Q: I am 78 and in good health but recently have been troubled with a very stiff and painful neck. After reviewing my X-rays, my doctor said that I have degenerative disc disease. The only treatment she quoted was pain shots.

I understand that this condition does come with the aging process but I can’t help but wonder if there is any physical therapy that could relieve this condition rather than depend only on pain medication. Any information you can give me would be very helpful.

A: The discs of our spine resemble shock absorbers between bones. Ideally, they help the neck and back remain flexible, despite the forces we often unthinkingly place on them through exercise, the repeated lifting of heavy objects, trauma, and simple movement. Also, because of natural degeneration as we age, some of us develop small cracks or tears in the outer layers of the discs. When this occurs, the jelly-like fluid within the nucleus of the disc(s) may be forced out, causing the discs to bulge, rupture, or break. Without that jelly-like fluid, discs become less flexible and the space between the vertebrae narrows, making the spine less stable. The body may react by growing bone spurs, small growths that put pressure on the roots of the spinal nerves and spinal cord. The end result is pain and a pronounced stiffness on movement. I should make note of the fact that your “degenerative disc disease” is rather misleading. You are not contagious but rather have a condition related to age, trauma, arthritis, a compression fracture, or a long list of other possibilities.

Pain can present in the neck or back in the location of the disc damage and varies from person to person. Damage to a disc in the neck can extend to arm pain, while lower back damage can present in the buttock or leg areas. That pain may be accompanied by tingling and numbness to further compromise a person’s ability to move without discomfort.

Diagnosis is generally made through a physical examination and the medical history a patient provides to his or her physician. A loss of motion, pain on palpation, numbness and tingling, weakness of a specific area and more are all possible indications. X-rays may be ordered to rule out fractures or tumors, or an MRI may be more appropriate if a physician is concerned (because of the signs and symptoms) of possible nerve impingement.

Medication, which may include over-the-counter acetaminophen and NSAIDS (non-steroidal anti-inflammatories) or prescription drugs may be appropriate for pain relief. Physical therapy is commonly ordered to help strengthen muscles, decrease pain and increase mobility. Should spinal stenosis be the cause of the problem, injections may decrease inflammation. The specific form of therapy used will depend on a number of considerations, such as the degree of pain, your age, level of daily activity performed, and other medical conditions present. In extreme cases when all efforts fail, surgery may be a consideration that will involve actually removing the damaged disc. In this instance, the bones may be fused to help protect the spinal cord from further damage or in rare instances, an artificial disc may replace the damaged one that was removed. Hopefully you won’t get to that stage.

I recommend you present your thoughts to your physician, indicate you do not want injections or drugs and prefer a trial of physical therapy. Ask for recommendations on the best site nearest you and give physical therapy a try before moving on to the next level. Ask the new therapist what you are capable of adding to your unsupervised daily functions at home. While you feel you are in good health, determine when your last physical examination was. Have you had an EKG and blood testing recently for such things as cholesterol, sugar and thyroid levels? If appropriate, address your weight and dietary issues and consider adding more fruits, vegetables, whole grains and omega-3 oils. Practice good posture and do all in your power to overcome the disorder.