Degenerative Disc Disease

Degenerative disc disease is a condition where typical changes in the spinal discs lead to pain. Regardless of its name, it’s not a disease but rather a progressive condition that can result from injuries, day-to-day activities, sports, or the drying out and shrinking of a spinal disc over time

Degenerative disc disease usually occurs in the most mobile areas of the spine, specifically the lower back and neck. The two types include:

Lumbar Degenerative Disc Disease (Lower Back): Approximately 90 percent of disc disorders due to degenerative disc disease originate from the lowest parts of the lumbar spine.

Cervical Degenerative Disc Disease (Neck): While most people don’t show any symptoms, disc degeneration occurring in this region can cause painful and difficult movements.

Symptoms

Degenerative disc disease can cause sharp or persistent pain in the back and neck. The specific symptoms often depend on the location of the affected disc and the related changes triggered.

The most common signs are:

• Pain that worsens when sited but improves with movement or walking
• Increased discomfort during lifting, bending, or twisting
• Relief from pain when lying down or changing positions

The condition may sometimes lead to numbness, tingling in the arms and legs, or weakened leg muscles. This indicates that the damaged discs are impacting neighbouring nerves.

Although the pain can be intense, it isn’t always constant. It may come and go because of instability in the bones surrounding the affected disc, with flare-ups lasting anywhere from a few days to months.

Causes

Drying out: Spinal discs are mostly composed of water at birth, but with age, they lose moisture and become thinner. This loss of water reduces their ability to absorb shocks effectively. Thinner discs also provide less cushioning between vertebrae, potentially resulting in additional spinal issues and pain.

Cracking: Strain on the spine can create tiny tears in the external layer of the discs containing nerves. If these tears occur close to the nerves, they can cause pain. When the outer walls weaken, the soft inner core of the disc may press through the cracks, leading to bulging or slipping (slipped or herniated disc). This could impact the neighbouring nerves.

Common causes of disc cracking include:

• Everyday activities: Repeated wear and tear from everyday tasks such as lifting heavy items, gardening, or picking up children can gradually lead to disc degeneration.
• Injuries: Minor back injuries due to falls or inappropriate lifting techniques can increase the likelihood of disc damage. While the pain may not be immediate, these small injuries accumulate and worsen over time.

Risk Factors

Some factors that can increase the likelihood of developing degenerative disc disease are preventable, whereas others are not. They include:

• Aging: The most significant risk factor is aging. As you get older, your discs naturally start to wear down. Around 90% of people notice disc degeneration signs at the age of 60, though it’s often asymptomatic and common. If symptoms do appear, they may indicate degenerative disc disease.
• Obesity: Being overweight is linked to spinal damage, as well as degenerative disc disease. Excessive body weight, especially around the abdomen, places additional stress on your spine, raising the risk of degeneration.
• Heavy lifting and manual labour: Occupations that require regular heavy lifting or strenuous physical labour can slightly increase the possibility of disc degeneration over time.
• Family history: A genetic predisposition may also play a role. If one or both parents suffer from degenerative disc disease, you may be at a higher risk. Certain genes have been identified that could as well increase susceptibility to this condition.

Diagnosis

Diagnosing degenerative disc disease involves a thorough physical examination and medical history review. The doctor will assess your back’s flexibility and range of motion, looking for signs indicating nerve root damage. Muscle strength and reflexes are tested to ensure normal function and help identify any abnormalities.

A series of X-rays may be taken to confirm the diagnosis. If there is disc degeneration, X-rays usually reveal narrowed spaces between the vertebrae, indicating that the disc has thinned or collapsed. Bone spurs may also appear around the vertebral bodies and facet joint edges, which can reduce the available room for the nerve roots. The nerve roots, which leave the spinal canal via the neural foramen, can be compressed as a result.

Mostly, an MRI or CT scan may be recommended for further evaluation. An MRI provides detailed images of soft tissue, allowing the doctor to assess disc herniation and nerve root compression. A CT scan, on the other hand, is useful for examining the spinal anatomy, showing the amount of space present around the nerve roots and within the spinal canal and neural foramina.

Treatment

The Joint Pain Clinic offers surgical and non-surgical options to help manage degenerative disc disease. The treatment choice is based on factors like the patient’s age and the intensity of the condition.

Non-surgical treatment

For individuals without nerve root compression or muscle weakness, traditional approaches are typically recommended. These include medication, exercising, resting, and physical therapy.

Surgical treatment

Surgery is considered only when non-surgical treatments fail to provide sufficient relief from symptoms such as persistent pain, numbness, or muscle weakness. Surgical options may include decompressing the spinal cord, performing a discectomy to remove the damaged disc, and fusing the adjacent vertebrae to stabilize the spine.

What to Avoid with Degenerative Disc Disease

To support your back and manage symptoms, it’s important to steer clear of the following:

• Smoking: This can exacerbate pain and reduce the effectiveness of treatment.
• Heavy lifting: Repeatedly lifting heavy objects places excessive strain on the spinal discs.
• Excessive alcohol consumption: Drinking heavily can increase your possibility of back pain.
• Prolonged sitting: Sitting for prolonged periods can worsen discomfort; walking or standing helps improve the situation.
• High-impact workout: Activities like running, twisting, jumping, or strenuous sports such as football, tennis or weightlifting can stress your spine. Instead, choose low-impact exercises, including walking or swimming.