Degenerative disc disease
Degenerative disc disease is a condition that causes discs between the vertebrae of the spinal column to deteriorate. Most symptoms of degenerative disc disease occur in the lower back or neck.
What causes discs to deteriorate?
Several factors can cause discs to degenerate, including:
- Drying out with age.
- Tears in the outer portion of the disc.
Unlike other tissues of the body, discs get very little blood supply. So once a disc is injured, it cannot repair itself, and the disc deteriorates.
Diagnosing degenerative disc disease
To start, your doctor will review your medical history and conduct a physical exam.
Next, your doctor may order imaging tests like X-rays, a magnetic resonance imaging scan (MRI) or computed tomography (CT) scan to get a better look at the discs and bony structures.
Symptoms of degenerative disc disease
Most symptoms of degenerative disc disease occur in the lower back or neck.
The pain may:
- Cause weakness in the leg muscles or foot drop, which may be a sign of damage to the nerve root.
- Come and go.
- Extend to the arms and hands.
- Primarily affect the neck and lower back.
- Radiate to the buttocks and thighs.
- Range from mild to severe and disabling.
- Worsen when sitting or after bending, lifting or twisting.
Why is degenerative disc disease so painful?
In general, there are two main sources for degenerative disc disease pain:
Inflammation. As the disc breaks down, proteins from the interior of the disc can leak into the surrounding spinal structures and cause swelling. This, in turn, can cause muscle tension, muscle spasms, and local tenderness in the back or neck.
Abnormal micro-motion instability. As the outer layer of the the disc deteriorates, the cushioning and support the disc provides declines. Eventually, that part of the spine becomes more unstable, due to unusual movement of the vertebrae above and below the disc. With those micro-motions comes tension and irritation in the surrounding muscles, joints, and/or nerve roots, which can cause more intense bouts of pain.
Treatments for degenerative disc disease
Treatment options include:
- Artificial disc replacement.
- Heat and ice.
- Manual manipulation by a chiropractic professional.
- Massage therapy from a physical therapist.
- Nonoperative treatment of symptoms, including acupuncture, back braces and pain management via a combination of over-the counter and prescription medications.
- Surgical intervention.
Frequently asked questions (FAQs) about degenerative disc disease
Spinal disc degeneration may start gradually or suddenly but will typically progress over the next 20 to 30 years. After it gets to a point of severe and, at times, disabling pain, the spine will eventually restabilize and the pain from the disc will decrease.
No. The two conditions are sometimes thought to be interchangeable because the disc and facet joints are both part of the same three-joint complex. However, degenerative disc disease and osteoarthritis are different conditions that occur independently of one another. A person can have degenerative discs without experiencing any facet osteoarthritis. Conversely, a person can have facet osteoarthritis but not have degenerative discs. It’s also possible to experience both conditions simultaneously.
It depends on the severity of the herniated disc. When a disc is herniated, the capsule cracks or breaks, and the nucleus squeezes out. This irritation of the spinal cord or nearby nerves can make the arms or legs go weak or grow numb. If the disc is herniated enough, it can cause paralysis.
No. Degenerative disc disease will never entirely “go away.” Once your disc starts to degenerate, you can’t reverse the process. However, as the spine restabilizes, the amount of pain you experience will eventually decrease over time.
When sleeping with DDD, proper alignment of your spine is key. No matter what your preferred sleeping position is, it’s especially important to keep your ears, shoulders, and hips in alignment.
If you feel strain on your muscles and spine due to gaps between your body and the bed, try using pillows to fill the gaps and help reduce the stress.
Knowing that twisting and turning motions can easily put your spine out of alignment, you need to be careful while turning in bed. Think about tightening your core, pulling it in, and moving your entire body together. As you roll over, it may even help to bring your knees toward your chest.
Drink water. The more water you drink, the better chance you give your body to adequately replenish the water in your discs. This is a simple, healthy way to reduce your chances of developing back pain.
Get a massage. Although no standardized treatment for DDD exists, both physical therapy and massage therapy have proven effective in relieving back pain for some patients.
Take a walk. Taking short, frequent walks during the day can decrease lumbar disc pain. As with any physician-approved exercise with DDD, the key is to take it slow and not overdo it.
Try heat or ice. As a general rule, use whichever treatment you find brings you the most relief. However, if you’re attempting to treat an acute condition like DDD for the first time, you should start with ice, especially if swelling is present. inflammation and swelling are always the biggest symptoms within the first two weeks, so ice is the best treatment option.
After that initial phase, you can use either ice or heat to bring relief, depending on your preference.
Here are some practical self care tips that can help you live with DDD:
- Engage in controlled, progressive exercise and active rehabilitation.
- Increase hydration and improve nutrition to keep your spinal discs healthy.
- Minimize aggravation to the disc by limiting strenuous activity.
- Reduce your pain to a tolerable level.
Good foods. Note too that certain foods are recognized for their positive impact on spine health:
- Healthy fats.
- Leafy greens.
- Lean protein.
- Whole grains.
Beneficial vitamins. Vitamin D chemically bonds to receptors found on the discs in the spine, helping to strengthen them.
In addition to Vitamin D, some supplements are being researched that may provide pain relief and help slow the progression early-stage degenerative disease. These include:
- Chondroitin sulfate.
Arthritis Foundation. Degenerative Disc Disease (https://www.arthritis.org/diseases/degenerative-disc-disease)
National Center for Biotechnology Information (NCBI): National Library of Medicine. Lumbar Degenerative Disk Disease (https://www.ncbi.nlm.nih.gov/books/NBK448134/)
MedlinePlus: National Library of Medicine. Intervertebral disc disease (https://medlineplus.gov/genetics/condition/intervertebral-disc-disease/)