Degenerative disc disease

Degenerative disc disease: Symptoms, Causes, and Diagnosis

Introduction

Degenerative disc disease is not a condition when the disc inside the vertebrae breaks down or deteriorates and causes pain. The spine is composed of 33 vertebrae, and they are stacked on one another. A rubbery portion among these vertebrae is the intervertebral disc. Mainly, older adults are more affected by this condition. Many people face spinal degradation after the age of 40. This pain can make a person debilitate and often leads to back pain. It causes pain, weakness, and numbness that radiates toward the leg. 

Explanation

Generally, a rubbery disc inside the vertebrae helps bend and flex the back, such as shock absorbers. In this condition, the flexible disc becomes worn and causes pain. The intervertebral disc has been referred to as spinal disc or intervertebral fibrocartilage. Their elastic structure is composed of fibrocartilage tissue. In addition, the disk was made up of gelatin at 30. When an injury occurs, a person loses some gelatin and reduces the disc volume. Therefore, the disk becomes less flexible and flatter. Sometimes, the rough surfaces of vertebrae rub together, resulting in inflammation and pain. This pain or discomfort lasts from a few weeks to months. 

Symptoms

The various symptoms of degenerative disc disease are as follows:

  • Stiffness and pain in the back
  • Neck pain that spreads in the shoulder or arm
  • Numbness and tingling of body parts
  • Discomfort in the groin, buttocks, and upper thighs
  • Weakness in the leg and foot 
  • Osteoarthritis 
  • Pain gets worse with bending, lifting, twisting, or sitting
  • Instability in the spinal column (leads to muscle spasms

Causes

These are the different causes of the degenerated disk, such as

  • Injuries:  Injuries cause soreness, instability, and swelling
  • Sports and daily activities: This condition is higher in soccer players, elite gymnasts, and weight-lifters. Moreover, frequent jumps, repetitive flexion, and kick motions may lead to degenerative disk
  • Loss of fluid: The spinal disc in an adult consists of 80% fluid. The fluid content is decreased with age. With these changes, the disc becomes thinner, and the distance among vertebrae becomes smaller.
  • Disc structure: Small cracks are developed in the disc, resulting in the ruptured or bulging disk. 
  • Spinal stenosis: It occurs when the spaces surrounding the spine become narrow, causing weakness, numbness, and pain.
  • Herniated disk (bulging disk)

Diagnosis

A physical therapist evaluates the patient’s medical history and disease symptoms. He determines the degree and location of the degenerative disk using diagnosing techniques, which may include:

    • X-ray: It helps the surgeon to see the osteophytes, fractures, osteoarthritis, or spinal stenosis. 
  • CT scan: It has been used to see soft tissues in the spinal column. CT scans help in detecting problems, such as herniated or bulging discs. It has helped evaluate the bones. 
  • MRI scan: MRI scans show damage in the disc or pinched nerves. 
  • Bone scan: A surgeon uses this test to identify spinal problems like fractures, osteoarthritis, and infections. 
  • Discogram (Discography): This procedure has been used to confirm or deny the disc and analyze back pain
  • Physical examination: The specialist conducts a physical exam to observe the patient’s physical condition, motion range, and posture. He checks the nerve function using the reflex hammer and examines the reactions. The specialist presses at the specific positions of the back and measures pain levels. Furthermore, shrinkage or weakness in the muscle shows degenerated disks or nerve damage.   

Treatment of degenerative disc disease

A routine consultation with a doctor is compulsory to treat degenerative disc disease. The treatment has been initiated with non-surgical techniques that provide relief from pain. The doctor recommends medications, physical therapy, occupational therapy, and surgery to treat the signs and symptoms, thereby reducing the risk factors. 

Non-surgical treatment

  • Pain control: There are several methods of pain control. Examples include manual manipulation, electrical stimulation, anti-inflammatory medications, ice therapy, back braces, heat therapy, or steroid injections. These methods reduce the pain from the affected disk and help the patients to return to their daily activities. 
  • Lifestyle modifications: A specialist suggests daily exercises, losing weight, avoiding smoking, reducing alcohol, and changing posture to decrease stress on the deteriorated disk and slow the process of further degeneration. Regular exercise is fundamental in enhancing the strength of muscles supporting the spinal column and increasing mobility. He further recommends taking supplements and multivitamins, like iron, zinc, and calcium, to reduce back pain and help collagen repair and bone formation. 
  • Physical therapy: It has been used to reduce back pain by strengthening the muscles. It also helps in improving the movement of the joints. A physical therapist helps treat this condition using strengthening, stretching, and aerobic exercises. Aerobic exercises, such as swimming, walking, and aerobic class, help in relieving pain, preventing obesity, and improving mobility. Moreover, physical therapists also apply manual therapy like massage to enhance flexibility, mitigate pain, and reduce muscle strain.  
  • Medications: Certain medications are used to relieve the pain, like acetaminophen (Tylenol). The other medications are nonsteroidal anti-inflammatory drugs to decrease inflammation and relieve pain. For example, aspirin, naproxen, and ibuprofen. Muscle relaxants, steroids, and anti-depressants have been prescribed to relieve chronic back pain. Furthermore, Neurontin (gabapentin) has been used to reduce nerve pain that may be caused by spinal stenosis, disk herniation, and diabetic neuropathy. 
  • Steroid injections are injected into the spinal nerves, joints, or disks to reduce pain and inflammation. 
  • Radiofrequency ablation: This treatment uses radio frequency waves to relieve chronic back pain and treat degenerative disc disease. 

Surgical treatment

Surgical options have been recommended for patients with severe pain who are not responding to non-surgical treatments. 

  • Spinal fusion is a surgical treatment to reduce pain by removing the disk and improving spinal stability. In this procedure, bonelike material is inserted in the space among two vertebrae.  
  • Disk replacement: It involves replacing and removing the deteriorated disk with the new one composed of metal and plastic. 
  • Foraminotomy: In this, bone and tissue have been removed to expand the opening of nerve roots. 

Risk factors

These are the risk factors that enhance the development of spinal disc, which may include: 

  • Obesity
  • Smoking
  • Acute injuries
  • Older age 
  • Physically demanding job

References

https://www.medicalnewstoday.com/articles/266630 

https://my.clevelandclinic.org/health/diseases/16912-degenerative-disk-disease 

https://www.cedars-sinai.org/health-library/diseases-and-conditions/d/degenerative-disc-disease.html#:~:text 

https://www.hopkinsmedicine.org/orthopaedic-surgery/specialty-areas/spine/conditions-we-treat/degenerative-disc-disease.html 

https://www.choosept.com/guide/physical-therapy-guide-degenerative-disk-disease

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