Degenerative Disc Disease: Symptoms, Treatment, Outlook
- Symptoms don't typically begin within the disc, but instead in the surrounding muscles, spinal nerve roots, or spinal joints.
- Age is the most significant risk factor for degenerative disc disease.
- Degenerative disc disease is commonly diagnosed in women.
- Doctors treat degenerative disc disease using conservative, nonsurgical methods aimed at stopping pain-inducing inflammation.
- Adopting a health diet and lifestyle, as well as taking measures to improve your posture and ergonomics, is the best prevention.
Degenerative disc disease is a condition that affects the discs in the spine. Although this is called a “disease,” the changes that occur in the spinal discs are part of normal aging, and they often don’t cause symptoms.
As you grow older, spinal discs become less flexible, wear down and offer less padding. When a disc degenerates to a certain point, it no longer functions properly as part of the spinal joint. This can lead to back or neck pain, as well as numbness, tingling or other symptoms in the arms or legs.
Common Symptoms of Degenerative Disc Disease
The most common symptom of degenerative disc disease is ongoing, low-level pain around the degenerated disc. This may occasionally flare up into more severe pain. Sometimes it is severe enough to affect daily activities.
These flare-ups of pain can happen after certain activities that put extra stress on the spine, but they may also occur for no apparent reason. Flare-ups can last for a few days to several weeks, before becoming less severe or going away completely.
Other symptoms of degenerative disc disease include:
- Pain that increases when bending or twisting the spine, lifting heavy objects, or staying in one position for too long, such as sitting, standing or looking down while reading or using a cell phone.
- Numbness, weakness or pain in the extremities — the shoulder, arm or hand for cervical disc degeneration, or the hips, buttocks or back of the leg for lumbar disc degeneration.
- Muscle tension or spasms in the back or neck, sometimes with severe pain during muscle spasms.
- Instability in the back or neck that feels like the spine cannot support weight, or a sensation of the spine locking up.
- Back or neck pain that goes away when changing positions frequently, or in certain positions, such as lying down with the knees propped up or when sleeping with a pillow that keeps the neck in its natural position.
The amount of pain due to disc degeneration varies from person to person, ranging from little or no pain to severe pain that makes it difficult to do even common daily activities.
Causes of Degenerative Disc Disease
The pain and other symptoms associated with degenerative disc disease is not usually the result of damage to the disc itself, which has very few nerves running to it. Instead, symptoms arise when other parts of the spine are affected, such as the muscles, spinal nerve roots, or spinal joint.
This damage can happen in two ways:
- Inflammation. As the disc degenerates, it can cause inflammation in nearby structures. This is the body’s way of responding to infections, wounds and damaged tissue. Inflammation in the muscles can cause spasms or tenderness in the neck or back. If a spinal nerve root is affected, pain and numbness may occur in the arm or shoulder, or the hips or leg.
- Instability in the spinal joint. Spinal discs provide cushioning and support for the bony vertebrae. When the disc degenerates, the vertebrae no longer move naturally. This can cause irritation and tension in the muscles, spinal nerve roots or spinal joint near the damaged disc.
In some cases, degenerative disc disease can lead to disc herniation. This is when the tough outer ring of a spinal disc develops an abnormal bulge, crack or tear, allowing the softer interior to leak out.
The herniated disc may push against the nearby spinal nerve root or inflammation that occurs during herniation may irritate the nerve. This causes symptoms similar to those of degenerative disc disease.
One of the main risk factors for degenerative disc disease is aging. As you grow older, your discs grow more rigid and less flexible. Other risk factors include:
- Having other family members with chronic pain in the neck or back, or with disorders of the bones or muscles
- Extra strain on the neck or back due to heavy lifting or high-impact sports
- Strain on the discs of the spine due to sitting for long periods, as a result of poor posture, such as looking down at a book or cell phone
- Weakness in the muscles of the core
- Use of tobacco or other nicotine products
Degenerative disc disease is diagnosed using:
- Medical history. A doctor will ask a patient about symptoms like pain, numbness, tingling, as well as about injuries, physical activities, sleep habits and family history.
- Physical examination. During the physical exam, a doctor will feel the part of the neck or back related to the symptoms and check the range-of-motion for that part of the spine. The doctor may also ask the patient to perform certain movements to see if they make the pain worse or better.
- Medical imaging. A doctor may also check for a potential disc problem using an MRI, X-ray, or CT scan. This can show whether there is disc degeneration, as well as identify other problems with the spine that might be causing the symptoms.
These exams and tests help determine the cause of the symptoms, after which the doctor is able to work with the patient to decide on the best treatment options.
Who Gets Degenerative Discs?
Disc degeneration is a natural part of aging, although not everyone develops symptoms. This condition is more common in older people, but it can also start earlier in life.
In one study, six percent of women under age 20 had degeneration in one or more of the discs in their lower back (lumbar). This increased steadily with age to 79 percent of women over age 60.
Having one or more of the risk factors listed above can increase your chance of having symptoms related to a degenerated disc. Some research also suggests that heredity may play a big part in disc degeneration — you are more likely to have it if one or more of your parents do.
What are the Best Options for Treating Degenerative Discs?
Several nonsurgical treatments are available to help relieve pain and inflammation related to degenerative disc disease, including:
- Over-the-counter pain medications. Aspirin, ibuprofen and naproxen can reduce inflammation near the degenerated disc that causes stiffness, pain or irritation of the nerve root. Acetaminophen relieves pain by changing how the brain senses pain signals.
- Prescription medications. For severe pain that isn’t relieved with over-the-counter drugs, prescription pain medications and muscle relaxants may help. These drugs may have serious side effects, including the risk of misusing them, so they are not intended for use longer than a few weeks.
- Heat and ice. Applying a heated gel pack or ice pack to the part of the neck or back that is tender can reduce inflammation and relieve symptoms.
- Physical therapy and manual manipulation. Physical therapy can help strengthen the muscles supporting the neck or back, which may provide relief from pain. Chiropractic or osteopathic manipulation can reduce tension in the joints and muscles, which can reduce symptoms.
- Pilates. Pilates will improve posture, help you move more efficiently and can relieve pain associated with degenerative disc disease. It focuses on strengthening the muscles that support the spine, including the muscles of the abdomen, back, sides and pelvic floor.
- Lifestyle modifications. Eating healthy, drinking plenty of water, and giving up tobacco are good for the health of the body, including the spinal discs. Staying active can keep your body strong and reduce pain symptoms, as long as you avoid activities that worsen the pain or other symptoms.
- Massage and yoga. These may help reduce pain in the neck and back. It is important to seek out a massage therapist or a yoga teacher who has experience working with people with neck or back pain.
If conservative therapies have failed to relieve symptoms of degenerative disc disease, surgical intervention may be warranted. Surgery may involve a decompression (to remove degenerative portions of the bone) and/or fusion (to stabilize vertebrae that have become unstable).
Because disc degeneration is a natural part of aging, you can’t stop it entirely, but you can take steps to reduce the chance of developing pain or other symptoms related to the affected discs. This includes:
- Stay healthy. Eating healthy, exercising regularly, staying hydrated and giving up tobacco can keep your body healthy and reduce inflammation that occurs when a disc degenerates.
- Keep good posture. Poor posture adds extra strain to the spine, which may increase the degeneration of a spinal disc. Maintain good posture while sitting and standing. This includes not looking down too long at a book, computer, or cell phone.
- Be proactive. If you develop discomfort, pain or other symptoms in your back or neck, talk to a doctor or physical therapist. They can identify the cause and help develop a plan to relieve the symptoms and maintain a healthy spine.
Many people with degenerative disc disease will be able to manage their pain and other symptoms with nonsurgical methods. Often, the symptom will go away or lessen after a few months.
Even many patients whose pain continues can learn how to manage their pain with a program of self-care and nonsurgical methods. This includes learning to identify the pain flare-ups early on and taking steps to reduce making the pain worse.
Neck and back pain affect a large part of the population. Not everyone’s symptoms are caused by degenerative disc disease. However, it is useful to understand this condition because it will enable you to seek help early on and find ways to relieve your symptoms and manage your condition going forward.