Degenerative Disc Disease
To understand what is degenerative disc disease (DDD), it is helpful to review the anatomy of the spine.
The spine is a remarkable combination of design and functionality. It helps our body as a shock-absorber for the stresses of movement, and at the same time provides the flexibility to move in all directions.
It is composed of the vertebral column, otherwise known as the backbone. There are 33 vertebrae, separated by protective discs. These discs include a cartilage outer band and a gel-like inner substance.
What Is Disc Degeneration?
With age (wear and tear), injury or disease, discs lose their protective properties: their shock-absorbing and flexibility capacities. When this occurs, it can become problematic and painful.
Although it is called degenerative disc disease, it is not a disease in the traditional sense. DDD is a natural process that happens over time. By age 35, about 30 percent of the population has some disc degeneration at one location or another. By the age of 60, that number jumps to 90 percent.
Symptoms of Disc Degeneration
Diagnosis and treatment of disc degeneration arer considered for people who have symptoms of pain. Many do not suffer and sometimes disc issues resolve on their own. A study on asymptomatic patients showed that degenerative disc disease was present in some 37 percent of 20-year-olds and increased to 96 percent in 80-year-olds.
DDD can affect any part of the spine, but it most commonly affects the low back (lumbar spine) or neck (cervical spine). Most people with DDD have neck and back pain.
This pain has particular patterns, such as:
- worsening with prolonged sitting, or when twisting, bending or lifting.
- the pain may abate with movement, changing positions or lying down.
Common symptoms include:
- Pain that worsens, and can be described as cramping or throbbing and/or burns when it radiates to the extremities
- Tingling or “pins-and-needles” feeling
- Numbness or weakness of the muscles
- At severe stage, loss of bladder or bowel control.
Diagnosing Degenerative Disc Disease
Arriving at a diagnosis of DDD follows the customarily thorough path. The doctor reviews the patient’s medical history, seeking to determine both the source of the symptoms and the risk factors (including a family history). A full review of symptoms includes determining when and how those symptoms worsen.
This is followed by a complete physical exam to determine the location of the problem. A test of function, including range of motion and reflexes, also helps narrow down the criteria for diagnosis.
Finally, imaging tests are used to confirm a diagnosis and rule out any underlying problems, such as a fracture or tumor. Common imaging tests include X-rays, computed tomography (CT) or magnetic resonance imaging (MRI).
Making a DDD diagnosis can require additional tests. These include:
- Myelogram to view any spinal cord abnormalities
- Nerve conduction study and electromyogram (EMG) to pinpoint the origin of symptoms
- Discogram to check for disc dysfunction.
Treating Disc Degeneration
Nonsurgical methods of treatment include:
- over-the-counter or prescription medications
- physical therapy
- lifestyle changes.
However, if after months of this treatment, pain and other symptoms are still significant and quality of life is seriously impacted, a surgical consultation is recommended.
Surgery for Severe Disc Degeneration
Spine surgery has significantly improved since the 1990s with the use of video imaging for surgery. That progress continued with the advent of advanced microsurgical techniques. These have created the possibility for much less invasive surgery, with fewer potential risks and complications.
There are two categories of surgery, decompression and stabilization. These are often done simultaneously, and can include a microdiscectomy. Various relevant surgical options (minimally invasive surgery, microdiscectomy and fusion) are described here.
Recovery from Disc Surgery
While surgical incisions heal within a week or two, general recovery from a procedure such as a microdiscectomy can take one to four weeks. It may take a more significant amount of time, at least several months, to heal from fusion.
Recovery means limiting activities and usually also includes undergoing physical therapy. However, this does not mean activities cannot be modified. Light work duties may possibly be resumed in a week or two, while more significant activity, including exercise, may require four to six weeks.
A surgeon instructs patients carefully on recovery after disc surgery, creating a customized plan depending on the type and extent of the surgical procedure and the age and general health of the patient.
If you have experienced any of the above symptoms, contact our team to discuss your treatment options.