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For many people, being diagnosed with Degenerative Disc disease seems like a life sentence to continual pain that’s only going to get worse.
However, the true picture is quite different, and that’s what we’re going to look at here.
The question is: is it possible to cure degenerative disc disease naturally? And if you could, what would that process look like?
Degenerative disc disease is also known as DDD, and we’ll be calling it this throughout this document. DDD is a diagnosis that is made by looking at xray / CT / MRI scans. 7
But because the diagnosis of DDD is primarily made by MRI scans, it’s important to know that an MRI is an extremely sensitive diagnostic tool. This means the MRI scan picks up all the changes of your discs and spine. (Regardless of whether they’re causing pain or not, recent, long ago, healing or healed.)
The other important thing to realise is that these changes have been given a pejorative, negative name: degenerative disc disease.
Names have power, and if you want to understand what’s really going on, we’re going to have to take apart this name and understand why it’s not the best term for what’s really going on in your back.
Let’s look at the last part of this name: disease.
There are many, many diseases recognized by medicine. A disease is a destructive process that occurs in us, which, if left unchecked, will progress and get worse.
If you think of the words that are given here, degenerative means everything’s getting worse. Disc is descriptive. And disease says this is a process which is destructive and progressive and needs somehow to be interrupted by medicine.
Put these together, and it paints a very scary picture.
When people are given a diagnosis of DDD, here’s how it usually plays out. You go and see a doctor because you have spinal pain, usually lower back pain, but sometimes thoracic or neck pain.
The doctor examines you. In most western countries you may have your x-ray first, but quite quickly you will go on to the definitive investigation, which is an MRI.
Here’s where things start to get really interesting…
In tandem with the diagnosis of degenerative disc disease, most people are told the changes you can see on the MRI are the cause of their pain. Next, they’re often told by their doctor: “Sorry, there’s nothing we can do.” And that their condition will continue to get worse.
They then go home, and ask Professor Google ‘what is degenerative disc disease.’ As you’ll see below, all the information on the first page of google confirms their doctor’s statement.
The first statement says DDD is a progressive disease process. Here’s a screenshot:
This entry goes on to say once you have DDD, it will continue to cause you back pain. And once you have this diagnosis, there is no effective treatment for it. You will “have to learn to live with your pain.”
That’s a perfect storm of anxiety, pain and misinformation, and it’s right there at the top of Google search.
I’m going to give you an alternate view, one which will dispel some myths, and give hope to people with this diagnosis.
Quietly in the background of this first scenario, investigators have been taking MRI’s of whole populations of people, most of whom are asymptomatic. In other words, most of the people they’re studying don’t have back pain. 5
The largest (well executed) studies have looked at thousands and thousands of people. All the results were collected together in a meta analysis in 2014.8
Here’s what they found. In people aged 30-39, more than 50% of people showed the changes thought of as degenerative disc disease. In people of 20 years old, one large study showed that 37% of people showed some DDD changes.
When you’re over 50, you were 80-90% likely to have scans which showed the symptoms of DDD. In other words, 80% to 90% of people over 50 had changes that could be diagnosed as degenerative disc disease. And the majority of these people did not have pain. 1,2,6,
So what does this mean?
This means that the MRI is very sensitive in picking up certain changes in your spine. But most of those changes are part of the natural aging process, and do not predict pain. 6
What’s happening is a selection bias. 90% of people over 50 in the large population studies show signs of DDD. But in a normal situation, people who don’t have pain don’t go in and get an MRI scan, because there’s no reason for them to do so.
The people with pain do get scanned, and medical professionals mistakenly tell them the changes they can see on their MRI scan are causing their pain, because that’s all they see.
This causes needless anxiety, and often a downward spiral as people stop moving for fear of further damaging their spine. In fact, something quite different is happening. It’s been dubbed by the NOI group9 as ‘wear and repair’ and this is a much more positive. It’s also a far more accurate description of what’s going on in the vast majority of people.
What happens in your spine as you age? Let’s start by looking at what happens in the disc. The disc is a strong structure, which has a thick outer wall. Inside this wall it has some jelly-like material which acts as a shock absorber.
What is special about the disk is that it has poor blood supply. As we move around and do the tasks of normal daily living, at some point you’ll cause a little tear in the disc wall.Because there is poor blood supply, the healing of the disc itself turns out to be clumsy and slow. What you can see on an MRI of a young perfect disc is a strong border and then the fluid in the middle, which is a light color.
Over time, the disc itself gets drier and once that has happened, it will never return to how it was. The MRI scan will never return to the pristine disc you once had.
Initially you often feel pain – but we are magnificent healers and after a few months, the process stabilizes and the pain should settle in the majority of people. 3
Once you get your first little bit of damage, and it can be very minor, what happens is the inner fluid content starts dropping. On a scan, the disc starts to look darker. This does not at all correlate with back pain. 30% of 20 year olds will have at least one disc showing signs of this.
Over 50% of 30 to 39 year olds will have these changes occurring in their spine. Finally, 90% of people over 50 will show signs of disc degeneration. 1,2,8
This 90% of people over 50 have these changes because they’ve used their bodies. As you age, you get a few wrinkles on your skin, and the changes shown on most MRI’s are like wrinkles on the inside.
What may happen in the beginning of the process is that you do have some back pain associated with it, but for the vast majority of people, that back pain will settle. Because the disc has a slow blood supply, it may take a few months for it to heal.
There are a proportion of people (and it turns out to be surprisingly high) who don’t have any pain while this process is occurring.
Now, there is a small proportion of people where the picture means something different, and serious. We’ll look at this now.
The important thing to know before we go into this, is that a scan of someone with the problem I’m about to describe, and someone with a normal ageing disc looks exactly the same.
This very small group of people have a big tear in the disc wall. Then, something unusual happens. There’s a bone fracture in the end plate of the vertebra below the disc.10 When this happens, the material from inside the disc squishes up into the vertebra and sets off an incredible inflammatory process. The inflammatory process that goes on here has a different name. It’s called internal disc disruption, or IDD. 10
So there’s DDD, or degenerative disc disease, which is not a disease. And then there’s IDD, which is a real disease. With IDD there is inflammation which tends to get worse with time. It usually lasts 1-3 years. A proportion will settle, but for the rest, the only cure for that is to take the disc out surgically.
The issue here is that an MRI does not discriminate between the two. And therefore when you look at an MRI, you are getting no valuable information apart from the fact that at particular levels of the spine, there are changes in the disc. Using purely an MRI scan, there is no way to discriminate between the two. IDD is much rarer though. And while DDD is quite common, the majority of people who show the signs of DDD on their scans don’t have pain.
Suppose you go along and see a surgeon and tell them: “I have terrible back pain.” The surgeon does an MRI and there’s one disc that looks worse than all the others because you’re over 50. This can be all too often a false positive result, because at that age you’re 90% likely to have these changes showing in your disc.
If you’re unlucky, the surgeon may say: “You have degenerative disc disease at this level. This is what’s causing your pain, but don’t worry, I can cure you by doing a discectomy & fusion.”
This is an operation when he will take out the disc and fuse the vertebrae above and below the disk. The results of this type of surgical intervention where the operation is chosen purely on the basis of MRI changes are poor. 4
And it’s not surprising because the MRI changes do not discriminate between IDD and DDD. The majority of people actually should not have this kind of surgical intervention.
It’s part of the human condition that when something happens, we often imagine the worst. It’s a primal protective reflex.
In ancient times if there was a rustle in the grass, it could just be the wind or it could be a sabre tooth tiger that’s going to jump out on you. The people who survived over the millennia were the ones always imagined and reacted to the worst case scenario.
After all, you can be wrong many times about the wind in the grass, but if you were wrong just once about a tiger, you’re dinner. And so the more relaxed and comfortable of our ancestors died out, and the paranoid ones survived. Our brains are hardwired to imagine the worst case scenario as a survival strategy.
Over 90% of people over 50 are going to have these changes, which are usually a natural part of ageing. As people age, many of the bony changes you see are the bone adapting to the disc drying, and growing ledges to protect the whole area and stabilize the whole area.
Again, these changes are called negative things like ‘bony spurs or osteophytes’ when they are simply clever & efficient adaptations as you age.
Then there’s a small portion of people who have exactly the same changes on the MRI but have a significant problem.
Now, supposing you’ve read this far, and you have back pain, and you’ve been diagnosed with DDD. Perhaps you’re wondering if you are in that small proportion of people with Internal Disc Disruption, or IDD?
How would you find out?
It turns out to be very difficult to diagnose IDD. In the past, the diagnosis was made by surgeons operating, pulling out the old disc, and sending it away for analysis.
The lab would then look for signs of active inflammation in the disc. They found a proportion of the disks taken out had this inflammatory process, and so had IDD.
However, most of the discs didn’t have IDD. The sad news is once you’ve pulled out a disc and fused two vertebrae together, that’s it. You can’t un-fuse them and put the disc back in.
Many people in this situation ended up with their same back pain, and a spinal fusion.
Surgeons then thought about how they could diagnose IDD without taking out the disc.
The investigation they hit upon was sticking a needle into the disc. It’s called a discogram. It’s a relatively simple procedure done under CT imaging.
Once the needle is in the disc, you inject some dye. Once you put the dye in, the pressure goes up inside the disc.
What you’re trying to do is recreate the person’s pain, which turns out to be utterly, horribly excruciating.
So that’s the first test. However, if your back is already sensitised, sticking a needle and pressurising the disc could cause this – whether or not the disc is inflamed. Therefore there is still a significant proportion of what are called ‘false positive’ results.
The next step is to use a CT scan to slice picture sections through the disc. The surgeons are looking for a tear in the wall of the disc. If the tear is over a certain part of the disc and a certain size, and then you can say, it’s probably IDD. Even then there’s no real certainty.
When surgeons started to do discograms, they thought if the pain gets worse when you stick the dye in, are we sure that it’s actually because it’s because the disc is infected and inflamed? Could it be some other cause?
So some bright spark thought of how to test this.
The way they tested discogram as a diagnosis tool was to inject an adjacent normal looking disc with dye as a control. Doctors thought if they injected dye into a normal disc, and there was no change in the pain, then they’d have a good test.
The problem was that if you put a great big needle into this pristine disc, which has virtually no blood supply, it’s very disruptive.
No blood supply means everything in the disc happens very slowly, as in a glacier. That’s why it doesn’t heal very well, and most changes that occur are irreversible. But these don’t necessarily mean you will get pain from them.
So what doctors found was that a number of years after injecting a normal disc with dye, a proportion looked very similar to the other disc where they’d diagnosed IDD.
This meant injecting dye to diagnose IDD was not a benign procedure at all and it wasn’t 100% accurate. Eventually the majority of back surgeons have stopped doing it.
So there isn’t an easy way to diagnose IDD. The real problem is only a tiny proportion of the people who show changes in their spine and discs have IDD. And for most people, the changes that are diagnosed as DDD are just natural ageing, and not necessarily the cause of their pain.
As we age, we all get wrinkles on our skin, but no one thinks this means our skin is diseased, or degenerated.
They’re just wrinkles. Changes showing up on a spinal MRI is like having wrinkles in your back. For most people this is normal, and not a cause for huge concern.
If you have back pain, there are many non-invasive ways you can get pain relief (including what is taught in this program.) Very few people actually need surgical intervention to recover from back pain.
THEREFORE:
THERE are TWO POSSIBILITIES:
Since it is very difficult to accurately diagnose IDD & its treatment is so invasive, it makes great sense to treat the more common central sensitization first. This is where our program comes in.
Sometimes in the search for what is truly causing your pain, you won’t find a clearcut answer. This can be frustrating, even maddening. This search, however, can take up all your energy, leaving none for the small, simple (but not easy) daily actions which move you towards health.
This is the part where you need to take over ‘your’ side of the equation. Use medical science to help you as much as it can. However, your side is actually a lot bigger than you may have thought in the past. By taking control there, many people have returned to health, and put chronic pain behind them.
1 M.Teraguchi† N.Yoshimura‡H.Hashizume† S.Muraki§ H.Yamada † A.Minamide† H.Oka ‡ Prevalence and distribution of intervertebral disc degeneration over the entire spine in a population-based cohort: the Wakayama Spine Study
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