What Is Degenerative Disc Disease?

Degenerative disc disease (DDD) is a condition caused by tear-and wear of your spinal discs and is associated with aging. Spinal discs or intervertebral discs are circular rubbery cushions between your spinal bone columns that absorb shock from impact and prevent the spinal bones (vertebrae) from grinding against each other.
This condition can occur in any spine area (cervical, thoracic, lumbar). Most people, after the age of 40 years, begin to experience spinal degeneration conditions, and once a disk is damaged, it cannot repair itself.

Causes of Degenerative Disk Disease

DDD causes pain if the spinal discs wear down. However, not everyone experiences pain. The disks can degenerate when they:

• Dry out: The core of the discs contains water. As you age, the core naturally loses some water resulting in thinner discs. As a result, the discs flatten and cannot absorb shock as well as they used to. This also means your vertebrae will have less cushioning or padding.
• Tear or crack: Minor injuries and everyday movements can lead to tiny tears near nerves which can become painful even when minor. If the outer wall of the spinal discs cracks open, the disc may slip out of place, resulting in a herniated disc.
• Injuries and overuse: Sports or repetitive activities can cause soreness, swelling, and instability resulting in lower back pain.

Risk Factors of Degenerative Diseases

A significant risk factor for this condition is age (especially in adults over 60 years). Other factors may include:

• Injuries from car accidents
• Genetic disposition to joint pain or musculoskeletal disorders
• Spinal diseases such as ankylosing spondylitis, an inflammatory spine condition that causes vertebrae to fuse
• Long-term repetitive activities that increase pressure on certain discs
• Arthritis
• Osteoporosis
• Overweight or obesity
• Sedentary lifestyle
• Smoking

Symptoms

Spine disc degeneration is very gradual, and many people might not start to experience DDD symptoms until they are in their 60s or 70s. You might not notice any symptoms in the early stages, but when it happens, they include;

• Pain in the legs, neck, thighs, and buttocks that worsens with standing
• Stiffness in your neck
• Radiating pain through your buttocks and legs or arms and hands
• Worsening pain when sitting, lifting, bending, or twisting
• Loss of motion in your spine
• Pins and needles or reduced sensation to touch
• Nerve injury, muscle spasms, or deformity
• Leg or foot weakness in severe cases

Diagnosis

Your doctor will evaluate your medical history, and you will be asked to answer some typical degenerative questions to diagnose the problem, such as:

• When the back or neck pain began
• What activities have you engaged in recently
• Remedies and treatments you have tried
• Anything that has increased or reduced the pain

Your doctor might conduct other examinations, which include:
Physical exam
In this exam, your doctor will observe your range of motion, posture, and physical condition. Your doctor will also feel your spine, noting its curvature alignment and muscle spasms.
Neurological exam
During the neurological exam, your doctor will test your muscle strength, reflexes, pain spread, and other nerve changes that may affect your nerves and spinal cord.
Your doctor may order imaging tests to diagnose DDD, such as:

• X-ray is very effective at showing spinal channels (osteophytes), fractured bone spurs (osteophytes), or osteoarthritis.
• A computerized tomography (CT) scan clearly shows the nerves and bones and checks if a bone spur is pressing on a nerve.
• EMG test will be able to measure how fast your nerves respond
• A bone scan will help detect DDD-related spinal problems like fractures, osteoarthritis, or infections.
• Myelogram can see if you have a spinal cord or spinal canal disorder, such as a nerve compression that might be causing pain and weakness
• Discogram is used to verify and locate the damaged discs.

Treatment

The goal of treatment is to prevent the condition from worsening and to relieve pain and other symptoms. These may include:

Noninvasive treatment options

Physical therapy: Specific exercises to strengthen back muscles, improve posture, and spine flexibility.

Steroid injections: Also known as an epidural to reduce swelling and inflammation. The shot is administered in your epidural space into your nerve, fluid space around the spinal cord, or muscle.

Medications: These help with pain relief and inflammation, such as over-the-counter medications such as aspirin, acetaminophen, or ibuprofen and nonsteroidal anti-inflammatory drugs (NSAIDs) to control pain and other symptoms.

Radiofrequency neurotomy: This utilizes electric currents to prevent pain signals from getting into your brain.

Bracing: to limit motion and assist in healing.

Other options include acupuncture, activity modification, and ice or heat therapy.

Surgery

This is considered the last resort when noninvasive options are ineffective (within about three months). It is recommended when there are:

• Difficulty walking or standing
• Leg numbness or weakness
• Pain is severe and getting worse
• Leg and back pain that is preventing you from doing your job or regular activities

Surgical options may include:

Spinal fusion or stabilization surgery: This is done to permanently fuse two or more vertebrae in your spine to provide stability and eliminate motion between them. The surgery can be done anywhere in the spine, especially in the neck and lower back, to relieve extreme pain.

Laminectomy or decompression surgery: This minimally invasive surgery creates space by removing part of the joint of the disc. This enlarges the spinal canal to relieve pressure on the nerves or spinal cords.

Discectomy: This surgery removes part of the spinal disc for nerve pressure relief. The surgery helps alleviate pain from a compressed nerve.
Osteophyte removal involves removing bone spurs that might restrict the joint range of movement or irritate the spine.

Contact us today for more information about our comprehensive, advanced treatment options at Axon Health Associates. You can also schedule an appointment online. We are happy to answer any questions you may have about degenerative disc disease.