Degenerative disc disease occurs when the cushion in your spine begins to wear away. The condition is most common in older adults. After age 40, most people experience some spinal degeneration.
Your spinal discs act as a cushion to absorb shock between the vertebrae during movement. As a result of aging or injury, sometimes the spinal disc loses its cushioning effect which may result in a loss of disc height. This loss of disc height reduces the distance between the vertebral bodies and may cause irritation or pinching of the nerves. The spinal disc may also bulge or herniate, where the disc material contained within the intervertebral disc is pushed into the spinal canal. This may cause inflammation and pressure on the local nerve.
The loss of disc height and / or bulge of the disc may result in the following symptoms.
- Pain or discomfort in the neck or back
- Tingling or loss of feeling in arms or legs
- Shooting pain or discomfort in one or both legs
- Discomfort that worsens upon standing or activity
When the cushions (discs) wear away, the bones can start to rub together. This contact can cause pain and other problems, such as:
- Adult scoliosis, where the spine curves
- A herniated disc, also called a bulged, slipped, or ruptured disc
- Spinal stenosis, when the spaces around your spine narrow
- Spondylolisthesis, when vertebrae move in and out of place (slip forward, backward, or sideways)
Degenerative changes of the spine
Degenerative changes of the spine occur from natural aging associated with pathological changes of the vertebral bodies, intervertebral discs, ligaments and vertebral joints.
These changes can greatly limit both the mobility and stability of the spine.
The stability of the spine can also be compromised by unnatural weight distribution caused by a hereditary abnormality, or a lack of movement associated with a sedentary lifestyle. Any previous operation or trauma to the spinal column can also cause a loss of stability.
Any form of instability can progress to become a pain generator.
Treatment
Non-Surgical
Usually, your healthcare provider will recommend noninvasive treatment options first. Your treatment may include the following:
- Physical therapy: Participating in strengthening and stretching exercises with a trained healthcare provider.
- Medications: Taking nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxers, or steroids.
- Steroid injections: Injecting medicine near your spinal nerves, disk, or joints to reduce inflammation and pain.
- Radiofrequency neurotomy: Using electric currents to burn sensory nerves and block pain signals from reaching your brain.
Surgical Treatment
Many patients suffering from degenerative disk disease do not require surgery. However, if you have tried many non-surgical therapies and continue to have discomfort and/or weakness, surgery may be a viable choice.
Your surgeon may use one of a few types of spinal surgery:
- Discectomy: Removing part of a spinal disc to relieve pressure on your nerves.
- Foraminotomy: Expanding the opening for your nerve roots by removing tissue and bone.
- Laminectomy: Taking out a small portion of bone from your lower spine (lamina).
- Osteophyte removal: Removing bone spurs (osteophytes).
- Spinal fusion: During this procedure, your surgeon connects two or more vertebrae together to improve stability.
Herniated Discs
The described degenerative changes or trauma can cause tears in the intervertebral disc. The escape of the nucleus (or soft interior) of the intervertebral disc outward through these tears may cause a disc herniation.
The disc herniation can impinge on the nerves and depending on the location can cause pain in the neck, arms and shoulders. In the extreme case, it can cause paralysis.
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