Degenerative Disc Disease
What is degenerative disc disease?
In addition to bones—your 33 vertebrae—your spine is also made up of intervertebral discs. These discs are situated within the spinal joint spaces acting like cushions or shock absorbers as you bend and twist your back. At birth, these discs are about 80% water. As people age, the intervertebral discs begin to dry up and wear out, and the spinal bones have to absorb more of the shock when you move. This condition is called degenerative disc disease. Degenerative disc disease in the neck affects the cervical spine, degenerative disc disease in the upper and middle part of the back affects the thoracic spine, and degenerative disc disease in the lower back affects the lumbar spine. The sacral spine and coccyx follow the lumbar spine.
Older age is the biggest risk factor for degenerative disc disease. Nearly everyone will experience some form of disc degeneration at some point in life, although the condition won’t cause pain for every person. For those people who do experience pain, they usually hurt in the neck or lower back. The pain can be mild or severe, and it may get worse as the discs continue to deteriorate. Some people experience intense pain that comes and goes, often for days or even months at a time.
You may be able to manage degenerative disc disease symptoms with gentle stretches and rest, along with ice or heat to relieve stiff or sore joints and muscles. If those therapies don’t help, your doctor might recommend pain medication, either over-the-counter or prescription drugs. Surgery is necessary in some cases.
Without treatment, degenerative disc disease and pain symptoms can get worse with time. If you have severe pain, you might have trouble doing your daily activities. See your primary care doctor or an orthopedic or spine specialist for unexplained neck or back pain, for pain that comes and goes but persists over time, and for pain, tingling or numbness in your arms, buttocks or legs. More serious symptoms include weakness in your extremities and loss of bowel or bladder control—seek immediate care.
What are the symptoms of degenerative disc disease?
Pain is the main symptom, although in some people degenerative disc disease causes numbness or tingling in the arms or legs due to spinal nerve compression. The discs and spinal joints can press on nerve roots as they exit the spinal column.
Pain can range from mild to severe. People with cervical degenerative disc disease experience pain in their neck (the cervical spine) that may radiate to the arms and hands. People with lumbar degenerative disc disease experience pain in their lower back (the lumbar spine) that may radiate to the buttocks and legs. Some people develop multilevel degenerative disc disease, which means the discs are deteriorating in more than one place along the spine.
People with degenerative disc disease often experience worse pain when sitting, bending, twisting or lifting. The pain usually decreases with walking or upon lying down.
Don’t delay seeing a doctor about signs and symptoms of degenerative disc disease. It’s important to talk with your doctor about any symptoms you can’t manage with rest and pain medicine.
If you experience weakness in your leg muscles or loss of bladder or bowel control, seek immediate medical care. You could have nerve damage due to a shifted vertebra putting pressure on your spinal cord.
What causes degenerative disc disease?
Rather than an actual disease, progressive disc degeneration is a result of aging. With time, the fibrous outer coat of the discs begin to dry out, deteriorate, and bulge. As they wear out, the gel contents can leak and the discs can no longer cushion the bony vertebrae well, and the bones have to absorb more of the stress from movement. The discs also begin to flatten out and lose height, which can cause the vertebrae to shift.
Sometimes, a shifted vertebra or contents from a ruptured disc can put pressure on a nerve causing pain and muscle spasms. As the condition progresses, intervertebral discs may collapse, which can cause the person to become physically shorter in stature.
Sporting activities and injuries can also damage the spinal discs and accelerate disc degeneration. Because there’s only a limited blood supply to the discs, they don’t repair themselves after an injury like other body tissues.
What are the risk factors for degenerative disc disease?
Older people are at the highest risk for degenerative disc disease, simply because the spinal discs have been in use longer. Like the wearing away of joint cartilage in osteoarthritis, the discs in between each vertebra have had more time to wear out.
While you can’t change your age, regular physical activity can help you strengthen your back and abdominal muscles that support your spine. Exercise can improve your flexibility as well as increase blood flow to the joints and muscles in your back. Your doctor can help you determine an exercise routine that’s right for you.
How is degenerative disc disease treated?
The goal of degenerative disc disease treatment is to strengthen your core, stabilize the spine, and control pain. There are several pain management options.
Electrical stimulation and applications of heat and cold therapy are nonmedicinal ways to help soothe stiff or sore joints in your back and neck. Physical therapy, stretching, spinal mobilization, and low-impact exercise can help improve flexibility and strength in your back as well as your abdominal muscles. Talk with your doctor before beginning any degenerative disc disease exercises.
If you’re still experiencing pain after a course of physical therapy and self-care, you might need medication. This can include over-the-counter pain relievers or nonsteroidal anti-inflammatory drugs. If those don’t work, your doctor may prescribe arthritis medication. This type of medicine can take a few weeks before you feel relief.
Some people need spine surgery to treat the painful effects of degenerative disc disease. Surgical treatment for degenerative disc disease includes:
Disc replacement replaces a damaged disc with an artificial disc.
Spinal fusion physically fuses two or more vertebrae together with bone grafts or metal implants. Spinal fusion is an option for people with severe disc degeneration who are not responding well to more conservative pain management therapies.
What are the potential complications of degenerative disc disease?
Degenerative disc disease may worsen with time, and it could eventually interfere with your daily activities. If the condition worsens to the point your doctor recommends spine surgery, be sure you fully understand the surgery, including its advantages, disadvantages and recovery time specific to your situation. In most cases, the benefits of surgery outweigh the risks, although surgical complications are possible. Complications can include damage to nearby nerves and blood vessels, infection, and complications specific to the surgery you need, such as problems with an artificial disc.