Degenerative disc disease
Degenerative disc disease is a condition caused by the degeneration or breaking down of the intervertebral discs that support the spine, causing chronic pain. This degeneration is a result of either aging or an injury. Pain medications, self-care, spinal injections, physical therapy, and surgery are various options used to manage the symptoms of this condition.
Definition & Facts
Also known as spondylosis, degenerative disc disease is a condition that usually occurs in the lumbar vertebrae, but can also happen in other areas of the spine such as the thoracic vertebrae and cervical vertebrae.
Degenerative disc disease is a condition in which the vertebral discs degenerate or lose their ability to provide cushion to the spine. This leads to added pressure in the spinal cord, which causes chronic neck pain and back pain.
Because these discs do not get blood supply, once worn out due to aging or damaged due to an injury, they do not have the capability to repair or heal themselves.
Symptoms & Complaints
The location of the pain depends on where the affected disc is located. If the affected disc is located in the neck area, the pain occurs in the neck or arm area. On the other hand, if the affected disc is located in the lower back area, then the pain occurs in the back, legs, or buttocks.
Some people experienced tingling and numbness in the legs and arms. Oftentimes, the pain gets worse with certain movements like twisting, reaching up and bending over. These symptoms may start immediately after an injury such as from falling down or a car accident or after, a normal movement like bending over. The symptoms may also start with a slight pain for no known reason and gradually gets worse over time.
Degenerative disc disease is caused by one or more of the following:
- Aging – As the person ages, the repeated stresses on the spine over the years will start to take their toll. The vertebral discs will start to run out of fluid, which reduces their ability to function as shock absorbers in the spine. Thus, making your spine less flexible. The loss of fluid in the discs makes them thinner, which narrows the space in the vertebrae. With the lesser padding between the discs, the spine becomes unstable. This also causes bone spurs or osteophytes to start growing in the spine. Bone spurs add pressure to the spinal nerve roots, causing chronic pain and affecting nerve functions.
- Injury – Tears or cracks in the outer layer of the disc caused by a minor or major injury can cause the jelly-like material contained in the nucleus part of the disc to come out, causing bulged discs, herniated discs and ruptured discs. These damaged discs add pressure to the spine, causing chronic pain in the back and legs.
Diagnosis & Tests
The diagnosis for degenerative disc disease is done through medical history, physical examination and medical imaging tests. To understand the symptoms, the doctor will take into consideration the patient’s complete medical history, which includes previous injuries, conditions, treatments, habits, lifestyle and activities.
The doctor, then, performs a physical exam to determine the main source of the pain and conducts further tests for any muscle numbness or weakness, areas of tenderness, and changes in reflexes. The physical exam also includes checking for any bone fractures, infections, and tumors.
If the symptoms started after an injury or nerve damage is suspected, the doctor may request for imaging tests such as magnetic resonance imaging (MRI) scan, X-ray, discogram, myelogram, and computed tomography (CT) scan to determine a herniated disc, tumor, or other conditions that put pressure on the nerve roots. Depending on the results, the doctor may refer the patient to a neurologist, neurosurgeon, or orthopedist for treatment.
Treatment & Therapy
The first step in treating degenerative disc disease is to avoid aggravating it. Doctors will advise their patients to start modifying their activities to exclude heavy lifting and activities or sports that require body twisting such as basketball. To provide relief from pain, doctors prescribe one or more treatments, which may include physical therapy, epidural injection, anti-inflammatory medications, corticosteroids, muscle relaxants, special exercises, and wearing a back brace or corset.
If none of the conservative options work, surgery is recommended. Surgery is necessary only if the pain limits the patient’s normal activities, if there is numbness or weakness in the legs and thighs or if there is a difficulty in standing or walking. The most common surgical treatment for degenerative disc disease is the spinal fusion.
The spinal fusion entails removal of the damaged part of the intervertebral disc and replacing it with a bone graft or other substitute, and in time, it will heal and fuse with the vertebrae. Other surgical treatments include discectomy, corpectomy, laminotomy, arthroplasty, facetectomy, foraminotomy, interverbral disc annuloplasty, spinal laminectomy and spinal decompression.
Recent treatments have been developed, but are still in the clinical trials stage. These treatments include glucosamine injections, artificial disc replacement, adult stem cell therapy and mesenchymal stem cell therapy.
Prevention & Prophylaxis
Lightweight training and pilates exercises can also help keep the spine strong and flexible. Have a disciplined and well-balanced diet. A low fat diet and high fiber diet can help reduce body mass, which reduces the spine’s stress. Foods like leafy greens, nuts, and fish are high in antioxidants and omega fatty acids, which are essential for joint and spine health.