• Degenerative Disk Disease

    (Degenerative Disc Disease)

    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
    si1929 97870 1 degenerative
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    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:

    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.

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