Degenerative Disc Disease

Degenerative disc disease is not actually a disease in the traditional sense. It is a term used to describe age-related or wear-related changes in the spinal discs. These discs act like cushions between the vertebrae. When they dry out, thin or develop small tears, the spine may become less stable and more painful.

Some people have mild changes on imaging and few symptoms. Others develop ongoing pain, reduced range of motion or nerve compression that can cause symptoms similar to a herniated disc, sciatica or spinal stenosis.

Degenerative disc disease is often described by the part of the spine involved:

• Cervical degenerative disc disease: affects the neck and may cause neck pain, headaches, shoulder pain or arm symptoms
• Thoracic degenerative disc disease: affects the upper and mid-back and is less common
• Lumbar degenerative disc disease: affects the lower back and may cause low back pain, hip pain or leg symptoms

It may also be discussed based on what is happening in the disc and surrounding structures, such as disc dehydration, loss of disc height, annular tears, bulging or degeneration associated with arthritis, instability or nerve compression.

Symptoms vary depending on which discs are involved and whether nearby nerves are affected. Common symptoms include:

• Back pain or neck pain that comes and goes or gradually becomes more persistent
• Pain that gets worse with bending, twisting, lifting, sitting for long periods or certain activities
• Stiffness and reduced flexibility
• Muscle spasms
• Pain that radiates into the buttocks, legs, shoulders or arms
• Numbness, tingling or weakness when a nerve is irritated or compressed

Symptoms may flare up for days or weeks and then improve. In some people, pain is mostly mechanical, while in others nerve-related pain becomes the bigger issue.

The most common cause is normal wear and tear over time. Healthy discs gradually lose water content as we age, making them less able to absorb shock. Small cracks can form in the outer layer of the disc, and the disc can flatten or bulge.

Risk factors that may increase the chance of painful disc degeneration include:

• Aging
• Repetitive lifting, bending or twisting
• Physically demanding work
• Prior spine injury
• Smoking or nicotine use
• Excess body weight
• Poor posture or weak core support
• A family history of spinal degeneration

Degenerative changes can also contribute to or occur alongside herniated disc, sciatica, spinal stenosis and slippage of a vertebra known as spondylolisthesis.

Diagnosis starts with a detailed conversation about your symptoms, when they started, what makes them worse and whether pain travels into an arm or leg. Your specialist will also perform a physical exam to check posture, movement, strength, sensation, reflexes and signs of nerve irritation.

Testing may include X-rays to evaluate alignment and disc height, as well as MRI or CT imaging to look more closely at discs, nerves and nearby structures. In some cases, specialists in Nonsurgical Spine Care and Pain Management may use image-guided injections to help identify the source of pain. When surgery is being considered, you may also be evaluated by the Spine Surgery team.

Treatment depends on the location of the problem, the severity of symptoms and whether nerve compression is present. Most people begin with conservative care.

Nonsurgical treatment may include:

• Activity modification and short-term rest from aggravating movements
• Physical therapy to improve flexibility, posture and core strength
• Anti-inflammatory medicines or other pain-relief medications when appropriate
• Image-guided injections or other interventional pain procedures
• Rehabilitation strategies and home exercise programs

If symptoms do not improve or if there is significant nerve compression, weakness or instability, surgery may be recommended. Depending on the problem, surgical options may include:

• Laminectomy
• Minimally invasive spinal fusion

Without proper treatment, degenerative disc disease can sometimes lead to chronic pain, reduced mobility and activity limitations that affect work, sleep and quality of life. Ongoing disc collapse and inflammation may also place more stress on the joints and ligaments of the spine.

In some cases, degeneration contributes to disc bulging, herniated disc, nerve compression, sciatica or spinal stenosis. Severe nerve compression can cause increasing weakness, numbness or balance problems and should be evaluated promptly.

You cannot completely prevent normal age-related disc changes, but healthy habits may help reduce stress on your spine and lower the risk of painful flare-ups.

• Stay physically active and keep the muscles that support your spine strong
• Use proper body mechanics when lifting, bending and twisting
• Maintain a healthy weight
• Avoid smoking and nicotine products
• Improve posture and workstation setup
• Get early evaluation for persistent neck, back or radiating pain

Baptist Health Brain & Spine Care also offers Spine Care Resources to help patients better understand back and neck pain, treatment options and recovery.

If you have ongoing neck or back pain, pain that radiates into an arm or leg or symptoms that are interfering with daily life, the next step is a thorough evaluation. Baptist Health Brain & Spine Care specialists can help determine whether your symptoms are related to degenerative disc disease, another spine condition or a combination of problems.

To schedule a visit with a Baptist Health Brain & Spine Care provider, fill out an appointment request form or call 833-596-3876.