Degenerative disc disease is a very common cause of back pain. As we age, the discs in our spines can dry out and shrink. The discs are the shock absorbers of the spine–when they lose water content, they may lose flexibility and elasticity, making them unable to absorb shock effectively. Changes in the discs can lead to a number of conditions, including arthritis, herniated disc, or spinal stenosis.
What causes degenerative disc disease, and how do we treat it? Let’s break it down.
Causes and Symptoms
Degenerative disc disease is often the result of aging, so adults over the age of 50 are more likely to develop it. However, that doesn’t mean that younger people can’t develop this condition. Injuries and inflammatory conditions like arthritis can contribute to degeneration, or wear, on the discs.
Pain is a common symptom of degenerative disc disease, but the frequency and severity of the pain vary from patient to patient. Some find that pain gets worse with activity and lessens or goes away entirely with rest. Some have almost no pain, or mild, nagging pain, while others have severe pain. Bending, lifting, and twisting often make pain worse. If a patient has degenerative disc disease in the lumbar (lower) spine, standing is often more comfortable than sitting, because there is more pressure on the discs in the lower spine while sitting. For some, walking or running may even relieve pain more than simply standing.
Treatment of Degenerative Disc Disease
The damage that has been done to the discs cannot be reversed. However, the right treatment can help patients manage pain. As with most cases of back pain, degenerative disc disease is often treated using nonsurgical methods first. If a patient does not see positive results from conservative treatment, surgery may be needed.
Nonsteroidal anti-inflammatory medications (NSAIDs) like aspirin, ibuprofen, and naproxen are often recommended for pain and inflammation. Physical therapy can also be very helpful for those with degenerative disc disease. Physical therapy exercises help patients maintain strength and flexibility in the back, and movement gets the blood flowing so that the the spine gets the nutrients it needs to stay healthy.
Low-impact aerobic exercise is often recommended for those with degenerative disc disease because it gets the heart rate up without jarring the spine. Patients who participate in low-impact activities like water therapy, riding a stationary bike, or exercise walking on a treadmill often have fewer episodes of back pain and are able to retain their ability to perform everyday activities.
If a patient’s symptoms do not improve with conservative treatment, surgery may be recommended. The most common surgical treatment option for degenerative disc disease is a spinal fusion. A spinal fusion is generally only recommended if the spine is unstable, or if there are additional problems, such as a herniated disc.
The goal of a spinal fusion is to stop motion in painful segments of the spine by fusing these segments together. Although fusions do take away some of the flexibility of the spine, a fusion will usually only involve one or two segments, so range of motion is not too limited. During a fusion procedure, the damaged disc is removed, and the segments above and below the disc are fused together using bone grafts.
The goal of treatment for degenerative disc disease is to allow patients to perform everyday without pain. In most cases, patients with degenerative disc disease are able to lead a normal lifestyle and manage their pain with conservative treatment.