What is it?
DEGENERATIVE DISC DISEASE is a consequence of aging or “wear and tear” of the back. It refers to the changes that take place in the discs separating the bones of the back. Disc disease is very common and in the majority of cases, the outlook is good. Several factors are involved in disc degeneration including genetic make-up and repetitive overload or stress to the discs. As a result, other structures of the spine also suffer wear and tear. Commonly, this occurs at the joints that link the bones of the spine together called facet joints. This increases the risk of additional problems such as disc herniation and secondary problems such as spinal stenosis (spinal canal narrowing).
The symptoms present in degenerative disc disease depend upon what structures are being affected. In the early stages, back pain may be the main symptom. However, if the disc disease is advanced and facet joint degeneration has occurred, the space where the nerves exit the spine may be narrowed. In such a case, often both back and leg pain occur.
HOW TO REDUCE RISK
People who have degenerative disc disease must alter particular activities that cause or worsen their symptoms. Certain lifestyle changes are recommended. For example, smoking can lead directly to diminished blood flow in the back and can decrease the flow of vital nutrients necessary for a healthy spine. Consequently, smoking cessation is important. Maintaining ideal body weight is also important. The spine supports the body from the hips up and extra weight puts extra, unnecessary stress on it. It is helpful to follow a regular exercise program specifically designed for the back and pelvic region. Regular aerobic walking is also helpful. There are no specific guidelines regarding what activities should be avoided. Each patient must be evaluated and advised on an individual basis.
This condition is generally manageable with appropriate treatment. Physical therapy is often used to help with stretching and exercise in order to correct mechanical problems present in the region of the low back and pelvis. Degenerative disc disease may result from imbalances in the muscles and ligaments around the spine, but patients can be taught how to stretch tight muscles and strengthen weakened ones. Correction of such imbalances will alleviate stress on facet joints and discs.
The pain which results from degenerative discs can often be attributed to inflammation. Patients are often started on a trial of anti-inflammatory medications such as ibuprofen, naproxen and others. For more severe and persistent pain, an injection of steroid (a very strong anti-inflammatory pain medication) may be indicated. These procedures use x-ray guidance to place medications directly at the source of the pain. Surgery is rarely a consideration unless a patient experiences substantial problems with nerve compression or experiences significant changes in lifestyle that have not responded to non-surgical treatment.
Sometimes, in spite of our very best treatment efforts, pain may still be present. It is not uncommon and it is not usually dangerous. Exercise and modifying one’s activities can sometimes be the best way to achieve the highest degree of function and minimize symptoms.