Neck, Back, and Spine Pain: Degenerative Disc Disease

What Is Degenerative Disc Disease?

Degenerative disc disease is when normal changes that take place in the discs of your spine cause pain.

Spinal discs are like shock absorbers between the vertebrae, or bones, of your spine. They help your back stay flexible, so you can bend and twist. As you get older, they can show signs of wear and tear. They begin to break down and may not work as well.

Nearly everyone’s discs break down over time, but not everyone feels pain. If worn-out spinal disks are the reason you’re hurting, you have degenerative disc disease.

What Causes It?

Your spinal discs are made up of a soft inner core and a tough outer wall. The discs change in ways that may cause degenerative disc disease, such as:

Dry out. When you’re born, the discs in your spine are mostly made up of water. As you age, they lose water and get thinner. Flatter discs can’t absorb shocks as well. The water loss also means less cushion or padding between your vertebrae. This can lead to other problems in your spine that may cause pain.

Crack. The stress of everyday movements and minor injuries over the years can cause tiny tears in the outer wall, which contains nerves. Any tears near the nerves can become painful. And if the wall breaks down, the disc’s soft core may push through the cracks. The disc may bulge, or slip out of place, which is called a slipped or herniated disc. It can affect nearby nerves.

What Are the Symptoms?

You’ll probably feel a sharp or constant pain in your back and neck. Your exact symptoms depend on where the weak disc is and other changes it has caused.

Common signs include pain that:

• Is in your lower back, buttocks, or upper thighs
• Comes and goes. It can be nagging or severe and can last from a few days to a few months.
• Feels worse when you sit, and better when you move and walk
• Feels worse when you bend, lift, or twist
• Gets better when you change positions or lie down

In some cases, degenerative disc disease can lead to numbness and tingling in your arms and legs. It can also cause your leg muscles to become weak. This means the damaged disks may be affecting the nerves near your spine.

How Is It Diagnosed?

Your doctor will talk to you about your medical history and your symptoms. He may ask you:

• When the pain started
• Which part of your spine hurts
• If it has spread to other parts of your body
• If you’ve had past spine injuries
• If you have a family history of similar problems

He’ll look at your spine for signs of the condition, like pain in your lower back or neck. He may also ask you to walk or bend to see which movements cause pain.

Your doctor may order an X-ray or MRI to check for bone or nerve damage near your spine.

How Is It Treated?

The goal is to ease pain and stop more damage. Your doctor will suggest the best plan for you, based on your symptoms and how serious your condition is. Treatment may include:

Medication. Over-the-counter pain relievers like aspirin and ibuprofen can help fight inflammation. They can ease your pain and lessen swelling. Your doctor may prescribe a stronger drug for pain if you need it.

Degenerative disc disease may also lead to muscle spasms. Your doctor may suggest medicine to help relieve them.

Physical therapy. Specific movements make the muscles in your neck and back stronger and more flexible. This supports the spine.

In most cases, physical therapy and pain medication are enough for long-term relief.

Steroid shots. These have strong medications to ease pain, swelling, and inflammation. Your doctor may suggest you get a shot in the epidural space in your back, a fluid-filled area around the spinal cord, or get one in your nerve or muscle.

Surgery

If other treatments don’t work, your doctor may recommend surgery. One procedure, called a discectomy, removes the injured part of the disc. This helps take the pressure off your nerves.

In some cases, your doctor might remove the whole disc and put an artificial one in. If you have a severe problem, your doctor might fuse (permanently connect) the bones in your spine after he removes the disc.