Degenerative disc disease is a term used to describe age-related changes that occur in the soft discs present between the vertebral bones of the spine. These discs absorb stress and permit movement of the spine. Disc degeneration can lead to pain, limitation of movement and other symptoms. It is usually more pronounced in the region of the neck and lower back.
Causes
Continuous wear and tear with age causes the intervertebral discs to lose their water content and shrink in size. Initially, the nucleus at the center of the disc loses its ability to absorb water and becomes thick and dehydrated. Later, the outer layer of the disc, called the annulus, may bulge, develop cracks or rupture causing the disc to collapse.
As a result, discs lose their ability to act as shock absorbers, making the spine less flexible. The space between the bones becomes narrow resulting in compression of nerve structures. Increased stress on the vertebral bones can result in the formation of bone spurs which can also compress on the nerves producing symptoms. Degenerative disc disease can lead to osteoarthritis or loss of cartilage in the intervertebral joints and can also lead to narrowing or stenosis of the spinal canal.
Degenerative disc disease is more common in those who are overweight, those who perform repetitive lifting, and in smokers.
Signs and Symptoms
Symptoms of degenerative disc disease include pain in the neck, arm, lower back, buttocks and legs, depending on the region of the spine affected. The pain occurs gradually but can sometimes start after a sudden injury or a normal movement such as bending or twisting. Other symptoms such as numbness and a tingling sensation may also be present.
Diagnosis
To diagnose degenerative disc disease, your doctor will review your symptoms and medical history and perform a physical examination to evaluate the location of pain, range of motion, nerve damage or identify other abnormalities such as an infection or presence of a tumor. Imaging tests may be ordered if necessary.
Treatment
Symptoms of degenerative disc disease may be relieved by warm or cold packs applied to the area. Anti-inflammatory or pain medications may be prescribed to keep you comfortable. Physical therapy may be recommended to strengthen and stretch the muscles in the back. Your doctor will provide specific treatment for conditions such as osteoarthritis or spinal stenosis caused by degenerative disc disease. Surgery may sometimes be necessary in certain situations and usually involves removal of the degenerative disc and placement of a bone graft within the disc space to maintain an ideal distance between adjacent vertebrae and promote fusion of the adjacent bones. This limits movement of the region thus controlling pain. Sometimes, an artificial disc is inserted which permits movement.