What is Degenerative Disc Disease?
The clinical term “degenerative disc disease (DDD)” refers to a condition in which one or more discs between the vertebrae of the spinal column lose their strength. Despite its name, degenerative disc disease technically itself not a disease, but describes the process of disc degeneration. This condition occurs naturally and happens over time from wear and tear, or injury of the disc. This may cause mild to severe pain that interferes your regular activities. While left untreated, degenerative disc disease can worsen 1.
Usually, spinal disc acts as a shock absorber just like a cushion. By locating in between the vertebrae of the spine these discs will help you to stand up straight. Also, they help you to move through everyday motions like bending over and twisting around. The wear-and-tear on a spinal disc causes weakness, numbness, instability, and hot or burning pains in the arms or legs. Disc degeneration develops as a natural part of aging and over time everybody will show symptoms because of the changes in their discs 2.
Most of the time, the affected person never shows the sign of disc degeneration. Sometimes severe arthritis still produces no symptoms. Typical symptom of degenerative disc disease includes pain in the lower back that extends to the leg and buttock. After damaging the lower back, this discomfort may spread to the buttock and upper thigh. The patient may also suffer from tingling, numbness, or both, in the legs or feet. Disc degeneration in the cervical spine radiates pain to the shoulder, arm, and hand. You may present instability in the spine that leads to muscle spasms in the lower back or neck. The individual may experience intense pain while sitting, bending, lifting, or twisting 3.
Primary causes of disc degeneration include the wear and tear of spinal discs. Research shows the disc naturally tends to become dry over a period of time and affects almost 90% of the adult population worldwide 2. Other cause includes sudden injury and heavy trauma from sports or repetitive activities. The potential risk factors of disc degeneration comprise obesity, strenuous physical work, smoking, and a sudden fall. Remember that a damaged disc can’t repair itself.
How do Neurosurgeons Diagnose Degenerative Disc Disease?
The initial diagnosis of the degenerative disc disease includes a brief clinical presentation and pain patterns of the patients. Your doctor will ask about symptoms, when and where the pain occurs, whether and in which situation you feel pain, tingling, or numbness. They will also ask about any history of falls, injuries, or accidents. A physical examination includes the strength of muscle, pain with motion or in response to touch, and nerve function test. Your physicians may further confirm by 4:
- Imaging tests such as X-ray, Computed tomography (CT), and magnetic resonance imaging (MRI)
- Discogram: This involves injecting a dye into the soft center of the disc to see whether the disc is painful.
How do Neuorsurgeons Treat Degenerative Disc Disease?
The treatment protocols for patients include non-surgical conservative treatment and surgical options. Depending on the condition of disease, your doctor may suggest to do surgery. Treatment options include 5:
- Heat or cold therapy: Applying hot and cold therapy decrease pain associated with a damaged disc.
- Pain management: Medications may include pain relievers, muscle relaxants, corticosteroids, and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen to relieve pain.
- Physical therapy: This includes strengthening your back muscles to alleviate pain. You may practice gentle yoga, swimming, walking, or hydrotherapy to improve your condition.
If you still have problems after following the above treatments, your doctor may advise to go for surgery. Surgical optionincludes an artificial disc replacement or a spinal fusion. Always consult with your physician to select the best option for you.
- Fernandez-Moure, J. et al. Novel therapeutic strategies for degenerative disc disease: Review of cell biology and intervertebral disc cell therapy. SAGE Open Med. 6, 205031211876167 (2018).
- Kos, N., Gradisnik, L. & Velnar, T. A Brief Review of the Degenerative Intervertebral Disc Disease. Med. Arch. (Sarajevo, Bosnia Herzegovina) 73, 421–424 (2019).
- Haddadi, K. Degenerative Disc Disease: A Review of Cell Technologies and Stem Cell Therapy. Iran. J. Neurosurg. 1, 6–10 (2016).
- Taher, F. et al. Lumbar Degenerative Disc Disease: Current and Future Concepts of Diagnosis and Management. Adv. Orthop. 2012, 1–7 (2012).
- Inoue, N. & Espinoza Orías, A. A. Biomechanics of Intervertebral Disk Degeneration. Orthop. Clin. North Am. 42, 487–499 (2011).