Degenerative Disc Disease
When a back is young and healthy, discs between the vertebra provide height and allow bending, flexion, and twisting. The discs work like shock absorbers, designed to help the back remain flexible while resisting forces. As aging occurs, the rubbery discs begin to shrink and lose integrity, resulting in lower back and neck pain. In other words, these discs degenerate over time. This degenerative condition–though not actually a disease–is referred to as degenerative disc disease.
Common Symptoms of Degenerative Disc Disease
Disc degeneration is actually a natural part of aging, however, not all people will develop symptoms. In fact, degenerative disc disease varies quite a bit in regards to its nature and severity. Patients that do develop symptoms, however, will generally find they are concentrated in the lower back or neck, depending on where the degenerated disc(s) are.
Facet joints, which are found in the posterior aspect of the spine (or the back end), together with the discs in the front or anterior aspect, give the spine balance and stability. These facet joints can degenerate over time, just like the disc (sometimes more so), and are an important source of pain in the neck or lower back, and may also give rise to muscle spasm which may in turn also lead to pain. Common symptoms include:
Activity-related pain that flares up but then returns to a low-grade pain level, or disappears entirely
Pain that is worse when sitting
Pain that affects the low back, buttocks and thighs
Pain that sometimes radiates from the neck to the arms and hands
Pain that lessens when walking, moving, changing positions or lying down
Pain that worsens when bending, lifting or twisting
Numbness and tingling in the extremities
Weakness in the leg muscles or foot drop (possible nerve root damage)
Periods of severe pain that come and go, lasting from a few days to a few months
Degenerative Disc Disease Treatment
The good news about degenerative disc disease is that it is approached with various conservative treatment options rather than surgery. Lumbar spine fusion may be the only way to relieve the pain for a small percentage of patients. For most other patients, however, goals for treatment usually include a combination of three areas: pain control, exercise and rehabilitation, and lifestyle modifications.
The focus of this part of treatment is reducing pain to a level that will allow the patient to enter a specific exercise and rehabilitation program. Since instability and inflammation are probable causes for degenerated discs, those two areas are generally addressed.
Medications can also help with pain management. Acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), oral steroids, muscle relaxants, and narcotic pain medications, are examples of medications that a physician may recommend or prescribe. Any medication, including many over-the-counter drugs, should be taken under a physician’s care, direction and supervision. Patients should address any questions about potential side effects with their physician or pharmacist.
Exercise and Rehabilitation
The primary way to get pain under control is to increase the strength and flexibility of muscles that surround and support the spine. Exercising increases blood flow to the back, which nourishes joints and muscles with oxygen and nutrients, while clearing away destructive inflammatory waste products. Exercising also releases endorphins that serve as a natural pain reliever for the body.
Spine specialists are trained in developing individualized back exercise programs and in instructing patients in proper form and technique. Stretches and low-impact aerobic conditioning are two examples of exercises patients may be instructed to do. Exercise should be done in a controlled progressive manner and with the help of a trained health professional, such as a physical therapist or chiropractor.
This part of treatment focuses on education and resources to help the patient develop a healthier lifestyle. Certain lifestyle changes can reduce stress on the spine and even support it.
Important areas to focus on include:
Supportive footwear, ergonomic furniture, proper lifting techniques, and avoiding static posture for prolonged periods of time can help alleviate pressure off the low back.
Losing weight can reduce low back pain by lessening the amount of stress on muscles and ligaments.
Quitting smoking can improve blood circulation and healing. Chronic tobacco use is closely linked to chronic back pain.