Degenerative Disc Disease

What is degenerative disc disease?

All of us have a breakdown, or deterioration, of our joints as we age. This is also true of our spinal discs, which act as shock absorbers for our body’s back. More specifically, the wear and tear of daily activities causes degeneration of the discs that exist between the vertebrae, which are the bones of our spine.

While degenerative disc disease can begin as early as your 30s or 40s, most people experience it as a slow-progressing condition past those ages. It’s possible to have it without even experiencing any pain.

The spinal column is divided into the cervical spine (the neck), the thoracic spine (the abdomen) and the lumbar spine (the lower back). Degenerative disc disease most often affects the cervical spine in neck and lumbar spine in the lower back, due to these areas having the most movement.

As discs deteriorate, they can lead to other conditions such as chronic back pain, cervical spinal stenosis, lumbar spinal stenosis, myelopathy and herniated discs.

The condition can also lead to spine instability, a general term for abnormal movement between vertebrae. As a result, nerves become irritated and you experience pain, a sensation that the back is “catching,” spasms or loss of motion when extending or flexing.

Physical therapy, anti-inflammatory medications and lifestyle changes such as weight loss and exercise can slow the progression of the disease and relieve symptoms.

For most patients, surgery isn’t necessary.

Degenerative disc disease symptoms

Neck pain and back pain are the most common symptoms. The pain you experience will likely:

• Come and go (or be constant) – for weeks or months at a time
• Lead to numbness or tingling in arms or legs
• Worsen while sitting, bending over or lifting — but may feel better while walking or moving around
• Radiate down your back
• Be mild or severe
• Continue to worsen over time

What causes degenerative disc disease?

The natural aging process is the main reason our discs deteriorate. The exact reason certain joints wear out sooner than others is unclear and is likely a combination of several factors including family history, lifestyle and your injury history. Some specific causes of degenerative disc disease include:

• Drying out of the spine discs – When we’re born, our spinal discs cushion our vertebrae by being made up of about 80% water. As we age, those discs dry out and don’t absorb impact as well as they did when we were younger.
• Daily wear and tear – Certain sports or activities can cause tears in the outer core of the disc. Not everyone who has disc degeneration will experience back pain.
• Injuries – An injury to your spine may cause swelling, soreness and instability. A herniated disc is a type of injury that can also lead to further degeneration of your discs.

Diagnosing degenerative disc disease

Early diagnosis of degenerative disc disease allows you to make lifestyle improvements such as weight loss, work adjustments or do more exercise to slow the deterioration of your spine discs.

Following a thorough family and medical history, as well as physical and neurological exam, Ohio State Spine Care specialists may order imaging tests to confirm a diagnosis. These could include:

• X-rays of the spine
• Magnetic resonance imaging (MRI) scan
• Computed tomography (CT) scan
• Electromyography (EMG) and electrophysiological testing – these tests will use electrodes

Many people have more than one degenerative disc. Our pain management specialists can identify the disc most associated with pain using a test called a discogram.

Under local anesthetic, you will receive a sterile fluid injected into the discs most likely to be responsible for your pain. Your response to the sensation within each disc, and the information generated from the test, will tell us which disc or discs need further treatment.

Degenerative disc disease treatment

Ohio State offers treatments ranging from physical therapy to the most complex neck and spine surgeries. Our physicians, therapists and other caregivers provide you with options that increase mobility and reduce pain.

Most people who come to Ohio State Spine Care don’t require surgery.

In addition to nonsurgical treatments, certain lifestyle changes may help you feel better and prevent your discs from breaking down further:

Lifestyle changes

• Exercise and weight loss to build strength and reduce pressure on your spine
• Smoking cessation

Nonsurgical treatments

• Acupuncture
• Anti-inflammatory medications
• Physical therapy, including utilizing real-time ultrasound imaging (RUSI) – We focus on pain-relieving movement strategies to improve strength and flexibility.
• Spinal injections, including nerve blocks or corticosteroids
• Transcutaneous electrical nerve stimulation (TENS) unit – This is a form of electrical stimulation that provides short-term pain relief
• Muscle relaxants
• Spine orthobiologics aims to help your body repair damaged cells

Surgical options for degenerative disc disease

In rare situations, we may recommend surgery if you have chronic symptoms that have not responded to treatment. Surgeries our doctors may recommend include:

• Spinal fusion – Aasurgery that will fuse vertebrae together and restore stability to the spinal column
• Decompression surgery such as laminectomy or osteophyte (bone spur) removal (osteophytectomy)
• Discectomy – this surgery removes the damaged part of a disc in the spine
• Artificial disc surgery/replacement
• Basivertebral nerve ablation – a minimally invasive procedure using radiofrequency to heat the basivertebral nerve so it stops sending pain signals