Degenerative Disc Disease

If we live long enough, we will all get degenerative disc disease to some degree. Fortunately, there are ways to minimize the risk of having severe symptoms and, if we do develop symptoms of degenerative disc disease, there are many effective treatments.


What Is Degenerative Disc Disease?

Degenerative disc disease requires two things: 1) a breakdown (degeneration) of one or more vertebral discs 2) this breakdown causes pain or other symptoms.

Why are both necessary? Because virtually everyone will have some degree of disc degeneration at some point in their adult lives, but not everyone will experience symptoms because of it. Some people have severe disc degeneration and few symptoms. Others have very mild disc degeneration, but it causes severe symptoms. For these reasons, the timing and severity of degenerative disc disease often depends on the degree of degenerative disc disease symptoms, rather than the degree of actual degeneration in the vertebral disc(s).


Degenerative Disc Disease Symptoms

Degenerative disc disease symptoms often include pain at or around the damaged disc. So, if a cervical vertebral disc causes symptoms, neck pain is often the prominent symptom. Likewise, lumbar disc disease often causes low back pain. Degenerative disc disease in the neck or lower back may cause shooting pains down the arms or legs, respectively. This occurs if the degenerative disc affects the spinal nerves or nerve roots. Pinched nerves can also cause odd sensations or weakness in the arms or legs. In some cases, pain may not be the most troublesome degenerative disc disease symptom; instead, the spine may simply feel stiff and immobile. Indeed, degenerative disc disease symptoms vary widely from person to person.


Causes of Degenerative Disc Disease

Unfortunately, simply living life is a cause of degenerative disc disease; vertebral discs suffer wear-and-tear over time from normal activities.

Research suggests the causes of degenerative disc disease are:

  • Age. Age is by far the biggest “cause” of degenerative disc disease in that the risk of having symptomatic disc pain increases with age.


  • Genetics. It seems that genetics plays a far greater role in whether someone develops degenerative disc disease than previously known. Genes related to the vertebral disc itself, the extracellular matrix, and connective tissues are all candidate genes (i.e., possible genetic causes of degenerative disc disease). If fact, studies are underway to test the possibility of using gene therapy to treat degenerative disc disease.


  • Use of handheld electronic devices. The human head weighs 12 (not 8) pounds. Looking down at an electronic device puts a considerable amount of stress on the cervical spine (neck). When the head is at a 45-degree angle, for instance, it is like holding a 50-pound weight around the neck. This stress can affect cervical discs (e.g., “text neck”).


  • Work and leisure activities. Historically, certain activities such as gymnastics and weightlifting were thought to contribute to degenerative disc disease. While people who perform certain tasks are more likely to suffer an injury that will, in turn, cause degenerative disc disease, today’s best evidence suggests sports and other activities do not necessarily increase the risk degenerative disc disease substantially. Simply put, people who manage to perform these activities safely are not at increased risk for wear-and-tear damage of the discs, but these activities do increase the risk for sports-related injury and subsequent degenerative disc disease.


  • Obesity. Degenerative disc disease appears to be more common in people who are overweight or obese based on body mass index definitions than people who are normal weight or underweight.


  • Atherosclerosis. Atherosclerosis, a disease in which the walls of arteries become inflamed and damaged, may increase the risk of degenerative disc disease. This certainly seems to be true in patients with atherosclerosis in the aorta and lumbar arteries.6 Poor blood flow through the lumbar arteries to the center of the disc may deprive the disc of oxygen and nutrition, leading to degenerative disc disease.



Degenerative Disc Disease Treatment Options

While most cases of neck and lower back pain will resolve within a few days, you can take steps to help relieve symptoms. Some degenerative disc disease treatments can be done at home, while others require a trip to the doctor.

At-Home Treatments

Short-term pain caused by degenerative disc disease may resolve on its own with rest and ice. These conservative treatments reduce inflammation, deaden pain, and allow the structures around the disc to recover. Muscle spasms, on the other hand, tend to respond well to heat. In between events, back muscle strengthening, stretching, and physical therapy may help prevent pain.


Exercises that strengthen your “core” also strengthen the back and help protect the spine. In essence, activities that build the stomach and back muscles like swimming, yoga and Pilates will help work the core muscles. Importantly, while sit-ups and crunches help strengthen stomach muscles, they can also put substantial strain on the back. Before starting any new exercise program, speak with your doctor and an exercise professional.

Alternative Options

Some people have found relief from degenerative disc disease symptoms after receiving therapeutic massage, acupuncture, or chiropractic care. Therapeutic massage mainly targets muscles, chiropractic mainly addresses joints, and acupuncture is based on principles of Traditional Chinese Medicine.


Patients may choose to treat degenerative disc disease with injections before moving to surgery. Typically, a corticosteroid is injected near the damaged disc, which reduces local inflammation and reduces pain and other degenerative disc disease symptoms.

Surgical Options

Degenerative disc disease surgery options include discectomy, spinal fusion surgery, and artificial disc replacement. Of note, a discectomy is performed during a spinal fusion or artificial disc replacement surgery.

  • Discectomy. As the name suggests, the damaged vertebral disc is removed during a discectomy. Any disc material that has moved out of its natural location is removed along with disc material that is pressing on nerves. If the disc is completely removed, the remaining upper spinal bone would rest directly on the one beneath it. Therefore, in these cases, the spinal bones may be stabilized with instrumentation (e.g., metal rods), a spinal fusion, or with an artificial disc.


  • Spinal fusion surgery. In spinal fusion surgery, the spine surgeon first removes the damaged disc in its entirety. Then the surgeon places a small amount of bone (taken from the hip, usually) or artificial bone material in the space between the spinal bones. Over time the bone or bone-like substance knits the two vertebral bones together, permanently fusing the spinal bones.


  • Artificial disc replacement. In spinal fusion surgery, the spine surgeon completely removes the damaged disc, then places an artificial disc in its place. The artificial disc fills the space between the two spinal bones. The artificial disc supports the weight of the spine and body above it, and allows the bones to rotate, bend and flex to a certain degree, much like the natural spine.



Getting a Degenerative Disc Disease Diagnosis

Include bullet point list of questions your doctor might ask you somewhere
As mentioned, a degenerative disc disease diagnosis requires that damage to one or more vertebral discs is the cause of symptoms. While your doctor may order imaging of the spine, the key to getting a degenerative disc disease diagnosis comes mostly from history and physical examination.

  • Be prepared to answer the following questions during your consultation:
  • Where is your pain?
  • Is your pain in one area, or does it shoot down the arms or legs?
  • What does the pain feel like? Is it shooting, stabbing, dull, burning, achy, or something else?
  • Have you had trouble moving your neck, back, arms, or legs since the pain started?
  • Did you injure your neck or back in some way?
  • What movements make the pain worse?
  • What movements tend to relieve the pain?
  • Have you experienced this pain previously? If so, how long did it last and what made it go away?

Your spine surgeon will perform a focused physical examination to determine if you have degenerative disc disease. This may include range of motion, sensation, and muscle strength testing.

After your history and physical examination, your spine surgeon will decide if you need a CT scan and/or MRI to confirm or rule out any diagnoses.


Finding a Doctor Who Treats Degenerative Disc Disease

Several doctors and medical professionals are capable of treating certain aspects of degenerative disc disease. Often, your primary care doctor is able to provide a list of conservative treatments that will be effective for most people. A physical therapist can guide you in a set of exercises and movements that may relieve degenerative disc disease symptoms.

Often the best person to consult about degenerative disc disease is a spine surgeon. Board-certified spine surgeons are either neurosurgeons or orthopedic surgeons by training. Spine surgeons are neck and back pain experts—they can distinguish degenerative disc disease from other causes of neck and back pain. Unlike other medical professionals, spine surgeons offer the entire range of degenerative disc disease treatments, from conservative treatments to injections to spine surgery.


Degenerative Disc Disease FAQ’s


How long does an artificial disc typically last?

The best degenerative disc disease treatment is the one that works for you. In other words, if inexpensive, conservative treatments like ice, heat, selective rest, and over-the-counter pain relief medicines work, then those are your best degenerative disc disease treatments. If these treatments fail, the best degenerative disc disease treatment options may be physical therapy, therapeutic massage, or prescription medications. Injections around the spine may provide relief from degenerative disc disease symptoms. Lastly, spinal fusion surgery or artificial disc replacement could be your best degenerative disc disease treatment option because they can be curative.

How can I prevent degenerative disc disease from getting worse?

You can’t change your genetics (yet!), but you can modify other risk factors for degenerative disc disease. While smoking may or may not contribute to degenerative disc disease, there are many other reasons to stop. Reducing cholesterol and body weight can combat atherosclerosis and obesity which, in turn, may reduce the risk of worsening degenerative disc disease. You can protect your neck by reducing handheld screen time or keeping your head in a neutral position when you use one (i.e., head held with your eyes looking straight in front of you, not down). Increasing your spinal muscle strength and flexibility can help stabilize your spine and reduce the risk of spinal injury.

Is degenerative disc disease hereditary?

Actually, yes. New research suggests that certain genes are associated with degenerative disc disease. While there currently isn’t a genetic test you can take to determine if you have degenerative disc disease; however, in the coming years we may have a genetic test that can provide you with your personal genetic risk for degenerative disc disease.

How are arthritis and degenerative disc disease different?

Arthritis is an inflammation of spinal facet joints while degenerative disc disease is a breakdown of the vertebral disc that causes symptoms. Degenerative disc disease may lead to osteoarthritis of the spine, but the two conditions affect different structures.

Can I become paralyzed by degenerative disc disease?

Yes, but it is highly unlikely. Degenerative disc disease usually progresses rather slowly, so symptoms appear long before paralysis could occur. That said, if degenerative disc disease contributes to a disc herniation, especially one that occurs from trauma, paralysis is possible. Warning signs for possible paralysis are sudden loss of bowel or bladder function or rapid onset or worsening back pain, weakness, or numbness. Any person who experiences these symptoms should be evaluated by a trained medical professional as soon as possible.

How fast does degenerative disc disease progress?

Usually slowly, over 20 to 30 years. However, injury or trauma can speed up the degenerative process.


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