What is Degenerative Disc Disease?
The discs are like the spine’s “shock absorbers.” In their location between the bones of the spine (vertebrae), they are key in the ability of the back to handle stress and maintain flexibility (bending, twisting, etc.).
Unfortunately, with age and wear and tear, osteoarthritis tends to develop in the spine, affecting spine anatomy. It causes the cartilage in the spinal joints to diminish and the discs to lose their shock absorbing capabilities.
This is called degenerative disc disease. While not actually a disease, it is a condition in which causes pain and other troublesome and potentially disabling symptoms.
Categories of this condition include lumbar degenerative disc disease (of the back), cervical degenerative disc disease (of the neck), or multilevel degenerative disc disease (in more than one location/vertebra).
Studies have shown that almost everyone over age 60 has at least some degeneration in the spinal discs. This is a large factor among the 80 percent of adults in the U.S. who report at least some experience of back pain.
Not everyone with disc degeneration disease experiences symptoms. But those who do usually suffer pain in particular.
This pain can:
- Come and go
- Be in the legs, thighs, buttocks
- Be in the neck and radiate to the arms and legs
- Range from mild to severe and crippling
- Get worse when sitting, bending or lifting
- Lessen with walking or movement
- Lessen with lying down or changing positions
Other symptoms may include:
- Tingling or numbness in the arms and/or legs
- Back or neck stiffness
- Weakness in the leg muscles
- Dropped foot
- Muscle spasms
Causes and Risk Factors
Vertebral discs receive a limited blood supply, so unlike other body tissues, they cannot heal themselves well. Therefore, when a disc is injured or damaged, it can deteriorate. Below are the main causes of degenerative disc disease.
- Drying out of the disc. Healthy discs are 90 percent fluid. With time, age and other factors the discs lose water, and as a result flatten. Flatter discs mean the distance between vertebrae becomes smaller, and thus the shock absorbing qualities of the discs are diminished.
- Disc structures change. Over time—with age, daily activity, sports—and with the stress of daily movements or minor injuries, small tears or cracks occur in the disc’s outer wall. These cracks or tears in this outer layer can cause pain in nearby nerves. If there is a breakdown of the outer layer, the soft core of the disc can leak, causing a herniated disc, or the disc can slip out of its place.
The biggest risk factor for degenerative disc disease is age. Other factors include:
- Smoking or other use of tobacco
- Family history of back pain or musculoskeletal disorders
- Excessive low back strain from sports or extended strenuous physical labor
- Prolonged sitting or poor posture that places strain on the spine
- Spine injury
The doctor will review medical history and symptoms. This includes when and how the pain manifests itself, past injuries and family history of similar problems. The doctor may also test pain in response to movement or touch/pressure; muscle strength; and reflexes, a lack of which may indicate a compressed nerve root. Heat and cold may also be used to test nerve reactions.
Several imaging scans can provide information about the condition of the spinal discs and nerves. An MRI can reveal disc height and shape, as well as show any pinched nerves. If the disc is compressed due to loss of fluid, it will appear black on the MRI (referred to as a black disc).
Discogram. This is performed by injecting dye into the soft center of the suspected degenerated disc(s) in order to show the inside of the disc. The purpose is to determine if the disc is injured, and thus the source of pain.
A discogram can also reveal any cracks on the disc’s surface. A discogram is done more rarely, such as in the case that an MRI fails to show a herniated disc, or if surgery is being considered. However, since degenerative disc disease does not always cause symptoms, the discogram can be controversial.
Degenerative disc disease cannot be cured, but it can be slowed and its symptoms controlled. There are a number of ways to do so, and most of them are nonoperative.
- Medications. This includes both over-the-counter pain relievers, and if necessary, prescription pain medication, meant for short-term use. Other symptoms of the condition, such as muscle spasms, can also be relieved by medication.
- Ice and heat. Ice can reduce inflammation and help to numb pain. Ice is also useful following activity to minimize inflammation. Heat helps to relieve muscle tension and spasms, improve mobility and increase circulation.
- Physical therapy. Various movements and exercises may help provide flexibility and strength to the muscles in the neck and back. This supports the vulnerable structures.
- Steroid shots. These are injections of strong medications to ease symptoms such as pain and swelling.
- Surgery. When all other more conservative means have been exhausted, surgery may be indicated. Surgical back procedures have made tremendous technological advancements. Procedures like microdiscectomy, cervical disc replacement and spinal fusion are some notable options.
If you are experiencing back pain, neck pain or radiculopathy, request an appointment at Edison Spine Center. Our expert surgeons will diagnose your problem and offer you treatment options that work for you and your particular life circumstances.