Degenerative Disc Disease

What causes degenerative disc disease?

Disc degeneration is typically caused by the natural aging process, as the condition of your discs changes over time. The severity of symptoms associated with disc degeneration does not necessarily continue to progress over time, however. Every patient’s discs change differently, and a number of factors contribute to the nature of degenerative disc disease, causing its effects to be quite variable from patient to patient.

As the name would imply, degenerative disc disease typically does not result from one injury or motion, but rather results from years of strain, movement and pressure on the spine. Many instances of lower back pain may be attributed at least somewhat to disc degeneration.

What are the symptoms?

Not all patients experience symptoms related to disc degeneration. Some patients may experience radiating pain, weakness or numbness. This pain or weakness may not worsen with time in some patients, and, in fact, many patients report that their symptoms lessen or resolve over time. Pain may also radiate in specific areas, such as down the back of one leg.

Pain may also be noticeable only during or after episodes of activity, such as lifting, twisting or bending. This type of pain may flare up during activity but lessen significantly or go away completely after the activity is completed.

Chronic, disabling pain from degenerative disc disease is rare but not completely uncommon. Some patients may experience severe pain.

For some patients, sitting or standing in certain positions may exacerbate pain because of the increased load placed on discs. For example, a patient with degenerative discs in the lumbar region may experience significant pain while seated. Conversely, patients with degenerative discs may be able to relieve some or all of their pain by changing positions. Lying or reclining may help some patients who feel pain while seated.

Degenerative disc disease may also be characterized by a basic level of chronic, dull pain that increases to severe levels during short, intermittent periods.

How is it diagnosed?

A physician will go over a patient’s history of pain and identify activities or positions that make the pain worse or go away altogether. Testing a patient’s pain tolerance, range of motion, muscle strength and tenderness, and other areas, such as the neck, arm or back, may help identify a degenerative disc. Other steps, such as taking an MRI image, may help confirm degenerative disc disease or eliminate other potential causes of pain.

How is it treated?

Most patients with degenerative disc disease may be treated conservatively and typically respond well to non-surgical care options. These steps include management of pain and inflammation through medication, behavioral modification and physical therapy. Some patients may also benefit from epidural injections.

By identifying the types or levels of activity that aggravate problematic discs, physicians may help patients develop a plan that mitigates the risk of significant pain resulting from such activity. Physicians may also counsel patients on ergonomic safeguards to reduce pain. These options include safe lifting practices or improved posture when sitting or standing to reduce the load placed on a specific region of the spine. Physical therapy options include back strengthening exercises, hamstring stretching and application of heat or ice to reduce inflammation and pain.

As with most courses of treatment for other spine problems, patients who do not respond to conservative treatment options after six months may wish to consider surgery after consulting with their physicians.

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