Degenerative Disc Disease
Degenerative disc disease (DDD) is a spinal condition caused by the deterioration of intervertebral discs, which are located between the vertebrae. It is a common cause of lower neck and back pain. As you age, the discs in your spine experience wear and tear, leading to drying out and shrinking. These age-related changes can result in conditions like arthritis, disc herniation, or spinal stenosis. These conditions can exert pressure on the spinal cord and nerves, causing back pain.
Symptoms of DDD
Degenerative disc disease manifests with several consistent symptoms, including:
- Pain and discomfort typically associated with physical activity, with occasional flare-ups followed by a return to a low-grade pain level or pain that completely subsides after a flare-up.
- The baseline level of pain varies among individuals, ranging from mild irritation to disabling pain.
- Neck and back pain can persist for several months before returning to the patient’s baseline pain level.
- In rare cases, chronic pain from degenerative disc disease can be completely debilitating.
- Activities such as running or walking may feel better for longer durations compared to sitting or lying down.
- Certain positions can exacerbate or alleviate the pain, with sitting often worsening the pain.
- Bending, twisting, and lifting tend to worsen the pain.
Causes of DDD
Degenerative disc disease can be caused by injury, but this is uncommon. Usually, DDD arises from factors such as gradual wear and tear, low-energy injuries to the discs over an extended period, inflammation, or abnormal micro-motion instability.
Abnormal micro-motion instability occurs when the outer rings of the disc (annulus fibrosus) are unable to effectively absorb stress on the spine due to wear and tear. Irritation of the nerves surrounding the disc space by proteins can lead to inflammation, resulting in pain that may radiate down the leg nerves.
Diagnosis and Treatment of DDD
Diagnosing degenerative disc disease typically involves a three-step process:
- Medical history: Your doctor will gather information about the onset of pain, activities or positions that worsen or alleviate the pain, and the most prominent symptoms and pain levels.
- Physical examination: This will likely include tests to assess your range of motion, tenderness, and muscle strength in the lower back and back of the legs.
- Imaging: If lumbar DDD is suspected, your doctor may order an MRI scan to rule out other potential causes of your symptoms.
Most cases of DDD can be managed with medication to control inflammation and pain, combined with physical therapy and exercise. Surgery is typically considered only if nonsurgical treatments have been ineffective after six months.
Home treatment for DDD involves avoiding activities that strain the back, such as rotational movements in sports like golf or heavy lifting. Exercise is a crucial aspect of DDD treatment, focusing on activities like walking, swimming, stretching, and back-strengthening exercises.