Degenerative Disc Disease is not really a disease but a term used to refer to a condition in which pain is caused from a damaged disc. Spinal discs are soft, compressible discs that separate the interlocking bones (vertebrae) that make up the spine. The discs act as shock absorbers for the spine, allowing it to flex, bend, and twist. Degenerative disc disease can take place throughout the spine, but it most often occurs in the discs in the lower back (lumbar region) and the neck (cervical region).
Nearly everyone shows some signs of wear and tear on the spinal discs as they age. To a certain degree, this process happens to everyone. However, not everyone who has degenerative changes in their spine has pain. It is important to remember that everyone is different and not everyone will have symptoms described as degenerative disc disease. A wide range of symptoms and severity is associated with this
The changes in the discs can result in back or neck pain and/or:
- Osteoarthritis, the breakdown of the tissue (cartilage) that protects and cushions the joints.
- Herniated Disc in neck or back, an abnormal bulge or breaking open of a spinal disc.
- Spinal Stenosis, the narrowing of the spinal canal, the open space in the spine that holds the spinal cord.
These conditions may put pressure on the spinal cord and nerves, leading to pain and possibly affecting nerve function.
What are the symptoms of Degenerative Disc Disease?
When degenerative disc disease becomes painful or symptomatic, it can cause several different symptoms due to the compression of the nerve roots. A herniated disc in the neck area may result in neck or arm pain, while an affected disc in the lower back may result in pain in the back, buttock, or leg. The pain often gets worse with movements such as bending over, reaching up, or twisting.
Depending on where your degenerative or herniated disc is located, it could cause
- Back pain
- Radiating leg pain
- Neck pain
- Radiating arm pain
- Pain is usually worse with activity or prolonged sitting or standing
These symptoms are caused by the fact that worn out discs are a source of pain because they do not function as well as they once did, and as they shrink, the space available for the nerve roots also shrinks. As the discs between the intervertebral bodies start to wear out, the entire lumbar spine becomes less flexible. The result can be back pain and stiffness, especially towards the end of the day.
Causes and Risk Factors
Several factors can cause discs to degenerate, including age. Specific factors include:
- The drying out of the disc. When we are born, the disc is about 80% water. As we age, the disc dries out and doesn’t absorb shocks as well
- Daily activities and sports cause tears in the outer core of the disc. By the age of 60, most people have some degree of disc degeneration. Not everyone at that age has back pain, however.
Injuries, which can cause swelling, soreness and instability. This can result in low back pain.
Degenerative Disc and Herniated Disc Treatment?
Your doctor will discuss with you the treatment options appropriate for your diagnosis.
For most people who do not have evidence of nerve root compression with muscle weakness, conservative, non-surgical therapies, such as medication, rest, exercise and physical therapy, are typically recommended.
A diagnosis is based on a medical history and a physical examination, as well as the symptoms and the circumstances where the pain started. Magnetic resonance imaging (MRI scan) can show damage to discs, but it alone cannot confirm degenerative disc disease.
Bulging disc surgery is offered only after conservative treatment has have failed to adequately relieve the symptoms of pain, numbness and weakness over a significant period of time.
The benefits of spine surgery, however, must be weighed against the risks. Dr. Lenard will be able to discuss the risks and benefits of surgery with you, and the likely results of operative versus non-operative treatment.