Degenerative Disc Disease
As aging progresses, most people expect to feel a few aches and pains. It is a known fact that the joints begin to wear out over time, not only in the hips and knees but also in the spine. Why this happens, science has yet to determine. What we do know is that wear and tear on the joints correlate with age and certain risk factors, such as doing a lot of lifting. We also know that the degeneration of discs in the spine is a problem to address sooner rather than later.
What Is Degenerative Disc Disease?
The term degenerative relates to the deterioration of an object over time.
Discs are the small structures that sit between the vertebrae, or bones, that make up the spine.
The term disease as it relates to spinal disc degeneration is more of a descriptor of the condition itself. Degenerative disc disease describes the changes that affect spinal discs over time. Most discs degenerate over time, but not all degenerated discs cause pain. Degenerative disc disease refers to deterioration that causes uncomfortable symptoms.
The spinal column is made up of 33 bones called vertebrae. There are three segments of vertebrae along the spine: the cervical, thoracic, and lumbar segments. In between each pair of vertebrae is an intervertebral disc. This fibrous cushion is tough on the outside and soft on the inside, thus absorbing shock and preventing bone-on-bone contact.
As we age, changes occur in the spinal discs. The tough, fibrous shell may become dry and thin, leading to cracks. Changes to the shell can then allow the soft cartilage within the disc to bulge outward. This is referred to as a herniated disc.
What Causes Discs to Degenerate?
Discs naturally degenerate over time due to various factors, including:
- Dehydration diminishes the discs’ ability to absorb shock along the spinal column
- Daily activities “work” each spinal disc, which naturally degrades structure over time
- Injury to any part of the spine can cause instability and inflammation that degrades discs
What Are the Symptoms of Degenerative Disc Disease?
Common symptoms of this condition include:
- Low back pain that worsens when sitting (due to increased load in seated positions).
- Pain when lifting, bending, or twisting.
- Pain decreases when lying down or frequently changing position.
- Pain decreases when moving (walking or running) versus standing still.
- Bouts of intermittent, severe pain lasting from a few days to several weeks.
- Tingling and numbness in the arms or legs.
- Noticeable weakness in the leg muscles.
- “Foot drop,” difficulty lifting the front part of the foot due to muscle weakness.
How Can Dr. Girardi Diagnose Degenerative Disc Disease?
A thorough consultation and medical history are combined with a physical examination during your initial visit. The data gathered from these evaluations can help Dr. Girardi begin to understand the source of pain. Additional testing with diagnostic imaging such as x-rays, CT scan or an MRI may be ordered to obtain accurate observation of discs in the affected spinal segment.
What Treatment Methods Are There for Degenerative Disc Disease?
Treatment for spinal conditions including degenerative disc disease is discussed based on the severity of the condition. In many cases, nonsurgical therapies and lifestyle remedies provide sufficient relief from existing pain. These include:
- Temporary activity modification, such as increased rest or postural changes
- Heat and ice therapy
- Anti-inflammatory or pain medication as needed
- Injectable steroid medication
- Physical therapy to strengthen and improve the flexibility of muscles around the spine
Surgery may be required in some situations, such as:
- Failure to respond to conservative therapies
- Pain relates to a correctable structural abnormality
- Spinal cord compression has occurred
- Pain is chronic and severe
Surgical treatment for degenerative disc disease is conducted to correct the secondary problems such as nerve decompression or spinal stenosis caused by inflammation or bone spurs. Depending on the spinal segment involves and degree of degeneration, a surgeon may recommend removing the offending disc (discectomy). Other approaches may involve fusing two vertebrae together to regain nerve space as well as spinal stability.
Recovery from Degenerative Disc Disease Surgical Treatment
Spinal surgery isn’t what it used to be. Today, many procedures are performed using minimally invasive techniques in an outpatient setting. Recovery can vary, but most patients can resume light activity within approximately 10 days of surgery for degenerative disc disease.
What Are the Risk Factors That Can Speed up the Process of Degeneration?
Disc degeneration is a matter of wear and tear. However, certain factors can accelerate the aging and deterioration of spinal discs. These include:
- Excessive strain on any part of the spine caused by a labor-intensive occupation, sports, or other activity.
- Strain on the spine due to poor posture or extensive sitting.
- Family history of musculoskeletal disorders.
- Smoking or nicotine use.
- Lack of spinal support due to weak core muscles.
At a Glance
Dr. Federico Girardi MD
- Triple fellowship-trained spinal surgeon
- Performs over 400 spinal surgeries per year
- Professor of orthopedic surgery at Cornell University
- Learn more