DEGENERATIVE DISC DISEASE

What is Degenerative Disc Disease?

The term “Degenerative Disc Disease (DDD)” refers to the most common causes of lower back and neck pain (Hemanta, Jiang, Feng, Chen, & Cao, 2016). This age-related condition happens when one or more discs between the vertebrae of the spinal column break down and cause pain. In some cases, this disc disease results in weakness, numbness, and radiating pain in the arms or legs. Despite its name, degenerative disc disease defines the process of disc deterioration rather than a disease. This disease develops over time as a result of wear and tear or damage to the disc. This also interferes with our regular activities and might get worse if left untreated.

Normally, the spinal disc between each vertebrae serves as a shock absorber, similar to a cushion. These discs directly help every person to stand up straight and assist in everyday motions like bending over and twisting around. The symptoms of wear-and-tear on a spinal disc include weakness, numbness, burning pain, or instability in the arms or legs. Disc degeneration occurs naturally as a part of aging and shows symptoms over time because of the changes in the discs. The process of degeneration can start as early as 20 years old but may take decades to develop pain (Hemanta et al., 2016).

What Are The Common Symptoms of Degenerative Disc Disease?

Maximum times, people with disc degeneration remain asymptomatic, which means producing no signs of degeneration that might hamper the regular activities. At first, this process develops from the spine, and severe conditions may produce symptoms in other parts of the body. Typical symptoms of degenerative disc disease start with discomfort and pain in the lower back, leg, upper thigh, and buttock (sciatica).

The pain may come and go, and radiate to the shoulder, arm, or hand in case of damages in the cervical region (cervicalgia). Patients also experience tingling, numbness, or both, in their legs or feet. Sometimes, instability of the spine eventually leads to muscle spasms in the lower back area. While sitting, bending, lifting, or twisting, the person may have severe pain flare-ups. Patients can reduce the symptoms by walking, lying down, or changing positions frequently.

What Are The Common Causes of Degenerative Disc Disease?  

The spinal discs contain a soft inner core and tough outer wall and act as a padding between the vertebrae of the spine. During spinal movement or weight bearing, these discs act as a cushion and help the spine to bend. According to study, these discs naturally become dry over time, and this affects almost 90% of people worldwide (Deane & McGregor, 2016). As people age, repeated stresses and injuries can affect and damage these spinal discs.

Changes in the spinal discs may include loss of fluid and changes in the discs structure. Usually, fluid makes up almost 90% of the spinal discs structure in a healthy young adult (Kos, Gradisnik, & Velnar, 2019). With age, the discs get thinner as they lose the fluid. Pain associated with degenerative disc disease derives from inflammation of the disc (arthritis) and abnormal motion instability. Potential risk factors of this condition include obesity, smoking, strenuous physical work, sudden injury, etc. The stress from everyday movements and minor injuries can damage the disc and cause a tear in the outer layer. These cracks increase chances of the disc breaking down and sometimes cause bulging of the disc, known as the herniated disc.

How Do Spinal Specialists Diagnose Degenerative Disc Disease?

Initial diagnosis of a degenerative disc comprises a check of the patients medical history and a brief clinical examination. Physicians will ask questions about the symptoms and pain patterns such as when and where the pain occurs, the presence of any tingling or numbness, etc. Physicians will also ask about the history of falls, accidents or injuries. Physical examination of the patient may include testing their muscle strength, checking for pain during movement, and a nerve function test using reflex hammer. Other diagnostic tests may include (Taher et al., 2012):

  • Imaging scans: This includes X-ray, CT scan, and MRI that provides information about the state of the spinal nerves and discs.
  • Discogram: This involves injection of dye material inside of the discs and later visualizing it by using a CT scan or X-rays to see any abnormalities or cracks.

How Do Neurosurgeons Treat Degenerative Disc Disease?

The goal of treating degenerative disc disease includes alleviating pain and stopping the condition from progressing. Treatment for this condition includes both non-surgical and surgical options. Treatment procedures may include (Inoue & Espinoza Orías, 2011):

  • Medications: This includes over-the-counter pain relievers like NSAIDs such as ibuprofen, muscle relaxants, steroid injections to relive the symptoms.
  • Physical therapy: This includes specific movements, such as strengthening the muscles to ease pain and supports the spine.

Neurosurgeons may recommend patients for surgery if the above option fails. Surgical options may include discectomy to remove the injured part of the disk and reduce the pressure from the nerve. Also, spinal fusion surgery or artificial disc replacement helps the patient to improve the condition. For any questions, contact us.

References

Deane, J. A., & McGregor, A. H. (2016). Current and future perspectives on lumbar degenerative disc disease: A UK survey exploring specialist multidisciplinary clinical opinion. BMJ Open, 6(9), 1–11. https://doi.org/10.1136/bmjopen-2016-011075

Hemanta, D., Jiang, X. xing, Feng, Z. zhou, Chen, Z. xian, & Cao, Y. wu. (2016). Etiology for Degenerative Disc Disease. Chinese Medical Sciences Journal, 31(3), 185–191. https://doi.org/10.1016/S1001-9294(16)30049-9

Inoue, N., & Espinoza Orías, A. A. (2011). Biomechanics of Intervertebral Disk Degeneration. Orthopedic Clinics of North America, 42(4), 487–499. https://doi.org/10.1016/j.ocl.2011.07.001

Kos, N., Gradisnik, L., & Velnar, T. (2019). A Brief Review of the Degenerative Intervertebral Disc Disease. Medical Archives (Sarajevo, Bosnia and Herzegovina), 73(6), 421–424. https://doi.org/10.5455/medarh.2019.73.421-424

Taher, F., Essig, D., Lebl, D. R., Hughes, A. P., Sama, A. A., Cammisa, F. P., & Girardi, F. P. (2012). Lumbar Degenerative Disc Disease: Current and Future Concepts of Diagnosis and Management. Advances in Orthopedics, 2012(Ivd), 1–7. https://doi.org/10.1155/2012/970752