestrate thousands of muscular contractions every moment of every day.  One slight miscalculation here ends in damaged tissue.  That’s often what causes the multitude of painful conditions we see and successfully treat at The North Wales Spine Clinic.