Understanding Degenerative Disc Disease and Treatment Options

Introduction

Degenerative disc disease is a condition in which the spinal discs begin to wear away leading to pain. Although the name suggests otherwise, degenerative disc disease is not a disease but a condition that develops over time due to aging, daily activities, sports, injuries, or if the spinal disc dries out and shrinks.

Spinal discs are the rubbery cushions between the vertebrae (bones in the spinal column). These discs act as shock absorbers and help a person move, twist, and bend. The spinal discs start showing signs of wear and tear as one gets older. Although everyone’s spinal discs degenerate over time, not everyone experiences pain. If you have pain due to worn-out spinal discs, you are suffering from degenerative disc disease.

Causes of Degenerative Disc Disease

The spinal discs are made up of an inner soft core and an outer tough wall. These discs may show changes leading to degenerative disc disease. The common causes of degenerative disc disease are as follows:

• Drying out: The soft core of the spinal discs is mostly made up of water. As age advances, the core loses some of its water naturally. This makes the disc thinner and reduces its power of shock absorption.
• Crack or tear: Minor injuries can cause small cracks in the spinal discs. These tears usually occur near the nerves. The tears, however small they may be, can be very painful. If the outer wall of the spinal disc cracks open, the disc could bulge out of its place to cause a condition known as a herniated disc, which causes spinal nerve compression.

Risk Factors of Degenerative Disc Disease

Certain factors can increase your risk of developing degenerative disc disease. These factors include the following:

• Aging
• Obesity
• More common in women than men
• Smoking
• Family history of degenerative disc disease
• Acute injuries, such as a sudden fall
• Manual labor and heavy lifting

Symptoms of Degenerative Disc Disease

The most common symptoms seen in people having degenerative disk disease include neck and back pain. The affected person may experience pain that:

• Appears and disappears, and may last for several weeks or months at a time
• Causes tingling or numbness in the legs or arms (which means that the damaged spinal discs are affecting the nerves close to the spine)
• Radiates to the lower back and buttocks
• Worsens on bending, sitting, or lifting
• Improves on lying down or while changing positions

Diagnosis of Degenerative Disc Disease

The doctor will first ask you about your symptoms, when and where you are having pain, whether you have any numbness or tingling sensation, and when your pain increases. The doctor will also inquire about any injuries, falls, or accidents.

The doctor will then physically examine you to check for the following:

• Pain in response to touch or with motion: You will be asked by the doctor to move in certain ways to check pain with motion. When pressure is applied to the lower back and it causes pain, it could be a symptom of degenerative disc disease.
• Muscle strength: The doctor will check for muscle atrophy reduced size and wasting of muscle tissue) and abnormal muscle movements.
• Nerve function: The doctor will tap the different areas of your body using a reflex hammer. A poor reaction or no reaction at all could be indicative of a compressed nerve root. Cold and hot stimuli may be used by the doctor to check how well the nerves react to the changes in temperature.

The doctor may recommend undergoing the following diagnostic tests to confirm the diagnosis of a degenerative disc disease:

• Imaging tests: Tests like CT scans and MRI scans help in providing information about the state of the spinal nerves, spinal discs, and their alignment.
• Discogram: This test involves injecting a dye into the soft core of a spinal disc or many spinal discs to check if a spinal disc is painful. The injected dye is visible on an X-ray or CT scan. However, it must be noted that herniated discs do not always lead to symptoms and a discogram may not be useful in such cases.

The doctor will also test for other medical conditions, like tumors or other types of damage, to rule out other conditions that may be causing pain.

Treatment Options for Degenerative Disc Disease

The doctor will first suggest undergoing non-invasive treatment methods to treat degenerative disc disease. These treatment options include the following:

• Physiotherapy: You will be guided by a physiotherapist to perform certain stretching and strengthening exercises to relieve pain.
• Medications: Doctors may prescribe certain medications like nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, or muscle relaxants to relieve your symptoms.
• Steroid injections: The doctor may inject strong medications near the spinal nerves, joints, or disks to reduce pain and inflammation.
• Radiofrequency neurotomy: The doctor may use electric currents to burn the sensory nerves and prevent the pain signals from going to the brain.
• Home remedies: Certain home remedies can help in relieving pain temporarily. But they do not help in treating the symptoms permanently. The different home remedies that can help in temporary pain relief include the following:

• Stretching: Gentle stretching exercises like yoga can help in improving posture.
• Exercise: Low-impact exercises like walking and swimming can help in strengthening the back muscles and relieving pain.
• Hot and cold therapy: Alternating between heating pads and ice pack applications every ten to fifteen minutes, three to four times a day can help in reducing inflammation and soreness.

If the non-invasive treatment methods fail to relieve your symptoms and you still have persistent pain or weakness, the doctor may suggest surgery. The different types of spine decompression surgeries that may be performed include the following:

• Diskectomy: This procedure involves the removal of a part of a spinal disc to relieve the pressure on the nerves.
• Laminectomy: This procedure involves taking out a small part of the bone from the lower spine or lamina.
• Removal of osteophytes: This procedure involves the removal of the bone spurs or osteophytes.
• Foraminotomy: This procedure involves expanding the opening for the nerve roots by the removal of tissue and bone.
• Spinal fusion: This procedure involves connecting two or more vertebrae to improve stability.

Degenerative Disc Disease Prevention

You can make certain lifestyle changes to prevent or at least slow the progression of degenerative disc disease. These lifestyle changes include the following:

• Maintain a healthy weight
• Quit smoking
• Exercise regularly to increase your flexibility and strength

Conclusion

Degenerative disc disease is a condition that involves the breakdown of spinal disks due to aging, injury, or daily activities. It may lead to pain and stiffness. 

Non-surgical treatment options like physiotherapy, spinal injections, and radiofrequency neurotomy can help in pain relief. Home remedies like hot and cold therapy and low-impact exercise can also help in reducing the pain. However, when these methods are not successful, surgery may be recommended for long-term pain relief. You should consult your doctor to determine which is the best treatment option for your condition.