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Degenerative Disk Disease by Krisha McCoy, MS

Definition

Disks lie between the spinal bones (vertebra). They serve as shock absorbers. This protects the spine and helps it stay flexible. Degenerative disk disease is wear and tear on these disks. This wear and tear causes pain and other symptoms. Some degeneration is normal as you age. Not all degeneration will result in symptoms of this disease.

Degenerative Disk

Causes

The disk is usually dehydrated, and not as resilient as normal. The fibrous tissue, which holds the disk material in place, may suffer small tears. These tears lead to further damage. There is some evidence that genetics may play a part for some people.

Risk Factors

Factors that may incerase your chance for degenerative disk disease:

Increased age
Family history of degenerative disk disease
Athletic activity
Back injury

Symptoms

Symptoms of degenerative disk disease include:

Pain in the low back, buttocks, thighs, or neck
Pain that worsens when sitting, bending, lifting, or twisting
Pain that feels better when walking, changing positions, or lying down
Periods of severe pain that gets better after a few days or months
Numbness and tingling into the legs
Weakness in the legs
Foot drop (inability to raise the foot at the ankle)

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Other tests may include:

Blood and/or urine tests to rule out other causes of pain
MRI scan —a test that uses magnetic waves to make pictures of structures inside the body
X-ray —a test that uses radiation to take a picture of structures inside the body, especially the bones
Discography —dye is injected into the affected spinal area to get clearer x-ray images
EMG/NCV-a neurophysiologic test used in some cases to evaluate nerves which may be irritated or impinged on by a disk.

Treatment

Talk with your doctor about the best plan for you. Treatment options include:

Physical Therapy

Therapy for this condition is focused on teaching you how to manage your back pain. This may involve:

Posture training
Exercise
Ice packs
Heating
Electrical stimulation
Relaxation
Other forms of physical therapy

Injections

Steroid injections may be used for some short term pain relief. They are injected around the nerves exiting the spinal cord.

Surgery

Surgery may be required for some. Surgery may involve removing the degenerated disk and fusing two of the vertebra together.

Prevention

Take the following steps to help protect your spine:

Begin a safe exercise program with the advice of your doctor.
Maintain a healthy weight .
If you have osteoporosis , follow your doctor's instructions for treating the condition.

RESOURCES:

American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/
North American Spine Society http://www.spine.org/

CANADIAN RESOURCES:

Canadian Orthopaedic Association http://www.coa-aco.org/
Canadian Orthopaedic Foundation http://www.canorth.org/

References:

Bogduk N, Anat D. Degenerative joint disease of the spine. Radiol Clin North Am. 2012;15(4):613-28.
Degenerative disc disease. Cedars-Sinai Medical Center website. Available at: http://www.csmc.edu/5757.html . Accessed July 2, 2007.
Degenerative disk disease. University of Pittsburgh, Department of Neurosurgery website. Available at: http://www.neurosurgery.pitt.edu/spine/conditions/ddd.html . Accessed July 2, 2007.
Paassilta P, Lohiniva J, Göring HH, et al. Identification of a novel common genetic risk factor for lumbar disk disease. JAMA . 2001;285:1843-1849.

Last reviewed September 2012 by Rimas Lukas, MD

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