Degenerative Disc Disease
The vertebrae and discs of your spine bear significant loads and allow a wide range of motion. Over time this leads to wear and tear of the spinal discs, which can develop into what is known as degenerative disc disease, one of the most common causes of lower back and neck pain.
What is Degenerative Disc Disease?
Degenerative disc disease isn’t actually a “disease,” but a condition where the natural wear and tear on a disc causes pain, instability, and other symptoms. The process of degradation of the discs is normal and occurs in most people. But “degeneration” doesn’t continue, as it would in a true disease. In fact, this condition mainly affects people between the ages of 30 to 50. It can actually improve as the discs become more dried out as the person moves into his or her later 50s and beyond.
These changes in the discs can occur throughout the spine, but are most typical in the discs of the lower back (the lumbar spine) and the neck (the cervical spine). Damaged discs in these areas can lead to neck and back pain, but the pain can also radiate into the arms and legs.
Causes of Degenerative Disc Disease
A natural part of aging is the breakdown of our spinal discs. This degeneration includes two major changes that can lead to pain.
- Decreasing fluid in the discs — As they lose fluid, the discs lose their ability to act as shock absorbers and they become less flexible. As they lose fluid, they also become thinner, narrowing the space between the vertebrae.
- Tears or cracks in the outer membrane — The outer membrane, called annulus fibrosis, can develop tiny tears or cracks, allowing the jellylike material inside the disc (the nucleus pulposus) to leak out. This makes the disc bulge or rupture.
These changes are more likely if a person performs frequent heavy lifting, is obese, or is a cigarette smoker. An injury from a fall or car wreck can also begin the degeneration process. Because the discs don’t have a blood supply, they cannot heal themselves.
When the distance between vertebrae closes as the discs thin, the body responds by creating bone spurs to try to stabilize the spine. These bone spurs can put pressure on the spinal nerve roots or the spinal cord, resulting in pain and affecting nerve function. Bulging discs can also apply pressure in the same way.
What Are The Symptoms of Degenerative Disc Disease?
Many people have degenerative disc disease but have no pain. Others may have the same amount of damage, but have severe pain. The location of the pain correlates to the location of the affected disc. A bad neck disc can lead to neck pain that radiates out into the arms. An affected disc in the lower back may lead to back pain that also radiates into the legs and buttocks.
The usual indication of degenerative disc disease is low-intensity continuous pain around the degenerating disc. This will change to occasional severe, debilitating pain, often after placing abnormal stress on the spine such as when improperly lifting an object or during a fall.
If the nerves are being impinged, the person will develop numbness in his or her leg or arm, depending on the disc location.
Degenerative Disc Disease Treatment
At DFW Center for Spinal Disorders, our treatment goal is to reduce the chronic pain and prevent flare-ups, if possible. Most cases can be managed through a combination of pain management methods, core strengthening exercises/physical therapy, and lifestyle modification.
These are non-surgical treatments for mild to moderate symptoms:
- Anti-inflammatory medications
- Postural training
- Physical therapy
- Core strengthening exercises
- Manual/chiropractic manipulation
- Epidural steroid injections
- TENS unit (electrical nerve stimulation)
If the patient has serious pain that isn’t responding to the above treatments, we may recommend decompression surgery to remove bone spurs that are pushing on nearby nerve roots or the spinal cord. Fusion surgery may also be an option.