Degenerative Disk Disease (Degenerative Disc Disease)

(Degenerative Disc Disease)

Definition

Degenerative disk disease occurs when wear and tear on the spinal disks causes pain [2] and other symptoms. Spinal disks serve as shock absorbers, protecting the spine and helping it stay flexible as it bends and twists. Most people experience some degeneration in disks as they age, but not all degeneration will result in symptoms characteristic of degenerative disk disease.

Degenerative Disk

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Causes

In degenerative disk disease, 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 leading to further disk degeneration. There is some evidence that genetics may play a part in the development of degenerative disk disease in some people.

Risk Factors

A risk factor is something that increases your risk of getting a disease or condition.

The following factors may increase your risk of degenerative disk disease:

Age: 30s or 40s
Family history of degenerative disk disease
Athletes
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 [2] 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 [3] at the ankle)

Diagnosis

Your doctor will ask about your symptoms and medical [4] history, and perform a physical exam. Other tests may include:

Blood and/or urine tests to rule out other causes of pain [2]
MRI scan [5]—a test that uses magnetic waves to make pictures of structures inside the body
X-ray [6]—a test that uses radiation to take a picture of structures inside the body, especially the bones [7]
Discography [8]—dye is injected into the affected spinal area to get clearer x-ray images

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:

Physical Therapy

Physical therapy for degenerative disk disease is focused on teaching you how to manage your back pain [2]. This may involve posture training, exercise [9], ice packs, heating, electrical stimulation, relaxation, and other forms of physical therapy.

Injections

Steroid injections around the nerves exiting the spinal cord may provide some pain [2] relief.

Intradiscal Electrothermal Therapy

Intradiscal electrothermal therapy, or IDET, involves inserting a small catheter with a heated tip into the disk. The heat shrinks the disk and deadens the nerve endings. This is not yet a generally accepted method of treatment.

Surgery

Surgery may be required in some cases of degenerative disk disease. Surgery may involve removing the degenerated disk and fusing two of the vertebra together.

Prevention

Take the following steps to help protect your spine:

Begin a safe exercise [10] program with the advice of your doctor.
Maintain a healthy weight [11].
If you have osteoporosis [12], follow your doctor's instructions for treating the condition.

RESOURCES:

American Academy of Orthopaedic Surgeons
http://orthoinfo.aaos.org [13]

North American Spine Society
http://www.spine.org [14]

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://www.coa-aco.org [15]

Canadian Orthopaedic Foundation
http://www.canorth.org [16]

References:

Degenerative disc disease. Cedars-Sinai Medical Center website.
Available at: http://www.csmc.edu/5757.html [17] . 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 [18] . 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.

Last reviewed May 2008 by Robert E. Leach, MD [19]

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical [4] advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health [20] provider prior to starting any new treatment or with any questions you may have regarding a medical [4] condition.