Degenerative Disc Disease
The vertebral column, also known as the spinal column or simply spine, is a column of 26 bones in an adult body (24 vertebrae interspaced with cartilage in addition to the sacrum and coccyx). In adolescents, the column consists of 33 bones as the sacrum's five bones and the coccyx's four do not fuse together until after adolescence. The spine is further divided into regions: cervical (the neck), thoracic (upper back), lumbar (lower back), sacral, and coccygeal. In between the vertebrae are thin regions of cartilage known as intervertebral discs, which are made of a fibrous outer shell (annulus fibrosus) and a pulpy center (nucleus pulposus).These cartilaginous intervertebral discs, which act as "shock-absorbers," help distribute weight, and keep vertebrae oriented in the correct spacing.
Degenerative disc disease refers to the breakdown of these intervertebral discs over time due to wear-and-tear or repeated trauma. Degenerative disc disease most commonly occurs in the cervical and lumbar regions, but can occur throughout the spine.
Degenerative disc disease is usually associated with the following signs and symptoms:
- General discomfort in the neck or the lower back
- Pain in the neck or lower back that worsens with certain activities such as prolonged sitting or twisting and relieved by other activities like laying down or walking
- If you feel burning or tingling pain down the arms, numbness and/or weakness in the hands or arms, it’s advised to consult a physician immediately
If the individual feels weakness in the arms or legs, it’s advised to consult a physician immediately.
Degenerative disc disease is diagnosed with a combination of physical examination and imaging studies. After discussing the individual's symptoms, the physician will examine the spine. The physician may then order an X-ray or MRI to identify the cause of pain and confirm diagnosis of degenerative disc disease.
To relieve pain caused by degenerative disc disease, it is recommended to place ice or heat depending on what provides relief along with the oral consumption of over-the-counter medication NSAID’s which usually help reduce pain and swelling. If these are deemed insufficient by the physician, they might prescribe stronger medication to relive pain and reduce inflammation. The exact treatment will vary based on any further damage the degenerative disc disease has caused as well as the severity of the pain the individual experiences. Physical therapy is often recommended for strengthening and stretching the back.
In some cases the physician may recommend an epidural steroid injection which is done using real-time X-ray imaging (fluoroscopy). Oral or IV sedation may be offered to keep the patient comfortable during this procedure.
In extreme cases, the physician may recommend operative treatments if non operative methods have been exhausted and unable to relieve pain and other symptoms. Depending on the condition, surgery usually involves removal of the damaged discs and in some cases permanently fusing the bones. Occasionally, artificial discs are used to replace damaged ones.
For single level involvement, the surgery can be performed as an outpatient procedure that takes 60 to 90 minutes.
Recovery will vary based on the severity of the degenerative disc disease, the number of levels involved, as well as the chosen treatment approach. Each patient is unique, so the therapy program will vary based on his/her level of pain, extent of damage, and desired level of activity they would like to return to.
CALL 911 IMMEDIATELY IF YOU ARE HAVING A MEDICAL EMERGENCY!
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