Degenerative disc disease refers to breakdown of the soft discs between the vertebrae. It generally develops as part of the normal wear and tear process of aging on the spine, but can also occur in younger individuals who have experienced a back injury.
Separating each vertebra of the spine is an intervertebral disk. The purpose of these disks is to act as padding and to function as shock absorbers. The disks cushion the stress when the spine moves or bears weight. As individuals age the intervertebral disks begin to degenerate. They become less flexible, less elastic, and less capable of absorbing the forces placed on the spine. When the disks breakdown, the pressure from the adjacent vertebrae increases. The force on the weakened disk may cause it to bulge or herniate resulting in compression or irritation of the spinal cord and/or surrounding nerve roots. Disk degeneration can also precipitate the development of other spinal conditions such as arthritis, spinal stenosis, and spondylolisthesis.
While some individuals with degenerative disk changes have no symptoms, others experience pain so intense that they are unable to carry out their daily activities. Degenerative disc disease most often occurs in the neck (cervical spine) or the lower back (lumbar spine). Strenuous work, obesity, regular tobacco smoking, or acute injury may accelerate the process of degeneration. The location of the affected disk determines where symptoms are manifested. Common symptoms of degenerative disk disease include neck or back pain that is worse with sitting and aggravated by such actions as bending, lifting, or twisting. Numbness and tingling in the extremities can also occur as well muscle weakness.
The diagnosis of degenerative disc disease begins with a medical history and physical examination. The doctor will inquire about your lifestyle, habits, past injuries, and the type and symptoms you are experiencing. This will be followed by a physical examination to check for pain with motion or upon palpation, nerve function, and muscle strength. Further diagnostic tests may be recommended to confirm the diagnosis and to rule out other causes.
Many degenerative disc disease patients respond well to non-surgical treatments. Medications, occupational and/or physical therapy, a supportive corset or brace, injections of steroids and local anesthetic, as well as emerging new therapies may manage symptoms and limit further damage. However, when conservative treatments do not provide relief, surgery may be recommended. Surgeries used for patients with degenerative disk disease can include such procedures as a spinal fusion to provide stability, decompression surgery to alleviate nerve impingement or artificial disk replacement.