Degenerative disc disease is a spinal condition in which the intervertebral disc which serves as a shock absorber wears down.
The spine is the body’s central support structure, and it helps perform various upper-body movements. Also known as the backbone, the spine also connects different parts of the musculoskeletal system. Certain body movements supported by our spine include sitting, standing, walking, twisting, and bending.
A healthy spine has a natural s-shaped curve, and it absorbs shock & prevents spinal injuries. Our spine is made of a number of vertebrae stacked on top of each other. They are separated by intervertebral discs. Facet joints in the spine help vertebrae glide smoothly on top of each other and allow us to twist and turn. They provide flexibility and stability to the spine. Besides these, the spine holds the spinal cord and nerves.
This article will discuss degenerative disc disease in detail along with its symptoms, causes, and treatment.
What is Degenerative Disc Disease?
Degenerative disc disease is a condition characterized by damage to spinal discs/intervertebral discs. These discs serve as cushions between the vertebrae and prevent injury to the spine. The function of intervertebral discs is to absorb shock and allow smooth and trouble-free movements of the spine. When discs stop working as they should, the risk of spinal injuries increases.
Now, if we talk about wear and tear in the spinal discs, then it is common as we age. This is why degenerative disc disease is commonly seen in the elderly. Disc degeneration is a normal part of aging as they wear over time. Sometimes, the symptoms are severe enough that medical assistance becomes necessary whereas, in some cases, no symptoms are experienced in the early stages.
When damage to spinal discs occurs, vertebrae start to rub against each other, and this causes pain & discomfort when the person moves. Besides pain, other symptoms caused may include:
- Adult scoliosis
- Spinal stenosis
- Herniated disc
Though the condition is termed degenerative disc disease, it is not a disease rather, it is a natural condition that arises with age.
If we talk about how common degenerative disc disease is, then the maximum number of adults above 40 years of age have some degeneration. However, not all adults show symptoms in the early stages yet back pain is common in most of them.
What Are the Risk Factors of Degenerative Disc Disease?
Aging is the biggest risk of degenerative disc disease as the condition commonly affects older adults. But there are certain factors that increase the risk of the condition:
Acute injuries like falling on the back may injure your vertebral disc and that later becomes big. As a result, back pain along with other symptoms occurs.
Obesity is the major cause of many orthopedic problems. Joints in obese bear more stress when compared to healthy adults. This is because of extra body weight. A similar is the case with the spine. Over time, joints and the spine wear down. Thus, the risk of damage to intervertebral discs is high in obese and it leads to degenerative disc disease.
Women are more likely to experience disc degeneration. This is because the skeleton of women is smaller and weaker than men. Plus, they also experience frequent hormonal changes. Thus, women are high at risk of spinal disc degeneration than men.
People who smoke have weak bones. Tobacco increases the speed at which bone deteriorates. Besides this, the rate of formation of new bone cells (osteoblasts) also decreases in smokers. Smoking also affects the blood supply to bones and other body tissues. As a result, the spine becomes weak, and the risk of disc degeneration increases.
People engaged in physically demanding jobs may experience spinal disc degeneration before age.
What Causes Disc Degeneration?
After 40, almost everyone experiences disc degeneration as it is a normal part of aging. But not everyone experiences pain or other symptoms. They are often noticed after some time.
Spinal discs have multiple layers whereas the outer disc is tough and fibrous. While on the other hand, the innermost part is soft and gelatinous. This part is the nucleus populous. When the disc degenerates, the nucleus protrudes out. Some of the common causes of the condition include:
Degenerative disc disease is common with age and hence, the commonest cause of the condition is aging. However, it is not necessary that symptoms develop right away after degeneration starts. Symptoms may take time to develop.
Athletes and people with high activity levels in routine life also cause wear & tear in spinal discs. Such activities include dancing, running, wrestling, and other sports like tennis, cricket, and hockey.
Back injuries are likely to cause spinal problems and disc degeneration is among the commonest. Accidents occurring because of automobile injuries also increase the risk of degenerative disc disease.
Studies have also found that degenerative disc disease runs in families. This means several genetic defects make the spine weak. As a result, the disc degenerates easily.
Inflammatory spine conditions like ankylosing spondylitis increase the risk of disc degeneration.
What Are the Symptoms of Disc Degeneration?
Disc degeneration is painful and causes discomfort when the person performs certain movements. According to research, spinal degeneration starts to occur at a constant rate in the mid-20s. As the age increase and people reach their 50s or 60s, symptoms start to occur.
More than 80% of people will show some sign of degeneration in MRI reports but, symptoms may not occur in all. In some, severe pain occurs.
Back pain is the first symptom that people with disc degeneration experience. Besides pain, other signs, and symptoms that may occur include:
- Locking of the back
- Neck pain
- Loss or limited motion of the spine
- Stiffness in the back
- Pain radiating through buttocks and legs or arms and legs
- Increased pain after sitting for long periods
- Weakness in the leg or foot, especially in severe cases
What is the Diagnosis of Degenerative Disc Disease?
Diagnosis of degenerative disc disease requires a thorough physical examination followed by imaging tests. During the physical examination, the orthopedic specialist will look for back pain and its severity. The patient will be asked to walk or move his upper body in different directions to check the range of motion.
The orthopedic specialist will also ask about any previous injuries like falls or accidents. The goal of physical examination is to assess nerve function, muscle strength, and painful areas. Besides this, imaging tests confirm the condition and its severity. The tests ordered may include:
X-ray is a basic imaging test that the healthcare service provider orders in almost all orthopedic conditions. X-ray reports show reduced spaces between the discs. If bone spurs are there, x-ray reports can detect them.
Magnetic Resonance Imaging (MRI)
MRI is required to detect soft tissue injuries that x-rays cannot show. Besides this, MRI reports also show shrunken discs, narrowed spinal canal, or damage to spinal discs.
Computed Tomography (CT) Scan
CT scan shows detailed images of bones, blood vessels, muscles, fats, or other soft tissues. CT scan is the choice when an x-ray examination fails to show clear images of the spine.
What is the Treatment for this Degenerative Disease?
After assessing the severity of the condition, the orthopedic specialist will decide on a feasible treatment. Although both surgical and non-surgical treatments are available for disc degeneration. Let us have a look at them one by one.
Mild cases can be fixed with conservative treatments and no surgical intervention is required. Symptoms can be relieved with:
- Rest and application of ice to improve pain
- Physical therapy
- Heat Therapy
- Chiropractic Treatment
Over-the-counter medications or prescription drugs may help improve symptoms like pain and swelling.
When oral drugs fail to relieve the condition or the symptoms are severe, the healthcare service provider will give therapeutic injections for instant relief. The injections given may include:
- Epidural corticosteroid shots
- Nerve blocks
- Trigger point injections
Cases that do not improve with medication or other non-surgical treatment may require surgery. It is often performed when:
- Pain is becoming worse over time
- Persistent pain for weeks or months
- Pain which is making it difficult for you to move
- Weakness in the legs
Here are the common surgical options available for the treatment of degenerative disc disease:
This is the procedure in which the orthopedic surgeon removes a portion or complete damaged disc. This helps relieve the pressure on the nerve.
Spinal fusion is the condition in which the orthopedic surgeon fuses the vertebrae after completely removing the damaged spinal disc. This is done to provide the stability to the spine and improve the quality of life. During spinal fusion, vertebrae are fused permanently.
Artificial Disc Replacement
Sometimes, the orthopedic surgeon recommends artificial disc replacement. Here, the damaged disc is removed and a prosthetic disc is placed in between. When compared to spinal fusion, artificial disc replacement has fewer complications and is commonly opted for in the neck region.
Siora Surgicals Pvt. Ltd. is a renowned orthopedic device manufacturer in India that manufactures a CE-certified range of trauma implants and instruments including spinal implants. The company owns an advanced production facility in the RAI District, Sonepat, Haryana. Siora is operating for over 3 decades and has served clients in over 40 countries. It is also a trustworthy OEM/contract manufacturing service provider across the globe.