Degenerative Disc Disease
Degenerative disc disease is a term used to describe age-related spine changes. Spinal disorders associated with degenerative disc disease (DDD) include disc problems (bulging, narrowing, herniation), spinal osteoarthritis (spondylosis), bone spur (osteophyte) formation and spinal stenosis.
Also Related to DDD
Discogenic pain is a term used to refer to pain caused by a damaged disc. A degenerating disc may cause mechanical (movement) or structural pain. This type of pain is usually felt in the low back. Pain may feel like it originates from your buttocks or upper thighs. This is called pain radiation – in other words, the pain spreads from one body part to another. As the disc begins to degenerate, there is some evidence that the disc itself becomes painful. Movements that place stress on the disc can cause back pain that appears to come from the disc. This is similar to any other injured body part that is injured, such as a broken bone. When still, these types of injuries do not cause pain. Pain begins with movement.
Bulging discs are common in young adults and older people, with or without back pain. Sometimes, a bulging disc develops in conjunction with aging and disc degeneration. While the term bulging may sound ominous, a bulging disc only becomes serious if it causes narrowing of the spinal canal.
About Degenerative Spinal Changes
Degenerative, age-related changes are normal, although genetics (uncontrollable) and lifestyle (controllable) can slow down or accelerate the process. From the start of life, change begins at the cellular level. While most cellular activity is essential for health and well-being, sometimes DDD develops.
The spine is the body’s support system at rest and during movement. Every day the spine encounters, absorbs and distributes mechanical body stress. Daily stresses and minor injuries add up over time and begin to affect structural integrity of the spine’s discs. Combined with age-related cellular changes, disc degeneration is set in motion.
Water is a primary component in the center structure of a healthy disc. Water gives the disc its spongy quality and helps it to absorb spinal stress. Excessive pressure to the disc or disc injury may damage the ligament that holds the disc in the center of the vertebral bodies above and below. The ligament is often the first portion of the disc to sustain injury in the form of small tears. The tears heal and form scar tissue that is not as strong as ligament tissue. Over time, and as more scar tissue forms, the ligament weakens. The disc begins to lose its water content and spongy resiliency and stiffens. The degenerative cascade continues as the ligament repeatedly sustains more stress, tears, and builds scar tissue. Lost hydration (water) leads to disc narrowing and collapse; the vertebral bodies above and below the degenerative disc move closer together affecting normal movement of the facet joints.
In an effort to self-repair, osteophytes (bone spurs) develop around the disc space and facet joints to stop excessive movement of the spinal segment. Spinal stenosis may develop when bone spurs grow into the spinal canal and compress the spinal cord and nerve roots.
DDD Symptoms
An early symptom of degenerative disc disease is back pain that spreads into the buttocks and upper thighs. This is a symptom of lumbar degenerative disc disease. Neck pain that spreads into the upper back, shoulders and arms may be symptomatic of cervical degenerative disc disease. Other symptoms include numbness, tingling, and weakness.
Accurate Diagnosis Essential
An accurate diagnosis is essential to develop your treatment plan for a good outcome. To begin, Doctor Frazier carefully analyzes your written medical history and opens up discussion by asking you many questions about your symptoms, when symptoms started, treatments tried, hereditary disorders, existing conditions, and lifestyle.
During the physical and neurological examinations, Dr. Frazier evaluates movement limitations, problems with balance, location of pain. He reviews possible loss of arm or leg reflexes, muscle weakness, loss of feeling and/or abnormal sensations such as numbness or tingling.
Diagnostic tests may be necessary to reveal more information about your symptoms and to confirm your diagnosis. To ensure the most accurate diagnosis, Dr. Frazier has access to a complete range of advanced diagnostic equipment including high-speed Magnetic Resonance Imaging (MRI), Computerized Tomography (CT scan), bone densitometry (DEXA), myelography, and discography.
Nonoperative Treatment of DDD
Nonsurgical interventions are usually the first step in the treatment of degenerative disc disease. Your treatment may include one or more therapies for maximum effectiveness.
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Medication to relax muscle spasms
- Pain medication
- Physical therapy to increase flexibility, strength, and endurance
- Injection therapies such as epidural steroid injections, trigger point injections, nerve root blocks, facet joint injections to relieve symptoms
- Back and neck pain prevention, such as proper posture and biomechanics
Your treatment plan may include acupuncture, reflexology or other complimentary alternative methods to relieve symptoms.
When Spine Surgery May Be Recommended
A surgical recommendation may be made after nonsurgical treatments are exhausted, certain symptoms progress, and/or pain is unrelenting. Of course, your individual treatment plan is adjusted to ease symptoms, restore and maintain function, and help you to lead an active and productive life.
If the cause of your degenerative disc disease requires surgery, be assured that Dr. Frazier will carefully and thoroughly explain:
- Why he recommends spine surgery
- How surgery may be of benefit
- Possible risks and complications
- When (how soon) is surgical treatment needed
- Procedure name and type
- How to prepare for surgery
- Surgery aftercare and recovery
Dr. Frazier and his professional staff understand you have choices. They have a deep commitment to patient education and want to help you make informed decisions about your health, medical care, and recovery.
