Degenerative Disk Disease
What is Degenerative Disk Disease?
Degenerative disc disease causes changes in the spinal discs creating back pain ranging from moderate to severe pain. This common condition affects approximately 30% of people aged 30 – 50 years old. It is actually not technically a disease, but a progressive ailment developing over time as a result of normal wear and tear to your spine. It is possible to be genetically predisposed to degenerative disc disease or to develop it from a traumatic injury. Going without treatment for degenerative disc disease can cause long-term spinal damage.
What Are The Symptoms?
The early stages of degenerative disc disease can be unnoticeable as there might not be any signs or symptoms a patient feels. However, as it worsens, a patient can begin to develop symptoms. These symptoms include pain in your legs, feet, and lower back, and muscle spasms/stiffness along damaged portion of the spine. Other symptoms can be presented as pain worsened when standing or sitting for long periods of time, sudden and sharp pain from lifting heavy objects or moving too quickly, pain emanating from the back to the extremities, tingling or numbing in legs or arms which make it hard to move around comfortably, and pain lasting longer than 6 weeks.
Most people with degenerative disc disease don’t have pain or other symptoms. However, if you do have back pain that is from degenerative disc disease it may change depending on your activity. Below are some examples of how your pain may change.
- The pain is worse when you sit, and better when you move and walk
- The pain is worse when you bend, lift, or twist
- The pain gets better when you change positions or lie down
What Are The Causes?
Your intervertebral discs are made of a soft jelly-like inner core (nucleus pulposus) and a tough cartilaginous outer wall (annulus fibrosus). Degeneration of discs can occur if they dry out or crack.
- Dry out. Discs in your spine are mostly made up of water. They can lose water and become thinner as you age. This results in less shock absorption and cushion between your vertebrae.
- Crack. Small tears in the outer wall can occur with normal wear and tear. There are small nerves in the outer 1/3 of the wall, so tears in that area can be very painful. The nucleus pulposus is also at risk of pushing through the tear and irritating or compressing near by spinal nerves.
In addition to degenerative disc disease being caused by the wear and tear from aging, it can also be caused by obesity, smoking, traumatic injuries, genetics, underlying spinal conditions, and occupations requiring heavy lifting. If you let degenerative disc disease go untreated, the condition may worsen and can cause serious damage to your spine. This can result in herniated discs and bone spurs. There are a few things you can do to reduce the risk of developing degenerative disc disease: maintain a healthy weight and stay active to strengthen bones in the spine, quit smoking if you’re a smoker, and if you have a job requiring heavy lifting, practice safe habits for all that lifting.
A thorough history and physical examination is key to diagnosing degenerative disc disease related back and/or neck pain. An X-ray and/or MRI may be ordered to further assess your discs and spine.
What Are The Treatments?
Typically pain related to degenerative disc disease is treated in multiple ways. Medication, physical therapy and exercising as well as interventional procedures are all used. Recently regenerative medicine therapies have helped patients improve their disc health.
Medication. Over-the-counter nonsteroidal anti-inflammatory drugs (ibuprofen, Aleve, Advil, naproxen, Motrin, etc) can help treat the pain and decrease inflammation. Sometimes a prescription strength is required. Muscle relaxers are sometimes prescribed if the inflammation causes nearby muscles to spasm and increase your pain.
Physical therapy. Improving your core (abdominal and back) strength and flexibility, as well as posture education can help your pain and support the spine.
Injections. Epidural steroid injections may be performed if medications and therapy alone do not help. Steroid medications can help reduce pain and inflammation.
Platelet rich plasma (PRP), stem cell and exosome injections have helped some patients regain healthy discs. These substances are injected directly into the disc or surrounding area to signal your body to send further new cells to promote healing.
Surgery is sometimes recommended if all other conservative treatments (above) have not helped your pain and functional capacity. Your pain doctor will refer you to a trusted surgeon to be evaluated to determine if surgery is right for you.
Those patients who suffer from more severe pain are recommended to have kyphoplasty done. Kyphoplasty is a minimally invasive procedure where a small needle with a balloon is inserted into the fractured vertebrae to inflate it back to the original position. The area is filled with cement inside the balloon raising the spine to the correct height. Kyphoplasty is a fairly short procedure that provides pain relief and stability to compression fracture patients.