What is degenerative disc disease?
Your spine is made up of a column of bones called the vertebrae. Between each vertebra is a gel-filled disc that acts as a shock absorber, keeping your vertebrae from rubbing together. These disks are made up of about 80% water that slowly lose water with age, and with it their ability to act as shock absorbers.
Degenerative disc disease, also known as spondylosis, is a spinal condition caused by the breakdown of your intervertebral discs. As you age, your spine begins to show signs of wear and tear as your discs dry out and shrink. When your discs “degenerate”, they lose their flexibility and ability to cushion your spine. These discs do not have a good blood supply, so once injured, they cannot repair themselves.
What causes degenerative disc disease?
Age-related changes can lead to arthritis, disc herniation, or spinal stenosis, which can put pressure on your spinal cord and nerves and may cause back pain. Other age-related changes include:
- Discs dry out and shrink – the disc nucleus is made of about 80% water. As you get older it slowly loses water and flexibility, which puts more stress on the disc annulus.
- Small tears occur in the annulus – sometimes the gel-like nucleus pushes through a tear in the wall and touches nearby nerves. This material has inflammatory proteins that can irritate nerves and cause pain. The tears also affect tiny nerves in the annulus and cause discogenic pain with small micro-motion instability of the disc. Over time the proteins dry up and the discs become stiffer.
- Disc gets thinner – due to loss of water, the discs get thin and the distance between vertebrae begin to collapse. Which is why we get shorter as we age.
- Bone spurs grow – without the discs holding apart the vertebrae, they can rub on each other and cause abnormal bone growths.
- Excess motion – abnormal rubbing adds stress to the facet joints. Pinched nerves may result in back or leg pain (sciatica).
- Spinal canal narrows – the added stress causes the ligaments and facet joints to enlarge as they try to compensate and spread the load over a larger area. This overgrowth causes the spinal canal to narrow, which can compress the spinal cord and nerves and result in pain.
What are symptoms of degenerative disc disease?
The symptoms of degenerative disc disease vary from person to person. Many people with deterioration have no pain, while others experience pain so intense that it interferes with daily activities. Although this condition can affect people starting as early as their twenties, people in their sixties or above are more likely to less back pain caused by deteriorated discs.
Pain often starts in one of three ways:
- A major injury followed by sudden and unexpected pain.
- A trivial injury followed by sudden back pain.
- Pain that starts gradually and gets progressively worse.
Usually, the pain begins in the lower back, and may be felt in one of both of your legs and buttocks – sometimes known as sciatica. It’s often described as pressure or burning pain. You may also feel numbness or tingling in your leg and foot.
How is degenerative disc disease diagnosed?
When you first experience pain, consult your family doctor. Your doctor will take a complete medical history to understand your symptoms, any prior injuries, or conditions, and determine whether any lifestyle habits are causing the pain. Next, a physical exam is performed to determine the source of the pain and test for any muscle numbness or weakness. Your doctor may order imaging tests such as an X-ray or MRI scan.
What are degenerative disc disease treatment options?
Several treatments can help relieve the pain. Each treatment offers benefits, but each has limitations. Usually, your healthcare provider will recommend noninvasive treatment options first, including:
- Physical therapy
- Medications
- Steroid injections
- Radiofrequency ablation
Many patients respond well to these noninvasive treatments, and do not require surgery to treat their degenerative disc disease. However, if you have tried these treatments and they do not provide pain relief, surgery may be a good option. Your surgeon may use a few types of spinal decompression surgery:
- Discectomy – removing part of a spinal disk to relieve pressure on your nerves.
- Foraminotomy – expanding the opening for your nerve roots by removing tissue and bone.
- Laminectomy – taking a small portion of bone from your lower spine.
- Osteophyte removal – removing bone spurs.
- Spinal fusion – connecting two or more vertebrae to improve stability.
Most people who have surgery for degenerative disc disease experience long-term pain relief. It is important to follow your provider’s instructions to keep your back strong and healthy. Degenerated discs can increase your risk of developing other spinal conditions, including:
Talk with your healthcare provider to see what treatment plan is best to treat your degenerative disc disease.