Degenerative Disc Disease
Despite being diagnosed as a “disease”, degenerative disc disease is more of a condition that occurs naturally in an aging body.
Degenerative disc disease is an age-related condition where one or more intervertebral discs degenerate over time as people grow older. This degeneration causes a wear and tear of the spinal discs, which are like the shock absorbers between the bones while enabling the flexible movement of the body.
Though it is a natural process in every human body, for some people the condition becomes much more serious. Damage in the spinal discs can cause several symptoms, with pain and instability of the limbs being primary among them. If you are experiencing these symptoms along with severe low back and neck pain, you should see a physician for professional diagnosis. Our physicians at Advanced Pain Care are here to conduct thorough and personal evaluations to properly diagnose your condition and develop a treatment plan specifically for you or a loved one.
While the degeneration of the discs will continue to progress over time, the pain caused by this condition can be treated and additional symptoms can be avoided using several non-surgical procedures.
What are the causes of degenerative disc disease?
The basic structure of the spine or the back bone of the body comprises three parts:
- Vertebrae — Interlocking bones in the spine supporting the whole body
- Intervertebral Discs or Spinal Discs — act as cushions for the vertebrae and enable flexible movement of the body
- Cartilage — protects the spine
The spinal discs have a tough exterior and a soft core. The inside of the human spine is mainly comprised of water at birth, however, as the body ages the water content starts depleting and flattens the discs out. The capacity of the spinal discs to absorb shocks starts reducing as the discs start drying out. Additionally, routine movements and injuries add stress to the exterior of the spinal discs which often causes tears in the outer wall which contains nerves and causes extreme pain. In the case of severe tears, there is also the danger of the disc entirely slipping or bulging out of place causing a condition called herniated disc, which can also impact the nerves in the region.
The most common areas where degenerative disc disease occurs is the neck or the cervical portion of the spine and the low back or the lumbar spine due to constant use and stress caused by normal, everyday movements.
What are some of the risk factors that increase incidence of degenerative disc disease?
While the drying out of the discs or the cracking of the walls expedite the onset of degenerative disc disease, there are several other causes that are not associated with the process of aging but can still initiate early onset of the condition. They include:
- Spinal disease such as ankylosing spondylitis
- Increased activity levels
- Genetic predisposition
- Sudden injuries
The natural process of degeneration in discs begins during the 20s; however, lifestyle conditions and accidents/injuries can cause the condition to progress more quickly depending on the severity of these events.
What are the symptoms of degenerative disc disease?
The most common areas degenerative disc disease pain is initially felt is in the cervical or lumbar spinal regions. The pain is initially manifested as “sharp and shooting” in the neck or lower back region. The pain usually starts spreading to the back of the legs and the thighs since this condition impacts the nerves in the surrounding regions.
If you have been experiencing similar pain, notice if you are also feeling any of the following symptoms:
- Painful stiffening in the back with a feeling that you cannot move
- Severe and nagging back/neck pain that lasts for months
- Limited range of motion in the back and neck
- Severe pain while attempting routine movements
- Constant need to change positions or movement to reduce pain
- Pain felt in the back of the legs and thighs
- Pain felt in the arms and hands
- Numbness and tingling in the arms and legs
- Inability to sit or stand for long periods of time
- Weakness in the legs
- Muscle spasms
It is also important to note that the extent of pain does not necessarily indicate the extent of degeneration or damage. In some cases, the patient may experience acute or chronic pain but the need for surgical intervention is not needed. Additional evaluations and testing will indicate what type of treatment is needed.
When should I see a doctor?
In some cases the pain, or the manifestation of some or all of the above-mentioned symptoms, could range from mild irritation to debilitating pain. While chronic pain and disability can occur in some cases, it is relatively rare.
If you have been experiencing any of the above symptoms for some time or have been suffering from persistent, low-grade pain in the back and neck region, which flares up at times into a very severe one, it is most definitely time to schedule a visit to Advanced Pain Care.
If you do experience sudden loss in bladder and/or bowel control, this could be due to extensive damage to the nerves. Seek immediate medical help or contact us at 512-244-4272.
How is degenerative disc disease diagnosed?
The physicians and pain care specialists at Advanced Pain Care follow a 360-degree approach to understanding and evaluating your condition before making a professional diagnosis.
They will begin with various questions to understand the causes and extent of the symptoms, such as:
- Did you have a minor/major injury/accident in the recent past?
- When did you begin to experience the pain and where do you feel it?
- Do you feel persistent pain, a radiating one or does it come and go?
- Do you feel a stiffness or numbness in your back and/or legs?
- What is your exercise routine?
- What is your lifestyle like?
- Did anyone in your immediate family suffer from similar symptoms?
Once this information is established, it is followed up by a physical examination to check for any abnormalities such as swelling and bulging, evaluate the extent of the pain, range of motion, etc.
Depending on what was revealed, the physician may ask for an X-ray to check for bone spurs, fractures, or to see if the space between the discs has reduced. However, an X-ray does not indicate the changes in the inner core of the spinal discs so an imaging test will be prescribed. The magnetic resonance imaging (or MRI) test indicates any tears, dehydration or herniations in the discs. It can also indicate if there is a narrowing of the spinal canal and show the extent of any damage.
How is degenerative disc disease treated?
With degenerative disc disease being a very broad-based condition, the physicians and pain management specialists at Advanced Pain Care follow a symptom-based treatment, emphasizing the management and reduction of pain and other symptoms to enable a better quality of life.
Before considering whether surgical intervention is required, doctors follow a conservative symptom treatment method which comprises the following:
- Medication — Over-the-counter medicines such as nonsteroidal anti-inflammatory drugs, opioid pain relievers, and muscle relaxants
- Therapeutic Injections — Commonly prescribed injections include nerve block injections, trigger point injections, epidural corticosteroid injections, etc.
- Lifestyle and dietary modifications
- Physical therapy
- Implantation of nerve stimulation devices to minimize pain (spinal cord stimulator)
- Ice and cold pack application
Treatment plans are developed for each patient individually. In some cases, conservative treatment plans may not relieve the pain or reduce negative symptoms. In such cases, spine specialists will begin evaluating surgical intervention and options.
What are the surgical treatment options for degenerative disc disease?
As a rule of thumb, spine specialists will recommend surgical intervention if conservative, non-invasive treatments do not provide relief after 12-16 weeks and the pain and symptoms persist or even get worse. The most common surgical procedures for this condition are:
- Spinal Fusion — This is considered if the spine is unstable, causing progressive weakness or loss of bowel/bladder control. In the case a disc is severely damaged, it is surgically removed and the surrounding vertebrae are fused together to re-stabilize that portion of the spine.
- Artificial Disc Replacement — As the name suggests, after a damaged disc is removed, it is replaced with a prosthetic or artificial disc. This is gaining wider traction with advances in technology. Again, this is reserved for an unstable spine.
- Discectomy — This procedure involves the removal of some or all of the damaged disc. This is done to relieve pressure on a pinched nerve, which causes severe pain in upper or lower extremities.
What are some of the pre- and post-operative considerations?
The decision for surgery rests entirely in the hands of the patient and their doctor. Before considering surgery as a final option, here are some pre- and post-operative considerations your doctor will go over with you:
- Surgery is recommended only in cases where the MRI clearly indicates the specific site and cause of the pain.
- The post-surgery recovery process may include changes to one’s lifestyle.
- Regular physical therapy, pain management options, medications, the wearing of a neck or back brace, etc., may be advised for weeks or months after surgery.
- To maintain post-surgery benefits, doctors will advise changes in lifestyle, including restriction of alcohol and nicotine, increase in activity levels, etc…
How can I prevent the onset of degenerative disc disease?
Once degeneration starts, it cannot be reversed. With timely treatment, doctors and specialists can treat the symptoms of the condition and help you live a normal life. In the case of degenerative disc disease, the saying “prevention is better than a cure” certainly holds true. Even though we cannot completely stop the natural wear and tear that occurs in each of our bodies, there are ways to slow down the progression or delay the onset of the symptoms. Doctors will ask you to follow a healthy and active lifestyle and adhere to recommendations, such as:
Q: Is degenerative disc disease serious?
A: Yes, it can be serious. Degenerative disc disease is considered more of a normal condition than a disease as is related to the process of aging. It, however, brings a chronic pain condition that can be managed with lifestyle modifications, conservative treatments and, if needed, surgical interventions.
Q: What causes degenerative disc disease?
A: There are no specific causes beyond the normal process of aging for degenerative disc disease. However, sudden injuries, genetic predisposition, obesity, smoking, increased activity levels, and spinal diseases such as ankylosing spondylitis are known to increase the potential of this condition occurring.
Q: Can you live a normal life with degenerative disc disease?
A: Absolutely. With the right treatment, you can live a normal life. Once discs start degenerating, the process cannot be reversed. The pain and the other symptoms, however, can be treated specifically along with modifications to lifestyle so you can regain normalcy in your everyday life.
Q: What is the best treatment for degenerative disc disease?
A: The best treatments for degenerative disc disease initially include a wide range of non-surgical treatments, such as:
- Heat therapy
- Ice and cold pack application
- Physical therapy
- Lifestyle and dietary modifications
- Therapeutic injections
- Implantation of nerve stimulation devices to minimize pain
- Surgical intervention
Q: Can a degenerative disc ever heal?
A: Yes, it can, but it may need help. The natural process of aging and any damage to the spinal discs due to injuries or genetic predispositions cannot be reversed. However, with treatment options to manage pain and a host of other individual treatments to treat the symptoms, patients can live a normal life.
Q: Is walking good for degenerative disc disease?
A: Yes, walking is the best exercise. Regular and moderate exercise such as walking, yoga, swimming, stretching, and Pilates is highly recommended for those suffering from degenerative disc disease.
Q: How can I prevent degenerative disc disease?
A: Maintain a healthy lifestyle with a good exercise regime and a balanced diet. Avoid excessive consumption of alcohol and nicotine. Avoid trauma and over use. Avoid heavy lifting.
Q: How is degenerative disc disease diagnosed?
A: The progression of the condition is slow. The onset of the symptoms and pain may begin in the 40s and slowly progress. Trauma, smoking and obesity can accelerate this process.
Q: How fast does degenerative disc disease progress?
A: Usually with X-rays and MRI’s. A thorough evaluation of your symptoms and medical history with the doctor, followed by a physical examination and imaging tests will enable the specialist to accurately diagnose the extent of your condition.