Degenerative disc disease occurs when changes to the spinal discs that are part of the normal aging process cause pain. The condition typically affects patients who are otherwise in good health, and it can develop as early as the 30s or 40s. While this ailment is considered to be a chronic disease, treatment can help significantly with symptom management.
What Are the Spinal Discs?
Nestled in between the vertebrae (bones) of the spine, the spinal discs function as shock absorbers. They are comprised of a hard outer part and a softer inside core. Properly functioning spinal discs support spinal flexibility and enable easy, pain-free bending and twisting motions.
What Causes Degenerative Disc Disease?
As the name suggests, this condition is caused by the natural degeneration and wear and tear on the spinal discs that develop with age. At birth, the soft inner part of the spinal disc is composed mostly of water, allowing it to absorb shocks easily. With age, the inner core loses water content and dries out; therefore, it cannot provide as much shock absorption as it once could, and there is less of a cushion between each vertebra. Aging also causes the discs to become thinner, resulting in an additional reduction in shock absorption.
Degenerative disc disease can develop due to cracks in the discs. These cracks are typically small tears that occur in the tough outer walls of the discs. Generally, these form over a period of several years as a result of repetitive strain from everyday movements or minor injuries. Since the outer discs contain nerves, even small cracks can cause pain. In some cases, having a cracked disc can cause the soft inner portion of the disc to push into the outer disc portion. This can lead to bulges in the discs and to slipped or herniated discs.
What Are the Symptoms of Degenerative Disc Disease?
The symptoms of degenerative disc disease vary according to the precise location of the degenerated disc and to the presence of other disc-related conditions such as slipped or herniated discs. At Spine Orthopedics and Rehabilitation New York, the most common symptom we see in our patients with this condition is a sharp, continuous pain in the neck and back. Patients also typically experience pain in the lower back, upper thighs, and buttocks, and tingling or a numb sensation in the arms and legs may occur. Patients may observe that their leg muscles are weaker than usual.
The severity and duration of pain can vary depending upon the stage of degenerative disc disease that a patient has. For some patients, pain may come and go; for others, it can last for a period of a few days to several months. While some patients may experience a type of pain that is merely annoying, other patients may have pain that severely disrupts their lives. In general, the pain will improve when a patient stands or walks and worsen when he or she sits, bends, twists, or lifts heavy items. Pain may resolve when a patient changes position or lies down.
How Is This Condition Diagnosed?
Degenerative disc disease is typically diagnosed through a health history and a clinical examination. Patients will be asked about any pre-existing health conditions they may have and about any medications they take, including over the counter medicines. In particular, questions will be asked about any personal or family history of previous spinal pain, conditions, injuries, or surgeries. Patients will be asked to describe the location and characteristics of their pain, including when it began, whether it is intermittent or constant, how long it lasts, and whether it is sharp or dull. Doctors will inquire as to if anything makes the pain worse or better. Information about whether the pain radiates to other parts of the body outside of the spine can be especially helpful to the physician.
After taking the patient’s health history, the clinician will conduct a physical examination. During the exam, patients may be asked to bend or twist to see if this causes pain, and the patient’s gait (walking) may also be assessed. The physician will gently palpate (touch) the spine to check for any soreness, bulging, or other abnormalities. The lower back will be evaluated for painful areas, and patients will also have a neck examination. This will involve asking the patient to turn his or her head from side to side and up and down, and the doctor will also touch the area to assess for any tender spots. Following the examination, the physician may order x-rays or MRI scans to look for potential damage to the bones or nerves that are located near the spinal column.
What Treatment Options Exist for Degenerative Disc Disease?
Where possible, doctors aim to treat this condition in a manner that effectively relieves pain while being as conservative as possible. As a first treatment method, the clinician may recommend the use of aspirin, ibuprofen, or other anti-inflammatory medication to ease pain and swelling in the discs. If necessary, a prescription-strength dosage of these medications can be provided, and more potent painkillers may be prescribed for particularly severe pain. Patients who experience muscle spasms due to this condition will be prescribed additional medications to alleviate these.
Many patients will be referred for a course of physical therapy. This therapy can help patients learn specific motions that can strengthen the back and neck muscles, allowing them to become more flexible and properly support the spinal column.
If these treatments are insufficient for pain relief, steroid injections may be recommended. Steroids work to alleviate pain, swelling, and inflammation simultaneously. At the integrated spine clinic in our practice, we provide a wide range of spinal injections in accordance with our patient’s needs. These injections are typically given into a nerve or muscle, and they can also be given in the epidural space, an area around the spinal cord that is filled with fluid.
In severe cases of degenerative disc disease, surgical options may be considered. These typically include procedures that remove either the injured part of the disc or the entire disc. The damaged disc may be replaced with an artificial one. For especially severe cases, surgeons may elect to fuse the spinal bones together after the damaged disc has been removed.