What Does having a Degenerative Disc Actually Mean?
The word degeneration, meaning decline or deterioration, becomes particularly worrisome when it’s paired with the discs of your spine. But there’s much you can do to combat disc degeneration’s variety of symptoms if this common back condition happens to strike, according to Kaixuan Liu, MD, PhD, endoscopic spine surgeon and founder of Atlantic Spine Center.
Linked most strongly with aging itself – a risk factor we cannot change – disc degeneration is typically a cascade of changes to spinal discs, which are located between the bony vertebrae and help us bend and flex while cushioning much of the pressure from everyday movements. Disc degeneration usually happens slowly over time and can happen in any area of the spine, though the lower back or neck are often prime locations, Dr. Liu says.
This condition happens more often in the lower back, as it faces more pressure during daily activities. The human spine consists of alternating vertebrae and discs which act as cushions, with most of the pressure and stress of everyday movements being absorbed by them. Vertebral discs play a considerable role in our spinal anatomy. Without them, the vertebrae would be unable to absorb stress, become unstable, and would eventually be unable to bend or flex.
“As the discs lose fluid, disc degeneration can lead to tears in their outer layers and the growth of nerve fibers within damaged discs,” explains Dr. Liu. “This domino effect, what some call the ‘Degenerative Cascade,’ can result in several other spinal problems, including bone spurs, herniated discs and spinal stenosis. Proper diagnosis is essential to catch the problem early.”
So, spinal disc degeneration is the result of chronic long-term wear and tear, that is a natural result of aging or an injury. With time, the discs lose some fluids or get cracked, which promotes bone spur growth and increases the pressure on nerves. This increased pressure causes pain, numbness, tingling, and other unpleasant sensations.
Symptoms to watch
What symptoms might clue you in to disc degeneration? Dr. Liu advises watching for these signs:
- Pain in the lower back, buttocks, thighs or neck
- Pain that worsens when sitting, bending, lifting or twisting
- Pain that gets better when walking, changing positions or lying down
- Periods of severe back pain that improve after days, weeks or months
- Numbness, weakness or tingling in the legs
Certain unchangeable risk factors make it more likely you’ll develop disc degeneration, including getting older and having a family history of the problem. But you can avoid or carefully control other predisposing behaviors such as smoking, obesity, heavy lifting, athletic participation, or, to a certain point, back injury.
As we’ve already covered, the issues start with natural wear and tear of discs. In most cases, the bone spur doesn’t have any signs or symptoms for quite a while, so you might not even know that you have disc degeneration. At first, you may feel some stiffness or soreness in the affected regions, which can usually be relieved by putting something cold or warm on it.
“You might not be sure you’re experiencing disc degeneration, but you’ll probably be aware you do have a problem,” Dr. Liu says. “Your doctor can zero in on it by doing a physical exam, performing imaging tests of the spinal discs and surrounding areas, or evaluating your nerve function with a variety of tests.”
To determine the best treatment plan, a doctor should first make a correct diagnosis. To do this, there are usually several steps. The first one is collecting a thorough medical history. During this stage, your doctor asks questions about the symptoms, their severity, occurrence, and length. They can also ask you when the pain started, if you’ve had any injuries, and if you have any relatives with similar problems.
Then a physician usually performs a physical exam to rule out other conditions with similar symptoms. A doctor will ask you to bend or to show some parts of the body to check for numbness or loss of sensations. You can also show the doctor the moves that either help ease the pain, or increase it.
Also, there may be other tests performed. For example, a blood test or imaging tests. Imaging tests include X-rays that show if there are any bone spurs. If there are reasons to think that you have a pinched nerve, an MRI or a computed tomography can be performed, as well as electromyography or a nerve conduction study.
Disc degeneration treatment
If you can, you’ll want to prevent disc degeneration from ever starting. Various lifestyle tactics can do wonders to discourage the condition, Dr. Liu says. These include regular exercise, quitting smoking, eating a healthy diet, drinking plenty of water, and correcting back positions and movements that might prove troublesome. Good posture and ergonomic furniture, as well as a good pillow, can ensure healthy positions of your spine and prevent further damage. If you have a sedentary
lifestyle, you should get up once in a while and have some movement to promote blood flow. Beyond that, an array of treatment approaches can help if disc degeneration is the culprit of your symptoms.
“Treatments aim at weakened back muscles, inflammation surrounding painful nerves, and structural problems in the spine that underlie disc degeneration,” Dr. Liu explains. They include:
- NSAIDs (non-steroidal anti-inflammatory drugs), either over-the-counter or prescription strength. These medications control pain and reduce inflammation.
- Physical therapy, which your doctor would prescribe. It may include exercise, posture training, ice or heat therapy, or electrical stimulation.
- Steroid injections in your doctor’s office. These would target areas surrounding painful nerves near the spinal cord and can calm inflammation.
- Surgery to remove degenerated discs and/or fuse together two vertebrae.
“Surgery, of course, is a last resort if more conservative measures don’t improve your pain and other symptoms over time,” he says. “Do your best to prevent disc degeneration, but other strategies can help you regain your quality of life if it occurs.”
So, the surgery is recommended as the last option. Usually a discectomy is performed to remove a part of the disc, which relieves pressure off the nerves, and therefore eases the pain. In severe cases, the disc can be fully replaced with an artificial one.
Curious about what a Degenerated Disc Looks Like? Check out our 3-D animation on our dedicated Disc Degeneration page: What is Degenerative Disc Disease?