Degenerative disc disease is a term used to describe the breakdown of spinal discs in the back that occurs naturally with age. It is not necessarily a disease but can be considered an age-related occurrence. Spinal discs interlock the bones that make up the spine. They are soft and compressible and act as shock absorbers, allowing the spine to flex, twist, and bend. Degenerative disc disease usually occurs in the discs located in the lower back and neck, and changes in discs can result in neck pain and other conditions that put pressure on the spinal cord and nerves, which may affect nerve function.
May Cause Neck And Back Pain
Degenerative disc disease may cause changes in the spinal discs that can develop into osteoarthritis, a herniated disc, or spinal stenosis. Osteoarthritis occurs when the tissue or cartilage that protects and cushions the joints starts to break down. A herniated disc is an abnormal bulge of a spinal disc, and it may also occur when one of the spinal discs break open. Spinal stenosis is characterized by the narrowing of the spinal canal or the open space located in the spine.
Most changes in the spinal cord are age-related, and they occur when the spinal discs break down or degenerate. This may be due to the loss of fluids in the spinal discs, which reduces the disc's ability to absorb shock or act as a cushion. Loss of fluid makes the spinal discs thinner and narrows the amount of space in between the vertebrae. It also causes inflexibility in the spine. Degenerative disc disease may also be due to tiny cracks or tears in the outer layer of the disc, which may cause the disc to break into fragments or bulge.
Degenerative disc disease is part of the normal aging process, but it is more common in individuals who smoke cigarettes and who do heavy lifting or physical work. Obesity also puts individuals at an increased risk of degenerative disc disease because the spinal cord works harder to carry around excess weight and may break down sooner. Degenerative disc disease may occur when an individual experiences a sudden fall and develops a herniated disc as well.
Bone spurs occur when the space between the vertebrae becomes smaller, which creates unstable conditions as there is less space between discs. The body responds by developing bone growths called bone spurs or osteophytes. Bone spurs may cause pain that can affect nerve function as they put pressure on the spinal nerve roots. They occur when spinal discs break down and the vertebrae in the back grind against each other. Bone spurs are a common symptom of osteoarthritis as well.
Symptoms may vary from person to person, but they tend to always include back or neck pain. Some individuals may experience no pain at all while others are limited in their daily lives. Pain is often associated with the location of the affected disc. An affected disc in the neck may cause neck and arm pain while a disc affected in the lower back may cause pain in the legs, back, or buttocks. Pain often feels worse while bending over, reaching up, or twisting. Some patients with degenerative disc disease may experience numbness or tingling in the arms or legs.
Receiving A Diagnosis
Degenerative disc disease can be diagnosed through a physical exam and by looking at a patient's medical history. A physical exam may include checking the affected area's range of motion and how much pain is caused by a certain movement. X-rays and imaging tests will be considered if symptoms progress or develop after an injury or if nerve damage is suspected. Image testing may also be done if bone disease, a tumor, or infection may be present.
Treatment for degenerative disc disease includes pain maintenance, usually in the form of ice or heat on the affected area. Painkillers and nonsteroidal anti-inflammatory medications may also be used to control pain. Physical therapy may be necessary if a patient develops osteoarthritis, spinal stenosis, or a herniated disc as a result of degenerative disc disease. Surgery treatments may include fusing the bones together to protect the spinal cord or replacing the affected disc with an artificial one.
Individuals who have particularly debilitating and severe cases of degenerative disc disease that do not respond well to other treatment methods, surgical intervention may be necessary. The most common surgical procedure used to treat degenerative disc disease is called spinal fusion surgery. During this procedure, the affected disc in the spine is extracted from its space, and implants, rods, screws, or plates are implanted in both vertebrae to help stabilize the spine. The actual spinal fusion happens over the months following the procedure. A solid, immobile structure replaces the degenerative disc when the two fused vertebrae grow together.
The alternative surgical procedure to spinal fusion is an artificial disc replacement surgery. During this procedure, the spinal disc is removed from its space, and the space between the vertebrae where the disc belongs is stretched back to its natural height. Once the desired height is achieved, an artificial disc device made from metal endplates and polyethylene core is implanted. This procedure prevents a common complication that occurs with spinal fusion where the spinal discs adjacent to the fusion are put under excessive pressure.
Medications And Injections For Treatment
Individuals affected by degenerative disc disease may need medications and injections to help ease debilitating symptoms and prevent further complications. Because the mechanism of degenerative disc disease causes progressive damage to bones and surrounding tissues, there is a response from the individual's immune system. This response has a result of severe swelling, redness, and inflammation of the affected area. Over-the-counter pain relievers and nonsteroidal anti-inflammatory drugs can help reduce pain and bring down mobility-reducing swelling.
For severe cases, stronger narcotic medications may be prescribed for the management of pain. Steroid shots may be useful for degenerative disc disease patients because they deliver medications directly to the affected area. Steroids are effective at mediating the immune system response, effectively reducing inflammation and the results of it. Steroid shots are usually given for degenerative disc disease in the epidural space or fluid-filled region around the spinal cord located in the patient's back. Steroid shots may also be injected into a nearby muscle or nerve.
Massage therapy may be included in a degenerative disc disease patient's treatment regimen to help reduce pain and soothe inflammation. Individuals with degeneration of the cervical discs or disks in the upper back and neck have benefited the most from massage therapy as part of their treatment. Soft tissue and fascial release is a massage method that improves lymphatic and blood circulation, relaxes contracted muscles, and stimulates the reflex of stretch in the muscles. Degenerative disc disease patients often have muscular problems that occur due to the compression of the nerve and muscle tissues around the cervical spine. In addition, cervical spinal disc degeneration causes the development of severe tension in the shoulder girdle and neck.
Massage therapy has shown to be successful at alleviating elevated resting muscle tension in many patients. The reduction in shoulder girdle muscle adhesions through fascial techniques have helped with the spinal range of motion in individuals affected by cervical degenerative disc disease. Massage therapy is also helpful in dispersing the waste products that result from adhesions that form around the nerve root and between the upper spinal vertebra.
Physical Therapy And Strength Training
Physical therapy and strength training are typically critical parts of treatment for degenerative disc disease. As an individual becomes older and degenerative disc disease develops, the muscles that help support the spine can become weakened over time. Physical therapy and strength training focus on strengthening the core, back, and neck muscles responsible for stabilizing and supporting the spine.
Physical therapy may use methods of spinal traction where the therapist stretches the patient's back to relieve any compression on the nerves that exit the spinal canal through the foramen. This method involves the readjustment of the vertebrae to make the foramen canal wider. The therapist also teaches the patient numerous different exercises that help with core stability, flexibility, strength, and range of motion. Some of these exercises are able to be done at home away from physical therapy sessions. Physical therapy and strength training are very individualized programs, so the methods used for one patient with degenerative disc disease may not be suitable for another patient.