Degenerative Disc Disease

(Degenerative Disk Disease)

Definition

Discs lie between the spinal bones (vertebra). They serve as shock absorbers. This protects the spine and helps 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 normal. 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

Your doctor will ask 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 you how to manage your back pain. This may involve:
  • Posture training
  • Exercise
  • Ice packs
  • Heating
  • 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 two of the vertebra together.

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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.

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.

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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