Bridging the Knowledge Gap

The Power of Our Words - Degenerative Disc Disease - August 2020

When I talk to my patients about their diagnoses, imaging results, and symptoms, I try my best to always remember how powerful my choice of words can be. There are times when I make a mistake in how I talk about a symptom, a diagnosis, or a procedure my patient has had or plans to have. Almost immediately, I have seen the negative effects this has on a patient’s beliefs, attitude toward their rehab and potential for improvement, and my ability to form a therapeutic alliance with them moving forward. One diagnosis in particular that can have this effect on patients is “degenerative disc disease.”

The American Academy of Orthopedic Manual Physical Therapists (AAOMPT) recently came out with a position statement (found here) that opposes the use of “Degenerative Disc Disease” as a diagnostic term for the cause of neck and back pain. They state that the changes denoted by this term are often related to normal age-related changes in the size and shape of the vertebral discs. Labeling these changes as a “disease” can and does sometimes lead to unnecessary and invasive treatments including opioids, injections, and surgical procedures. They also state that patients respond to this label by “avoiding beneficial physical activity for fear that exercise and movement will worsen their condition, possibly leading to chronic pain.”

Physical Therapists play a key role in the management of spinal pain, and can help decrease opioid prescriptions and unnecessary procedures. We can help patients to improve, manage, and learn about their neck and back pain before it becomes chronic. Let’s be part of the solution and think about the power of our words when talking to our patients about their diagnoses and symptoms.