by McCoy K

Definition

Discs lie between the spinal bones (vertebrae). They serve as shock absorbers. Discs protect the spine and help it stay flexible. Degenerative disc disease is wear and tear on these discs. This wear and tear causes pain and other symptoms. Some degeneration is normal as you age. Not all degeneration will result in symptoms of this disease.

Degenerative Disc
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Causes

The disc loses fluid and is not as resilient as a normal disc. The fibrous tissue, which holds the disc material in place, may suffer small tears. These tears lead to further damage. There is some evidence that genetics may play a part for some people.

Risk Factors

Factors that may increase your chance of degenerative disc disease include:

  • Increased age
  • Family history of degenerative disc disease
  • Sports
  • Back injury
  • Smoking
  • Heavy physical work
  • Obesity

Symptoms

Degenerative disc may cause:

  • Pain in the low back, buttocks, thighs, or neck
  • Pain that worsens when sitting, bending, lifting, or twisting
  • Pain that feels better when walking, changing positions, or lying down
  • Periods of severe pain that gets better after a few days or months
  • Numbness and tingling into the legs
  • Weakness in the legs
  • Inability to raise the foot at the ankle

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

Images may be taken of the disc and surrounding area. This can be done with:

Your bodily fluids may be tested. This can be done with:

  • Blood tests
  • Urine tests

Your nerves may be evaluated. This can be done with an electromyogram and nerve conduction studies.

Treatment

Talk with your doctor about the best plan for you. Treatment options include:

Physical Therapy

Therapy for this condition is focused on teaching how to manage back pain. This may involve:

  • Posture training
  • Exercise
  • Ice packs
  • Warm compresses
  • Electrical stimulation
  • Relaxation
  • Other forms of physical therapy

Injections

Steroid injections may be used for some short-term pain relief. They are injected around the nerves exiting the spinal cord.

Surgery

Surgery may be required for some. Surgery may involve removing the degenerated disc and fusing 2 of the vertebrae together.

Prevention

To help reduce your chance of degenerative disc disease:

  • Begin a safe exercise program with the advice of your doctor.
  • Maintain a healthy weight .
  • If you have osteoporosis , follow your doctor's instructions for treating the condition.
  • If you smoke, talk to your doctor about ways to quit.
  • If possible, make changes to your workplace to reduce symptoms, such as using proper posture and safe methods of lifting.

RESOURCES

North American Spine Society  http://www.spine.org 

Ortho Info—American Academy of Orthopaedic Surgeons  http://www.orthoinfo.org 

CANADIAN RESOURCES

Canadian Orthopaedic Association  http://www.coa-aco.org 

Canadian Orthopaedic Foundation  http://www.canorth.org 

References

Bogduk N, Anat D. Degenerative joint disease of the spine. Radiol Clin North Am. 2012;15(4):613-628.

Degenerative Disc Disease. Hospital for Special Surgery website. Available at: https://www.hss.edu/condition-list%5Fdegenerative-disc-disease.asp. Accessed November 12, 2017.

Low Back Pain. Ortho Info- American Academy of Orthopaedic Surgeons website. Available at: https://orthoinfo.org/en/diseases--conditions/low-back-pain. Updated December 2013. Accessed November 12, 2017.

Lumbar disk herniation. EBSCO Dynamed Plus website. Available at:  https://www.dynamed.com/topics/dmp~AN~T116077/Lumbar-disk-herniation  . Updated September 6, 2017. Accessed November 12, 2017.

Madera M, Brady J, Deily S, et al. The role of physical therapy and rehabilitation after lumbar spinal fusion surgery for degenerative Disease: a systematic review. J Neurosurg:Spine.2017:26(6):694-704.

Paassilta P, Lohiniva J, et al. Identification of a novel common genetic risk factor for lumbar disk disease. JAMA. 2001;285:1843-1849.

Urban J, Roberts S. Degeneration of the intervertebral disc. Arthritis Res Ther. 2003;5(3):120-130.

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