Understanding Degenerative Disease

Degenerative Disc Disease (DDD) is a condition that results from the gradual deterioration of the intervertebral discs in the spine. These discs act as cushions between the vertebrae, allowing for flexibility and movement. As people age, the discs can lose their hydration and elasticity, leading to several potential issues. Here are the key aspects of DDD:

There is a study published in the American Journal of Neuroradiology, where researchers reviewed spine image findings in people who were not experiencing back pain. They looked at the prevalence of degenerative disc disease based on age.

“By the age of 20, 37 percent of people show disc degeneration on imaging,” Yang said. The prevalence increases with each decade. “By the age of 50, we’re talking 80 percent of people have this degeneration on imaging,” Yang added. That number increases to 96 percent for octogenarians.

The symptoms of DDD can vary, but they often include chronic pain, particularly in the lower back or neck. This pain can be persistent, with occasional episodes of more severe discomfort. Additionally, one may experience numbness and tingling in the limbs, muscle weakness, and a limited range of motion. The pain might even radiate down the legs or arms if the nerves are compressed.

Symptoms:

1. Pain: Chronic, low-level pain with intermittent episodes of severe pain, typically in the lower back (lumbar spine) or neck (cervical spine).

2. Numbness and Tingling: These sensations may occur in the arms or legs if nerve compression occurs.

3. Weakness: Muscle weakness can develop due to nerve compression.

4. Radiating Pain: Pain can radiate down the legs (sciatica) or arms, depending on the location of the affected disc.

5. Limited Range of Motion: Stiffness and decreased ability to move the spine.

The primary cause of DDD is the natural aging process. As we grow older, the discs in our spine endure wear and tear. However, other factors can contribute to this degeneration, such as injury to the spine, repetitive stress from certain activities or occupations, and even genetics. Indeed, some families may be more predisposed to this condition.

Causes:

1. Age: Natural wear and tear over time.

2. Injury: Trauma to the spine can accelerate disc degeneration.

3. Genetics: Family history can play a role.

4. Repetitive Stress: Jobs or activities that put repetitive stress on the spine.

To diagnose DDD, a physician would begin with a thorough medical history and physical examination to assess the symptoms and physical function. Imaging tests such as X-rays, MRI, or CT scans are commonly used to visualize the condition of the discs and spinal alignment. In some cases, a discography might be performed, involving an injection to pinpoint the exact disc causing the pain

Diagnosis:

1. Medical History and Physical Examination: Assessment of symptoms and physical function.

2. Imaging Tests: X-rays, MRI, or CT scans to visualize disc condition and spinal alignment.

3. Discography: An injection to pinpoint the exact disc causing pain.

According to Dr Yang and Vanderbilt Health 

Patients are often told that they have degenerative disc disease, and they feel like they need to get all these expensive treatments. In reality, it’s just part of the aging process.”

If you do have acute or chronic back pain, seeing a spine specialist can help you pinpoint the cause, Yang added. And a specialist can work with you to find ways to alleviate your pain.

There are several avenues of treatment. Non-surgical methods often suffice, such as physical therapy to strengthen the muscles supporting the spine and improve flexibility. Medications like pain relievers, anti-inflammatory drugs, and muscle relaxants can provide relief. Injections, such as epidural steroid injections, can reduce inflammation and pain. Moreover, lifestyle modifications — including weight loss, ergonomic adjustments, and avoiding activities that exacerbate symptoms — can be quite beneficial.

Treatment:

Non-Surgical Treatments:

Physical Therapy: Exercises to strengthen the spine and improve flexibility.

Medications: Pain relievers, anti-inflammatory drugs, and muscle relaxants.

Injections: Epidural steroid injections to reduce inflammation and pain.

Lifestyle Modifications: Weight loss, ergonomic adjustments, and avoiding activities that worsen symptoms.

For those who do not find relief through non-surgical means, surgical options are available. A discectomy, where part or all of the damaged disc is removed, might be necessary. Spinal fusion, which joins two or more vertebrae to stabilize the spine, is another option. And, in some cases, an artificial disc replacement might be considered.

Surgical Treatments:

  Discectomy: Removal of part or all of the damaged disc.

  Spinal Fusion: Joining two or more vertebrae to stabilize the spine.

   Artificial Disc Replacement: Replacing the damaged disc with an artificial one.

Prognosis:

Variable: Some people experience significant pain relief and improved function with treatment, while others may have ongoing symptoms requiring long-term management.

Chronic Condition: DDD is typically a chronic condition, meaning it requires ongoing management to control symptoms and maintain quality of life.

Lifestyle Adjustments:

1. Regular Low-Impact Exercise: Walking, swimming, and cycling.

2. Proper Body Mechanics: Learning how to lift, bend, and move correctly.

3. Healthy Diet: Nutrition that supports overall health and weight management.

Prevention is always preferable. Regular exercise to strengthen the muscles supporting the spine, maintaining good posture, and keeping a healthy weight can all help prevent the onset of DDD. Ergonomic adjustments in the workplace and proper body mechanics during daily activities can also play a significant role in prevention.

Prevention:

1. Exercise Regularly: Strengthen the muscles supporting the spine.

2. Maintain Good Posture: Reduce stress on the spine.

3. Healthy Weight: Prevent extra strain on the spine.

4. Ergonomic Adjustments: Properly set up workstations to avoid repetitive stress.

Dr Yang has a quote

“I try to encourage people that motion is lotion. I want them to stay active as much as possible and maintain flexibility.”

Keeping the spine healthy

“I try to encourage people that motion is lotion. I want them to stay active as much as possible and maintain flexibility”, states Dr Yang.

Degenerative disc disease is irreversible, a term Yang said can also sound frightening. “We can’t necessarily reverse what we see on imaging or X-rays,” Yang said. “But that alone should not make you worry or change your activity levels.”

Instead, movement is a key factor in keeping the spine healthy. “I try to encourage people that motion is lotion,” Yang explained. “I want them to stay active as much as possible and maintain flexibility. I think, in the long run, that will help them the most.”

Living with Degenerative Disc Disease can be challenging, but with the right approach and treatment, it is possible to manage the symptoms and maintain a good quality of life. I hope this discussion has provided some clarity and assistance to those dealing with this condition.

Degenerative Disc Disease is a common condition associated with aging but can be managed effectively with a combination of treatments and lifestyle adjustments.