Degenerative Disc Disease

(Degenerative Disk Disease)
  • Definition

    Discs lie between the spinal bones (vertebra). They serve as shock absorbers. This protects the spine and helps it stay flexible. Degenerative disc disease is wear and tear on these discs. This wear and tear causes pain and other symptoms. Some degeneration is normal as you age. Not all degeneration will result in symptoms of this disease.
    Degenerative Disc
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  • Causes

    The disc loses fluid and is not as resilient as normal. The fibrous tissue, which holds the disc material in place, may suffer small tears. These tears lead to further damage. There is some evidence that genetics may play a part for some people.
  • Risk Factors

    Factors that may increase your chance for degenerative disc disease:
    • Increased age
    • Family history of degenerative disc disease
    • Sports
    • Back injury
    • Smoking
    • Heavy physical work
    • Obesity
  • Symptoms

    Symptoms of degenerative disc disease include:
    • Pain in the low back, buttocks, thighs, or neck
    • Pain that worsens when sitting, bending, lifting, or twisting
    • Pain that feels better when walking, changing positions, or lying down
    • Periods of severe pain that gets better after a few days or months
    • Numbness and tingling into the legs
    • Weakness in the legs
    • Inability to raise the foot at the ankle
  • Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done.
    Images may be taken of the disc and surrounding area. This can be done with:
    • MRI scan
    • X-ray
    • Discography
    Your bodily fluids may be tested. This can be done with:
    • Blood tests
    • Urine tests
    Your nerves may be evaluated. This can be done with an electromyogram and nerve conduction studies.
  • Treatment

    Talk with your doctor about the best plan for you. Treatment options include:
    Physical Therapy
    Therapy for this condition is focused on teaching you how to manage your back pain. This may involve:
    • Posture training
    • Exercise
    • Ice packs
    • Heating
    • Electrical stimulation
    • Relaxation
    • Other forms of physical therapy
    Injections
    Steroid injections may be used for some short term pain relief. They are injected around the nerves exiting the spinal cord.
    Surgery
    Surgery may be required for some. Surgery may involve removing the degenerated disc and fusing two of the vertebra together.
  • Prevention

    Take the following steps to help protect your spine:
    • Begin a safe exercise program with the advice of your doctor.
    • Maintain a healthy weight .
    • If you have osteoporosis , follow your doctor's instructions for treating the condition.
    • If you smoke, talk to your doctor about ways to quit.
    • If possible, make changes to your workplace to reduce symptoms.
  • RESOURCES

    American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org

    North American Spine Society http://www.spine.org

    CANADIAN RESOURCES

    Canadian Orthopaedic Association http://www.coa-aco.org

    Canadian Orthopaedic Foundation http://www.canorth.org

    References

    Bogduk N, Anat D. Degenerative joint disease of the spine. Radiol Clin North Am. 2012;15(4):613-28.

    Paassilta P, Lohiniva J, Göring HH, et al. Identification of a novel common genetic risk factor for lumbar disk disease. JAMA. 2001;285:1843-1849.

    Urban J, Roberts S. Degeneration of the intervertebral disc. Arthritis Res. Ther. 2003;5(3):120-130.

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