Degenerative Disc Disease
What is degenerative disc disease?
Degenerative disc disease
is not really a disease but a term used to describe the
normal changes in your spinal discs as you age.
Spinal discs are soft,
compressible discs that separate the interlocking bones
(vertebrae) that make up the spine. The discs act as shock
absorbers for the spine, allowing it to flex, bend, and
twist. Degenerative disc disease can take place throughout
the spine, but it most often occurs in the discs in the
lower back (lumbar region)
neck (cervical region).
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The changes in the discs can result in back or neck pain
breakdown of the tissue (cartilage) that protects and
Herniated disc, an abnormal
bulge or breaking open of a spinal disc.
Spinal stenosis, the
narrowing of the spinal canal, the open space in the spine
that holds the spinal cord.
These conditions may put pressure on the spinal cord and
nerves, leading to pain and
possibly affecting nerve function.
What causes degenerative disc disease?
As we age, our spinal discs break down, or degenerate, which
may result in degenerative disc disease in some people.
These age-related changes include:
- The loss of fluid in your discs. This
reduces the ability of the discs to act as shock absorbers
and makes them less
flexible. Loss of fluid also makes the disc
thinner and narrows the distance between the vertebrae.
- Tiny tears or cracks in the outer layer
(annulus or capsule) of the disc. The jellylike material
inside the disc
(nucleus) may be forced out through the
tears or cracks in the capsule, which causes the
disc to bulge, break open
(rupture), or break into fragments.
These changes are more likely to occur in people who
smoke cigarettes and those
who do heavy physical work (such as repeated heavy lifting).
People who are obese are also more likely to have
symptoms of degenerative disc disease.
sudden (acute) injury
leading to a herniated disc (such as a fall) may also begin
the degeneration process.
As the space between the vertebrae gets smaller, there is
less padding between them, and the spine becomes less
stable. The body reacts to this by constructing bony growths
called bone spurs (osteophytes). Bone spurs can put pressure
on the spinal nerve roots or spinal cord, resulting in pain
and affecting nerve function.
What are the symptoms?
Degenerative disc disease may result in back or
neck pain, but this varies
from person to person. Many people have no pain, while
others with the same amount of disc damage have severe pain
that limits their activities. Where the pain occurs depends
on the location of the affected disc. An affected disc in
the neck area may result in neck or arm pain, while an
affected disc in the
lower back may result in
pain in the back, buttock, or leg. The pain often gets worse
with movements such as bending over, reaching up, or
The pain may start after a major injury (such as from a car
accident), a minor injury (such as a fall from a low
height), or a normal motion (such as bending over to pick
something up). It may also start gradually for no known
reason and get worse over time.
In some cases, you may have
numbness or tingling in
your leg or arm.
How is degenerative disc disease diagnosed?
Degenerative disc disease is diagnosed with a medical
history and physical exam. Your doctor will ask about your
symptoms, injuries or illnesses, any previous treatment, and
habits and activities that may be causing pain in the neck,
arms, back, buttock, or leg. During the physical exam, he or
- Check the affected area's range of motion
and for pain caused by movement.
- Look for areas of tenderness and any
nerve-related changes, such as numbness, tingling, or
the affected area, or changes in reflexes.
- Check for other conditions, such as
tumors, and infection.
If your examination reveals no signs of a serious condition,
imaging tests, such as an X-ray, are unlikely to help the
diagnosis. Imaging tests may be considered when your
symptoms develop after an injury, nerve damage is suspected,
or your medical history suggests conditions that could
affect your spine, such as bone disease,
tumors, or infection.
How is degenerative disc disease treated?
relieve pain, put ice or
heat (whichever feels better) on the affected area and use
acetaminophen (such as Tylenol) or non-steroidal
anti-inflammatory drugs, including aspirin (such as Bayer),
ibuprofen (such as Advil), or naproxen (such as Aleve). Do
not give aspirin to anyone younger than 20 because of the
Acetaminophen (such as Tylenol) also can help relieve pain.
Your doctor can prescribe stronger medicines if needed.
Further treatment depends on whether the damaged disc has
resulted in other conditions, such as
herniated disc, or
spinal stenosis. Physical
therapy and exercises for strengthening and stretching the
back are often recommended, and in some cases surgery may be
recommended. Surgery for degenerative disc disease usually
involves removing the
damaged disc. In
some cases, the bone is then
permanently joined (fused)
to protect the spinal cord. In rare cases, an
artificial disc may be used
to replace the disc that is removed.