What is Degenerative Disc Disease?
The spinal column is made up of individual bones known as vertebrae that are linked together one on top of the other creating the spine. The spaces between these individual vertebrae are cushioned with pads of cartilage known as intervertebral discs.
These soft and compressible discs not only act as shock absorbers, but they contribute to the overall flexibility of the spine. As people age, wear and tear on these discs can cause changes leading to pain within the neck and back. Thus, degenerative disc disease is a condition related to the changes that occur within the intervertebral discs as people age.
This degeneration can also lead to other changes in the body, such as:
- Osteoarthritis: A chronic condition associated with cartilage damage. If the cartilage sustains enough damage, there is a high risk of bone rubbing directly onto bone.
- Herniated disc: A condition characterized by damaged intervertebral discs, causing them to bulge or break.
- Spinal stenosis: A condition characterized by a restriction of the spinal canal that is caused by a narrowing of the spinal column
The pain associated with degenerative disc disease can occur throughout the spine, though in some cases the pain is localized to the affected intervertebral disc. This pain may worsen with movement. The specific symptoms of pain associated with degenerative disc disease can vary widely. Some patients will experience the pain as a highly specific sharp stab, while others report that the pain is more general and widespread. Additional symptoms associated with degenerative disc disease include numbness and tingling sensations. In some cases, the pain can radiate from the spine to the extremities.
Causes of Degenerative Disc Disease
Though the literature remains somewhat unclear, the majority of existing evidence indicates that degenerative disc disease is primarily associated with normal changes within the intervertebral discs over time. Indeed, normal wear and tear on the body is not sufficient to account for the pain typically associated with this condition, and some scientists disagree about the actual cause of this condition. Nonetheless, the symptoms of pain associated with degenerative disc disease are believed to arise from inflammation resulting in compression and instability of the intervertebral discs. Instability of the intervertebral discs is believed to lead to reflexive muscle spasms that may also account for this pain.
Factors other than normal aging have been identified as playing a role in the degeneration of intervertebral discs. They include age, history of smoking, and ethnicity. Some studies have shown that degenerative disc disease tends to run in families, which suggests that the condition also has a genetic component.
Treatment for Degenerative Disc Disease
While there are many treatments available to help provide relief to patients experiencing pain associated with degenerative disc disease, it is recommended that patients who are not experiencing severe, debilitating pain attempt conservative, at-home treatments first. For instance, physical therapy, including targeted exercises, routine stretches, and low-impact aerobic conditioning has been shown to be beneficial to degenerative disc disease patients. Alternating applications of cold and hot compresses is also recommended to help with pain and discomfort.
Over-the-counter pain relievers may also be beneficial in providing relief from pain. A non-steroidal anti-inflammatory drug (NSAID) may help patients who are experiencing moderate pain. These medications are recommended because of their ability to reduce inflammation in the affected intervertebral disc and thereby reduce the associated pain. Oral corticosteroids, such as prednisone and cortisone, may also be recommended to reduce pain and inflammation of the affected area.
Individuals whose pain does not respond to over-the-counter remedies may wish to speak to their doctor about prescribing an opioid medication to help manage the pain. Opioids are among the oldest classes of drug therapies available. The effects, similar to morphine, are a decreased perception of pain, decreased reaction to pain, and increased pain tolerance. Studies have provided ample support for the use of opioids in short-term relief of sudden-onset, severe pain; however, concerns related to the misuse and abuse of this medication suggest that long-term use of opioids for managing pain is contraindicated.
Epidural Steroid Injection Patients with chronic or severe pain may wish to try more aggressive forms of pain management. For instance, epidural steroid injections have been shown to be successful in providing a reduction in pain for patients with degenerative disc disease. TENS units, which are devices that deliver a very mild electrical stimulation to the affected area, have also received some support for individuals with degenerative disc disease. Additionally, there is some indication that patients can experience a significant reduction in pain with spinal cord stimulation. This procedure involves implanting a device near the spinal column that delivers electrical impulses to control the transmission of pain signals from the nerves within the spine.
In terms of alternative techniques, biofeedback training has received support for helping patients manage the pain symptoms associated with degenerative disc disease. This treatment involves teaching patients relaxation and coping skills.
Complementary therapies have also shown promise for patients with degenerative disc disease. Techniques, such as acupuncture, when done in combination with other forms of treatment for pain, can be extremely beneficial
Degenerative disc disease is a controversial and frequently misunderstood condition involving pain that is associated with aging of the intervertebral discs within the spine. With age, these discs can become inflamed and irritated, leading to pain in the back and neck. There are a number of treatment options available for managing the symptoms associated with degenerative disc disease. Patients are encouraged to attempt conservative, at-home techniques as a first-line treatment for managing pain. However, if their symptoms persist or worsen, or if your symptoms are severe and debilitating, it is recommended that you speak with your doctor about more aggressive forms of pain management.