Degenerative disc disease: ALD (long-term condition)

La spine is strongly solicited by the many movements that we make on a daily basis. Whether it is the repetitive movements of the trunk, the postures when walking, the gestures made during the carrying of loads, these efforts can lead to certain pathologies in the long term.

Among them are the degenerative diseases of the vertebral discs gradual and slow onset like degenerative disc disease. Is this a long term condition? This is what we will see in this article.

Some basics

Degenerative disc disease, what is it?

Also called, disc degeneration, degenerative disc disease is akin to a process of slow and progressive deterioration of intervertebral discs.

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Degenerative disc disease is manifested by wear of the discs, related to age and the stresses imposed on the spine. It's about a natural consequence of the aging of the body, but which can also occur due to incorrect movements, bad postures or strain on the back (carrying heavy loads, intense sports).

Le intervertebral disc decreases in height by losing water. the drying out fact that it is no longer capable of ensuring the resistance and flexibility of the disc in the face of shocks. In addition, the space for the nerves to pass through the spine narrows.

Disc degeneration is considered a pathology when it causes an embarrassing loss of mobility ou intense back pain on a daily basis.

The first symptom of the condition basically results in back pain. However, the patient's level of impairment determines the patient's exact location. It is thus possible that it is a lower back pain (lower back), a back pain (back pain) or neck pain (neck pain). It is accompanied by tingling, loss of sensitivity and locomotor difficulties.

Disc degeneration is diagnosed using a physical examination, possibly supplemented by an MRI (Magnetic Resonance Imaging) or X-ray.

The possible treatments after diagnosis are extremely varied depending on the evolution of the disease. This ranges from self-care, to physical therapy (physiotherapy), to taking non-steroidal anti-inflammatory drugs and epidural injection of steroids. 

More advanced cases may require a surgical intervention. It consists of a discectomy, intervertebral disc annuloplasty, laminotomy, laminectomy, or other.

Support is provided by many practitioners. We can distinguish between the attending physician, the emergency physician, the orthopedic surgeon, the geriatrician, the neurologist, the neurosurgeon and the physiotherapist.

ALD (long term illness)

A Long term affection where ALD is defined as a serious chronic pathology. Some of these diseases require expensive and long treatment. And depending on the case, it is possible for patients to benefit from full care of the latter under conditions. We can thus distinguish 2 main types of ALD: exempting ALD and non-exempting ALD.

The Exempting ALDs entitle you to full reimbursement of health costs related to the illness. It's about a exemption from co-payments or "remains dependent" after the passage of Social Security. The hospital package, the medical deductible, the flat-rate contribution of 1 euro and excess fees are not affected.

To benefit from it, the patient must follow a coordinated care pathway. Then, a list of 30 pathologies was established, defining the diseases considered as long-term conditions. Among other things, we can find disabling cerebrovascular accidents, chronic arteriopathy with ischemic manifestations, paraplegia and progressive rheumatoid arthritis.

Added to these are off-list conditions or ALD 31 (disabling or progressive forms of serious illnesses) and cases of polypathologies or ALD 32 (multiple conditions).

As to Non-exempting ALD, these are long-term conditions that require treatment for more than 6 months and work stoppage. However, patients do not benefit from full healthcare coverage by health insurance. This is the case for epilepsy, hypothyroidism, osteoarthritis and glaucoma, for example.

However, it is possible to take advantage of a reimbursement of 65% of the BRSS (Social Security reimbursement base) by Health Insurance for these non-exempting ALDs. The individuals concerned will have to follow a coordinated care protocol. The indemnities are in the form of daily reimbursements for 3 years, a threshold beyond which the insured automatically becomes disabled.

How much downtime for degenerative disc disease?

Le treatment of degenerative disc disease varies significantly from one patient to another depending on the symptoms and limitations observed. It includes active rehabilitation of variable duration.

The time off work due to the illness usually equals the period of rehabilitation. However, if a surgical act is necessary, the stop can be extended, as well as the period of coverage (sometimes even going up to 6 months).

We can say that this pathology is part of the ALD according to its chronicity et specific conditions of each patient.

Can we work with degenerative disc disease?

The answer to this question depends on your particular condition. As mentioned previously, the symptoms (even more than the diagnosis as such) will determine your limitations, as well as the prognosis.

If your degenerative disc disease is causing acute back pain, your doctor may request a temporary work stoppage combined with physiotherapy (physiotherapy) sessions.

If the pain persists over time and limits the performance of your work, it is possible that certain limitations will be imposed on the practice of your trade. These restrictions may be temporary or permanent, and should be discussed with your doctor.

For example, the duration of prolonged sitting may be limited. Certain adjustments (such as an ergonomic seat) can increase your comfort while sitting. If your work is physical, it is possible that we limit the taking of heavy loads, and that we set a maximum weight that should not be exceeded.

In any case, a doctor and/or an occupational therapist will be better equipped to discuss your particular situation, and will provide you with advice and adjustments to work in the best possible conditions. Unfortunately, if your functional abilities do not match the physical demands of your job, it is possible that a professional redeployment be considered.

Remember that work seems to be an important factor in curing back pain. Moreover, many studies have shown that prolonged work stoppages could lead to chronic low back pain. It is also for this reason that your doctor may encourage you to continue your professional activities despite your degenerative disc disease.

Degenerative disc disease, occupational disease?

Since February 15, 1999, the law has considered back pain to be a occupational disease.

Degenerative disc disease is a disorder of the spine, manifested by back pain. It can be considered registered in the occupational disease framework if:

• it meets the criteria mentioned in the occupational disease tables (No. 97 or No. 98);
• its chronicity is greater than or equal to 3 months;
• the duration of exposure to the risk is equivalent to 5 years.

Although the general health of each patient is not threatened by degenerative disc disease, motor difficulties et loss of dexterity resulting from this are problematic in the workplace. This negatively affects quality and performance.

What compensation for degenerative disc disease?

People who suffer from disc degeneration benefit, as with any ALD, from a health insurance coverage. However, she is not optimal (100%) than :

• whether the pain is not absent or minimal;
• if there is no return to a high level of function;
• if there is no discontinuous or occasional analgesic intake.

A medical visit is made annually to the patient for an assessment of the progress of the disease. Depending on the diagnosis, treatment may be renewed, turn into invalidity pensions or daily allowances.

Projects

https://www.medtronic.com/fr-fr/patients/pathologies/discopathie-degenerative.html

https://soinscoordonnes.fr/peut-travailler-discopathie-degenerative/