Context:

Degenerative Disc Disease refers to the weakening of one or more vertebral discs. As we mentioned in our latest spine-education blog (on herniated discs,) the spine is comprised of 23 vertebral discs which act as shock absorbers or cushions in-between the bones (or vertebrae) in the spine.

Degenerative Disc Disease:

Degenerative Disc disease occurs when small tears form in the disc wall (annulus fibrosus). As these tears heal, scar tissue forms. Unfortunately, the scar tissue that forms isn’t as strong as the original outer wall of the disc. Consequently, as continual tears occur, the outer wall becomes weaker and weaker (hence the name “degenerative”).

Vertebral discs are mostly made up of water, and as a disc weakens through the aforementioned process of degeneration, the nucleus pulposus (or the center of the disc) begins to lose water. The loss of water causes the discs to dry out and become thinner. The more water the disc loses, and the thinner it becomes, the less effective it is at acting as a cushion or shock absorber.

As the annulus fibrosis weakens, the disc may “bulge” backwards, resulting in irritation of nerve roots.

Causes/Risk Factors:

Two of the most common causes of degenerative disc disease include:

1. Aging- As we age, the water located in the center of the discs can dry out naturally over time.
2. Injury – Injuries to the back can cause small tears in the disc wall (as mentioned above).

Symptoms:

If the degenerated disc is bulging and contacting nerve roots, patients may experience:

• Numbness, tingling in their legs
• Shooting pain in their legs, commonly referred to as “sciatica”
• Pain in the lower back/upper buttock, often involving the hips

Treatment Options:

• Over-the-counter pain medications/anti-inflammatories such as ibuprofen.
• Physical Therapy – certain exercises may help reduce pain, increase flexibility, and help prevent further degeneration.
• Rest – alleviating pressure from your spine is crucial in the process of healing. With that being said, too much rest can cause the muscles in your back to grow weaker. A physical therapist and/or spine specialist will help plan out a balanced regimen for rest.
• Epidural Steroid Injection (ESI) – may be indicated if conservative measures fail. These injections are administered to reduce inflammation.
• Surgery – while most cases of disc degeneration/bulging improve through a combination of pain medication/anti-inflammatories and physical therapy, surgery may be indicated as a last resort if all of the above measures fail.