The intervertebral discs are gel filled structures in the spine that act as cushion in between the vertebral bones. Degenerative disc disease (DDD) is a common condition that results from wear and tear of the intervertebral discs. As we age, the discs deteriorate due to repetitive stress, increased load, and decrease in blood flow and nutrition to the discs. Degenerative changes in the discs include: annular tear (tear in the outer fibrous ring of the disc), herniation or bulge, decrease in height, drying out, stiffness and bone spurs.
Symptoms of Degenerative Disc Disease
The symptoms of degenerative disc disease are dependent on the disc that is involved and changes in the surrounding spinal structures as a result of, or associated with the degeneration. The most common symptom of degenerative disc disease is a continuous deep pain in the neck, midback or low back that occasionally flares up to a more intense, disabling pain. The episodes can last for a few days or several weeks, and typically recurs. The baseline pain is variable in individuals and can range from almost no pain, nagging ache or severe pain.
The pain typically gets worse with prolonged sitting, standing and walking. Twisting and bending the spine, or carrying heavy loads can also aggravate the pain in the back. Prolonged tilting of the head down while reading or working on the computer can worsen neck pain.
The pain can refer to the buttocks and hips when the lumbar spine is involved, or to the shoulder blade region when the cervical spine is involved. When the degenerated disc compresses or irritates the nearby spinal nerves, radiating pain can be felt in the buttocks, hips, legs and feet (lumbar disc degeneration); or in the shoudler, arm and hand (cervical disc degeneration). Individuals with disc problems can also experience muscle tightness or muscle spasms.
It is not uncommon to see degenerative changes in the spinal imaging of patients over 60 years old. Majority of these patients will not present with symptoms.These imaging findings must be interpreted in the context of the patient’s clinical condition.
Treatment Options for Degenerative Disc Disease
Nonsurgical Treatments Options
Majority of patients who develop symptoms from degenerative disc disease respond well to conservative treatments without the need for surgical intervention.
- Medications: Non-steroidal anti-inflammatory medications (NSAIDS) decrease the symptoms of pain and inflammation associated with this condition. Analgesic medications or muscle relaxants can be helpful when the symptoms are severe. Medications to decrease nerve-related pain, called “sciatica” in the lumbar spine, can also be beneficial.
- Physical Therapy: Therapeutic exercises to strengthen the supporting muscles, improve spinal alignment, flexibility and stability, are critical in healing the spine. A physical therapist can help teach proper exercises and educate on activity modifications to help prevent recurrence of symptoms and injuries.
- Regenerative Treatments: These are innovative, non-surgical treatments using cells from your own body to heal and repair orthopedic conditions. These cell therapies, called Platelet-rich plasma and Cell-based Therapies derived from Bone Marrow, have been shown to help treat spinal conditions and provide long-term relief.
Surgical Treatment Options
Surgery is an option when all conservative treatment options have failed, when there is severe, debilitating pain that interferes with daily function, or when there is worsening neurologic function. These surgeries may involve the removal of a bulging portion of the disc (discectomy), removal of a portion of the bone in the spinal canal (laminectomy), replacing the degenerated disc with an artificial disc, or spinal fusion.
For help with your back pain and degenerative disc disease, please contact the experts at San Diego Orthobiologics Medical Center.