Degenerative Disc Disease


 

What is degenerative disc disease?

Degenerative disc disease is not really a disease but a process by which the disc degenerates over time. The disc acts like a shock absorber between the vertebrae. The discs help the back stay flexibe, allowing for bending and twisting. The disc is made of a soft, inner core known as the nucleus pulposus and a tougher outer covering known as the annulus fibrosis. As we age, the nucleus pulposus loses water content and the annulus fibrosus develops tears or cracks which leads to loss of height and strength of the disc. Over time, the body forms bone spurs around the disc to compensate for the loss of strength. Degenerative changes within the disc can lead to localized back pain. Disc loss of height and bone spur formation can result in narrowing of the spinal canal and pinching/irritation of nerves which can lead to leg pain symptoms.  

How is degenerative disc disease diagnosed?

Degenerative disc disease can result in back pain and leg pain symptoms. Many people have degenerative discs that are not causing any symptoms. The back and leg symptoms can come and go and can last from several days to several months. Pain can feel worse with sitting and better with walking and movement. Pain may worsen with bending, lifting or twisting. Pain improves with change in positions or lying down. A lumbar x-ray will show loss of height of the disc. A CAT scan study will show loss of height of the disc and the formation of bone spurs from around the disc and facet joints. An MRI study will show inflammatory changes around the disc and facet joints and potential nerve compression from narrowing and arthritic changes within the spinal canal.  

What is the treatment for degenerative disc disease?

The majority of patients will undergo nonsurgical treatment including medications, physical therapy, and injections. Common medications include Tylenol, anti-inflammatories and muscle relaxants. Physical therapy is useful to relieve muscle spasms and strengthen the core muscles and improve spinal alignment. Epidural steroid injections may be helpful if there is nerve irritation from narrowed spinal canal and bone spur formation. Facet injections help reduce localized back pain from added stress to the facet joints from weakened lumbar discs. Occasionally, a back brace may be helpful to alleviate the tension within the spine, especially if performing activities that can stress the disc.  

Surgery can play a role in degenerative disc disease. Surgery is utilized to remove arthritic bone spurs to relieve pressure on a pinched nerve to relieve leg pain symptoms. Occasionally, a lumbar fusion (ALIF/TLIF) operation can help relieve back pain symptoms caused by a degenerative disc to stabilize a weakened spine segment. The disc is removed and the two vertebrae are fused by placing bone material and a specialized spacer in the disc space.  

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