Degenerative Disc Disease
Diminishing and collapsing of the spine’s intervertebral discs over time.By Don O Stovall, JR MD
WHAT IS IT?
Degenerative disc disease (DDD) is a condition in which the disc loses support and stability. It is also sometimes called lumbar spondylosis or arthritis.
The disc is the cushioning between the vertebral bones. It consists of an outer layer of rings of cartilage (annulus) and an inner layer of gel (nucleus). Healthy discs have a large content of water that acts like a hydraulic cushion.
Most discs will degenerate naturally with aging. Everyone 40-50 years old will have some degeneration in their discs, although it does not necessarily cause pain in most people. Others will have underlying DDD that will activate by an injury or trauma to the back.
Back pain is the main symptom. This can especially occur with sitting. It can be aggravated by lifting, bending or standing for long periods of time. Leg pain can also occur in advanced stages of degeneration, if there is pressure or irritation of the spinal nerves.
Your physician may perform any of the following tests to determine if you have DDD:
- History and physical examination
- X-rays: Show narrowing of the disc and bone spurs.
- MRI or CT scan: May show osteophytes (bone spurs), disc bulging or annular tears.
- Neurologic testing: EMG/nerve conduction testing
The name implies that this is a disease. Although it cannot be cured, it can be managed in most cases, like any other disease (such as diabetes or high blood pressure).
Treatment options your doctor may recommend:
- Medications: To reduce inflammation, either over the counter or prescription NSAIDs (non-steroidal anti-inflammatory drugs)
- Physical therapy: To strengthen the core muscles and back muscles to help stabilize the spine
- Bracing: To help stabilize the spine in more severe cases
- Spinal injections: Corticosteroid (cortisone) injections reduce inflammation within the spinal canal and reduce irritation of the nerves. People with mild to moderate DDD can have long term relief from these injections.
- Surgery: Surgery is always a last resort, but may be elected in advanced cases or if nerve damage occurs. Options include disc replacement or minimally invasive fusion
WHAT YOU CAN DO
There are also many things a patient can do to help modify the disease and prevent it from advancing. This is often as important and goes along with the doctor's treatment.
- Smoking cessation - Smoking has been shown to dry out the disc and cause DDD to worsen
- Weight loss - Any extra weight puts extra pressure on the disc. This can increase pain and may advance the disease process.
- Exercise - Low impact exercise (swimming, biking, yoga and walking) is very important for strengthening postural muscles and improving flexibility.