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  • rkassam
    Post count: 8

    I am a 36 year old male and currently have degenerating discs at l4-l5 and l5-s1.

    I am trying to control this by focusing on a core stabilization program and ergonomics.

    Couple questions on ergonomics.

    1. How does a lumbar roll help your discs?

    1. What is the best position to sleep in? I have read some websites where they recommend a lumbar roll that you tie around your waist while you sleep. Is this any good?

    2. I have read that sitting is bad for the spine. Would switching over to a stand up desk in my office assist in slowing down the degeneration process.

    Donald Corenman, MD, DC
    Post count: 8459

    Do not worry about the progressive nature of degenerative disc disease. In general, it is really not under your control regarding the degenerative process. You can however control the amount of flair-ups you experience and strengthen your back to manage the day to day discomfort. The good news is that studies indicate that over time (years) the pain can lessen and become more manageable. Unfortunately, this does not happen to everyone.

    Loading the discs in symptomatic degenerative disc disease (DDD) occurs with some forward flexion (bending forward or lifting). If your facets are not painful, some extension (bending backwards) unloads the discs and loads the facets. This is why a lumbar roll can be effective at work or in the car. This roll extends the spine while sitting which loads the facets.

    Sleeping is dependent upon a number of factors. A firm mattress with a “pillow top” is generally the most effective to prevent night pain. You don’t want a soft mattress that allows the spine to “slump”. Sleeping on the side especially in the fetal position, with a pillow between the knees can be effective. Sleeping on your back with 3-4 pillows under the knees can also reduce night pain. If you sleep on your stomach, this generally extends the spine and even with DDD, can be uncomfortable. A pillow under the belly can solve this discomfort.

    Sitting for long periods can cause increased symptoms. There are three answers to this. The first is a “Balans” kneeling chair. This chair causes pressure to be borne by the knees and extends the spine. The second is an exercise ball chair. This chair uses an exercise ball on wheels that allows shifting of position. It is great to work on core while sitting and the position changes can be helpful with back pain. The third is a adjustable height office desk. This desk can switch from a standing position to a sitting position which is helpful for patients that need relief with change of position.

    Dr. Corenman

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