The degenerative lumbar disc: not a disease, but still an important consideration for OMPT practice: a review of the history and science of discogenic instability.
Degenerative disc
biomechanics
clinical reasoning
imaging
low back pain
manipulation
physiology
review
Journal
The Journal of manual & manipulative therapy
ISSN: 2042-6186
Titre abrégé: J Man Manip Ther
Pays: England
ID NLM: 9433812
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
pubmed:
5
5
2020
medline:
1
7
2021
entrez:
5
5
2020
Statut:
ppublish
Résumé
A recent AAOMPT position paper was published that opposed the use of the term 'degenerative disc disease' (DDD), in large part because it appears to be a common age-related finding. While common, there are significant physiologic and biomechanical changes that occur as a result of discogenic degeneration, which are relevant to consider during the practice of manual therapy. A narrative review provides an overview of these considerations, including a historical perspective of discogenic instability, the role of the disc as a pain generator, the basic science of a combined biomechanical and physiologic cycle of degeneration and subsequent discogenic instability, the influence of rotation on the degenerative segment, the implications of these factors for manual therapy practice, and a perspective on an evidence-based treatment approach to patients with concurrent low back pain and discogenic degeneration. As we consider the role of imaging findings such as DDD, we pose the following question: Do our manual interventions reflect the scientifically proven biomechanical aspects of DDD, or have we chosen to ignore the helpful science as we discard the harmful diagnostic label?
Sections du résumé
BACKGROUND
A recent AAOMPT position paper was published that opposed the use of the term 'degenerative disc disease' (DDD), in large part because it appears to be a common age-related finding. While common, there are significant physiologic and biomechanical changes that occur as a result of discogenic degeneration, which are relevant to consider during the practice of manual therapy.
METHODS
A narrative review provides an overview of these considerations, including a historical perspective of discogenic instability, the role of the disc as a pain generator, the basic science of a combined biomechanical and physiologic cycle of degeneration and subsequent discogenic instability, the influence of rotation on the degenerative segment, the implications of these factors for manual therapy practice, and a perspective on an evidence-based treatment approach to patients with concurrent low back pain and discogenic degeneration.
CONCLUSIONS
As we consider the role of imaging findings such as DDD, we pose the following question: Do our manual interventions reflect the scientifically proven biomechanical aspects of DDD, or have we chosen to ignore the helpful science as we discard the harmful diagnostic label?
Identifiants
pubmed: 32364465
doi: 10.1080/10669817.2020.1758520
pmc: PMC8550621
doi:
Types de publication
Historical Article
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
191-200Références
J Orthop Sports Phys Ther. 2009 Jan;39(1):4-11
pubmed: 19131678
Spine (Phila Pa 1976). 2015 Jul 15;40(14):1057-71
pubmed: 25943090
Acta Orthop Scand. 1948;17(3-4):224-30
pubmed: 18879766
Phys Ther. 2008 Apr;88(4):485-93
pubmed: 18258767
Spine (Phila Pa 1976). 2004 Feb 1;29(3):E39-46
pubmed: 14752362
J Manipulative Physiol Ther. 2017 Jul - Aug;40(6):411-419
pubmed: 28645452
Pain. 2009 Apr;142(3):183-188
pubmed: 19186001
J Manipulative Physiol Ther. 2017 Oct;40(8):580-586
pubmed: 29187309
J Electromyogr Kinesiol. 2003 Aug;13(4):333-51
pubmed: 12832164
Spine (Phila Pa 1976). 2015 Jun 1;40(11):842-50
pubmed: 25811262
J Pathol. 1980 Oct;132(2):95-104
pubmed: 6448280
Arthritis Rheum. 2002 Oct;46(10):2658-64
pubmed: 12384924
Spine (Phila Pa 1976). 2011 Oct 1;36(21):1728-36
pubmed: 21301396
Spine (Phila Pa 1976). 1996 Dec 1;21(23):2753-7
pubmed: 8979321
J Neurosurg Spine. 2010 Nov;13(5):576-80
pubmed: 21039146
Man Ther. 2006 Nov;11(4):254-63
pubmed: 16716640
Spine (Phila Pa 1976). 2014 Jun 1;39(13):1032-43
pubmed: 24583744
Scand J Rehabil Med Suppl. 1983;9:88-91
pubmed: 6585945
Spine (Phila Pa 1976). 2009 Nov 1;34(23):2537-44
pubmed: 19841613
J Orthop Sports Phys Ther. 2008 Feb;38(2):42-9
pubmed: 18560192
Spine (Phila Pa 1976). 1996 Dec 1;21(23):2763-9
pubmed: 8979323
Man Ther. 2009 Oct;14(5):562-6
pubmed: 18824391
Spine (Phila Pa 1976). 2003 Dec 1;28(23):2628-33
pubmed: 14652480
Development. 1990 May;109(1):217-23
pubmed: 2209466
Spine (Phila Pa 1976). 1994 Jun 15;19(12):1371-80
pubmed: 8066518
J Biomech. 1992 Oct;25(10):1165-72
pubmed: 1400516
J Biomech Eng. 2015 Oct;137(10):101007
pubmed: 26300418
Mol Med Rep. 2018 Dec;18(6):5709-5716
pubmed: 30365136
Spine (Phila Pa 1976). 2014 Aug 1;39(17):1365-72
pubmed: 24831499
J Bone Joint Surg Br. 1954 May;36-B(2):304-22
pubmed: 13163117
J Spinal Disord. 1992 Dec;5(4):390-6; discussion 397
pubmed: 1490035
BMC Musculoskelet Disord. 2018 Feb 20;19(1):62
pubmed: 29463258
J Manipulative Physiol Ther. 2000 Jun;23(5):332-42
pubmed: 10863253
J Orthop Res. 2017 Dec;35(12):2700-2706
pubmed: 28480978
BMC Musculoskelet Disord. 2006 Feb 23;7:16
pubmed: 16504078
Spine (Phila Pa 1976). 1988 Mar;13(3):309-12
pubmed: 2968665
Spine (Phila Pa 1976). 1984 May-Jun;9(4):405-8
pubmed: 6236566
Spine (Phila Pa 1976). 2005 Dec 1;30(23):2621-30
pubmed: 16319748
Spine (Phila Pa 1976). 1990 Dec;15(12):1300-6
pubmed: 2149207
Spine (Phila Pa 1976). 2009 Oct 1;34(21):2263-9
pubmed: 19934806
Neurosurg Clin N Am. 1991 Oct;2(4):791-806
pubmed: 1821758
Eur Spine J. 2004 Oct;13(6):567-72
pubmed: 15150701
Acta Orthop Scand. 1949;19(2):222-42, illust
pubmed: 15400964
Occup Environ Med. 2003 Apr;60(4):235-6
pubmed: 12660369
Clin Anat. 2008 Sep;21(6):539-46
pubmed: 18627104
J Biomech. 2006;39(13):2484-90
pubmed: 16198356
BMC Musculoskelet Disord. 2010 Jul 08;11:155
pubmed: 20615252
Spine (Phila Pa 1976). 1991 Apr;16(4):450-6
pubmed: 2047918
J Spinal Disord. 1992 Dec;5(4):383-9; discussion 397
pubmed: 1490034
Spine (Phila Pa 1976). 1980 May-Jun;5(3):245-53
pubmed: 7394664
Spine (Phila Pa 1976). 2000 Dec 1;25(23):3036-44
pubmed: 11145815
J Orthop Sports Phys Ther. 2010 May;40(5):256-64
pubmed: 20436236
Spine (Phila Pa 1976). 2012 Oct 1;37(21):1810-8
pubmed: 22366969
Spine (Phila Pa 1976). 2011 Jan 1;36(1):E45-52
pubmed: 21192214
J Bone Joint Surg Am. 2009 Jan;91(1):176-85
pubmed: 19122093
J Manipulative Physiol Ther. 2017 Jul - Aug;40(6):387-396
pubmed: 28822473
Spine (Phila Pa 1976). 1986 Jul-Aug;11(6):650-3
pubmed: 3787337
Spine (Phila Pa 1976). 1985 Apr;10(3):255-6
pubmed: 3992345
J Orthop Res. 2016 Aug;34(8):1389-98
pubmed: 26990567
Ann Biomed Eng. 2004 Jan;32(1):70-6
pubmed: 14964723
Eur J Pain. 2013 Sep;17(8):1138-46
pubmed: 23349066
J Orthop Sports Phys Ther. 2013 Feb;43(2):83-90
pubmed: 23321848
J Bone Joint Surg Br. 1996 Nov;78(6):965-72
pubmed: 8951017
Spine (Phila Pa 1976). 2011 Oct 1;36(21):1772-81
pubmed: 21358568
Eur Spine J. 2011 Apr;20(4):578-84
pubmed: 21125299
Am J Physiol. 1992 Mar;262(3 Pt 2):R356-63
pubmed: 1373039
Spine (Phila Pa 1976). 2015 Mar 1;40(5):316-22
pubmed: 25494318
Spine (Phila Pa 1976). 2001 Sep 1;26(17):1873-8
pubmed: 11568697
Spine (Phila Pa 1976). 2017 Apr 15;42(8):616-623
pubmed: 27517512
Spine (Phila Pa 1976). 2004 Dec 1;29(23):2700-9
pubmed: 15564919
J Anat. 1999 Apr;194 ( Pt 3):323-34
pubmed: 10386770
Pain. 1984 Sep;20(1):13-23
pubmed: 6436774
Spine J. 2008 Nov-Dec;8(6):982-90
pubmed: 17981092
J Neurosurg. 1994 Sep;81(3):350-3
pubmed: 8057141
Radiology. 2001 Feb;218(2):420-7
pubmed: 11161156
J Manipulative Physiol Ther. 2005 May;28(4):266-73
pubmed: 15883580
Man Ther. 2009 Oct;14(5):531-8
pubmed: 19027342
Spine (Phila Pa 1976). 1978 Dec;3(4):319-28
pubmed: 741238
Clin Orthop Relat Res. 1982 May;(165):110-23
pubmed: 6210480
J Orthop Res. 1997 Nov;15(6):814-9
pubmed: 9497805
Spine (Phila Pa 1976). 1994 Sep 15;19(18):2096-102
pubmed: 7825052
Eur Spine J. 2008 Sep;17(9):1149-59
pubmed: 18668268
Clin Biomech (Bristol, Avon). 1986 Nov;1(4):196-204
pubmed: 23915550
Br J Sports Med. 2009 Apr;43(4):247-52
pubmed: 19244270
J Manipulative Physiol Ther. 2019 Mar - Apr;42(3):187-194
pubmed: 31078315
Spine (Phila Pa 1976). 1993 Oct 15;18(14):2075-9
pubmed: 8272963
J Orthop Res. 2013 May;31(5):724-30
pubmed: 23239524
Spine (Phila Pa 1976). 1998 Dec 1;23(23):2493-506
pubmed: 9854748
Acta Clin Croat. 2016 Mar;55(1):117-24
pubmed: 27333727
AJNR Am J Neuroradiol. 2015 Dec;36(12):2394-9
pubmed: 26359154
Spine (Phila Pa 1976). 1990 May;15(5):391-401
pubmed: 2363067
J Orthop Sports Phys Ther. 2020 Jan;50(1):1-4
pubmed: 31892292
Spine J. 2001 Jan-Feb;1(1):47-56
pubmed: 14588368
J Neurosurg Spine. 2009 Apr;10(4):357-65
pubmed: 19441995
Br J Sports Med. 2001 Jun;35(3):186-91
pubmed: 11375879
Asian Spine J. 2017 Jun;11(3):348-355
pubmed: 28670402
Spine (Phila Pa 1976). 2007 Dec 1;32(25):2812-9
pubmed: 18246002
Spine (Phila Pa 1976). 1986 Dec;11(10):1008-12
pubmed: 3576336
Orthop Clin North Am. 1991 Apr;22(2):181-7
pubmed: 1826546
Man Ther. 2009 Oct;14(5):496-500
pubmed: 19027343
Spine (Phila Pa 1976). 2002 May 1;27(9):918-22
pubmed: 11979161
Spine (Phila Pa 1976). 2011 Dec 15;36(26):2260-6
pubmed: 21228748
Spine (Phila Pa 1976). 2006 Jul 1;31(15):1658-65
pubmed: 16816759
Man Ther. 2001 May;6(2):72-81
pubmed: 11414776
J Chiropr Med. 2017 Dec;16(4):271-278
pubmed: 29276459
Spine (Phila Pa 1976). 1988 Sep;13(9):1019-26
pubmed: 3206295
Spine (Phila Pa 1976). 1997 Dec 15;22(24):2959-67
pubmed: 9431633
BMJ Open. 2013 Apr 09;3(4):
pubmed: 23575999
Caspian J Intern Med. 2015 Spring;6(2):98-102
pubmed: 26221508
J Bone Joint Surg Am. 1971 Jun;53(4):663-70
pubmed: 5580025
Spine (Phila Pa 1976). 1995 Jan 15;20(2):192-8
pubmed: 7716624
Spine (Phila Pa 1976). 2000 Feb 15;25(4):431-7; discussion 438
pubmed: 10707387
Spine (Phila Pa 1976). 1995 Dec 15;20(24):2690-701
pubmed: 8747247
Front Biosci. 2007 Jan 01;12:174-91
pubmed: 17127292
Biomech Model Mechanobiol. 2017 Apr;16(2):537-547
pubmed: 27664020
Pain. 1984 Sep;20(1):25-44
pubmed: 6333660
PM R. 2010 Feb;2(2):142-6; quiz 1 p following 167
pubmed: 20193941
Acta Anat (Basel). 1959;38:96-113
pubmed: 14420325
Spine (Phila Pa 1976). 2009 Nov 1;34(23):2545-50
pubmed: 19841611
Life Sci. 2004 Apr 9;74(21):2627-42
pubmed: 15041445