Degenerative disk disease is a condition in which the fibrous disks that serve as shock absorbers between the spines vertebral bones become more brittle, shrink and otherwise lose their sponge-like quality due to a decline in their moisture content as a person ages.
As the disks dry out, they flatten, allowing the vertebral facet joints above and below them to rub against each other. This, in turn, may cause the development of bone spurs (osteophytes) that can press on a nerve root, causing pain, numbness and weakness throughout the area that the nerve supplies. Alternatively, as a disk degenerates, it may develop a tear in its outer layer, allowing some of the jelly-like substance from within to leak out. This herniated (or ruptured) disk can cause inflammation or put direct pressure on a spinal nerve, again resulting in back or neck pain along with numbness and pain that radiates down the nerve pathway.
The process of disk degeneration may be accelerated by trauma from a sports injury, car accident or fall, or from excessive bending, lifting and twisting as part of one's job or other physical activity. It can occur in any part of the cervical, thoracic or lumbar spine, but is most often symptomatic in the neck and lower back.
Read on for answers to frequently asked questions on this fairly common spine condition that drives many athletes and non-athletes to seek medical care.
What age groups are affected by degenerative disk disease?
Interestingly, you don't have to be a senior citizen to experience DDD, as its sometimes called, and its actually a fairly common condition in younger adults as well as older ones. In fact, about 30 percent of adults will show some evidence of disk degeneration by the time they are 35 years old. That said, almost all adults will experience some disk degeneration by the time they reach the age of 60 though not everyone will experience adverse symptoms.
What symptoms are associated with degenerative disk disease?
Depending on the location of the disks affected, patients may experience pain and stiffness in the neck, mid- or lower back especially during certain movements such as reaching upward, bending over or turning their neck to one side. These actions may also cause shooting pains and/or tingling sensations down the arm, back, buttock and leg in a condition known as sciatica. One characteristic symptom is low back pain that increases the longer you stay seated or standing but lessens when you're walking or lying down in bed.
Will symptoms continue to worsen over time?
Contrary to what its name implies, degenerative disk disease is not necessarily a progressive condition, at least in terms of its symptoms. In fact, many people with DDD experience acute flare-ups of low back or neck pain every now and then that last anywhere from a few days to a few months, but their symptoms rarely worsen over time. And in some cases, the symptoms of degenerative disk disease may actually lessen as a person gets older due to age-related stiffening of the disk that reduces movement and pain.
How is DDD diagnosed?
Diagnosing degenerative disk disease starts with obtaining a thorough medical history and performing a physical and neurological exam in which the patient's overall physical condition, range of motion, muscle strength, reflexes, posture and movements that cause pain are closely evaluated. It may also involve diagnostic imaging studies including X-rays, a CT scan or MRI, and electromyography to measure nerve response times.
Additional tests that your doctor may order to make a definitive diagnosis include a bone scan, discography (in which dye injected into the problematic disk shows up on an X-ray) and a myelogram (also accomplished using injected dye).
How is degenerative disk disease treated?
Typically, degenerative disk disease is treated via nonsurgical means, including oral medications for pain and inflammation, physical therapy, specially targeted exercises and strategies for addressing poor posture and ergonomic issues.
The overriding goal of such treatment is to strengthen the body's core muscles that support the spine, reduce pain and educate patients about the proper techniques for bending, lifting, sitting and other daily activities in order to avoid putting undue pressure on their affected disks. Importantly, prolonged bed rest (lasting more than a couple of days) is not recommended for patients with degenerative disk disease because of the adverse effects of this inactivity on their muscles, bones and cardiovascular fitness.
Beyond these noninvasive treatments, epidural or facet joint injections may be employed as a way to provide short-term relief from inflammation and pain and allow the patient to continue his or her rehabilitation schedule.
While surgery is generally considered the last course of action for treating patients with degenerative disk disease, it may be considered in extreme cases where there are progressive neurologic symptoms such as numbness and tingling in the extremities or pelvic area, when bowel or bladder dysfunction occurs, or when less invasive treatments have failed to bring needed pain relief. In this case, a minimally invasive spinal decompression procedure such as a microdiscectomy may be recommended along with spinal fusion to stabilize the affected disks.
Wondering if degenerative disk disease could be a factor in your chronic neck or back pain? Learn more at AdventHealth Medical Group Spine Health.