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What is Degenerative Disc Disease?
Degenerative disc disease is a condition that can develop in all sections of the spine due to wear and tear in the cushioning discs that sit between your spinal bones and protect them from being damaged.
Our partner physicians will first pinpoint the exact source or sources of chronic back pain, which is a critical step in proper treatment, and then, using a laser and other tools, is used to shrink the bulges and seal the cracks of the degenerative disc. This can halt or slow continued degeneration and the inflammatory process which is causing the pain and symptoms.
By eliminating most or all of the pain associated with degenerative disc disease, the patient is allowed a better quality of life.
What are the symptoms of Degenerative Disc Disease ?
In many cases, degeneration in the spinal discs does not lead to the onset of any noticeable symptoms. Typically, the first symptom of degenerative disc disease is pain in the lower back (lumbar spine) that can extend down into the buttocks and the upper parts of the thighs. When lumbar degeneration is accompanied by abnormal growths of bone, called bone spurs, nerves may be compressed and trigger the onset of additional symptoms such as tingling, numbness, or burning in the same areas. The main symptom that people experience with disc degeneration in the neck (cervical spine) is neck pain that worsens when standing or moving the head. If neck degeneration occurs in combination with spurs, potential consequences include the same nerve-related symptoms associated with lumbar bone spurs, as well as a loss of normal mobility in the neck.
Degenerative disc disease (DDD) can produce problems throughout your spinal column. The symptoms you experience depend partly on the location of your damaged disc(s).
Commonly Affected Spinal Areas
You are most likely to experience significant disc degeneration in two segments of your spine: your cervical spine (i.e., your neck) and your lumbar spine (i.e., your back). Some people also experience problems in the thoracic spine, which forms the anchor point for the rib cage. In some cases, degeneration in these areas leads to localized symptoms. However, since DDD can interfere with the health of your spinal nerves, it may also produce symptoms that extend along the track of an affected nerve.
Chronic pain is pain that lingers over time instead of fading away. Most cases of symptom-producing degenerative disc disease produce chronic back pain. Since DDD usually affects your lower back or neck, your pain is most likely to occur in one of these two areas (especially in your lower back and buttock region).
Many people notice an increase in their pain levels when they do such things as sit for extended time periods, twist their backs or necks from side to side, perform lifting motions or bend their backs or necks forward or backward. Conversely, many people experience a decrease in their pain levels when they do such things as alter their body positions often, walk, lie down or run.
Episodes of severe pain are also a frequent symptom of degenerative disc disease. Although no one knows for sure, this pain may stem from periodic muscle spasms that get triggered by chronic disc pain. Generally speaking, if you have ongoing, severe pain in your back or neck (rather than isolated episodes of such pain), you probably have some other health problem besides DDD.
Radiating Pain and Nerve Changes
If you have DDD in your neck, your chronic pain may radiate downward through your shoulders and travel as far as your forearms or hands. If your disc problem is located in your lower back, your chronic pain may radiate downward through your buttocks to your thighs, lower legs or feet. In addition to pain, degenerative disc disease symptoms may also include other changes in your normal nerve function. Fairly common examples of these problems include tingling in your arms or legs, numbness in your arms or legs, an unusual loss of muscle strength in your leg(s) and a condition called foot drop, which leaves you unable to properly lift your foot with the muscles that control your ankle joint.
Some problems associated with degenerative disc disease require rapid medical treatment if you’re going to avoid lasting consequences. Examples of these emergency symptoms include pain that impairs your ability to move or function, pain that grows increasingly worse over time, nerve changes in your legs (i.e., tingling, numbness or weakness) and impairment of your normal ability to control your bladder or bowels.
Do You Have Degenerative Disc Disease?
If you have any of the symptoms above, the good news is that you are not alone. DDD is a common condition, and many medical professionals are well trained in ways to help treat the pain.
How is Degenerative Disc Disease diagnosed?
While a physician can diagnose degenerative disc disease fairly easily by taking a medical history, conducting a physical examination and possibly ordering diagnostic tests such as an X-ray or MRI scan, many people will not seek treatment until their pain has become intolerable. Degenerative disc disease typically progresses very slowly. Many people who have reached middle age accept as a foregone conclusion that they will begin to experience stiffness, aches and pains in their back. When mild discomfort progresses to shooting pain, tingling, numbness or muscle weakness, it is important to see your physician for proper diagnosis and treatment
Often, a physician can diagnose disc deterioration through a simple physical examination including palpation (manipulation) of the affected area to determine if the discs are unstable. From there, he or she likely will take a full history of your symptoms and conduct a neurological examination to evaluate your muscle strength and reflexes. Finally, your doctor may order diagnostic imaging that could include X-rays or an MRI or CT scan and would show any spinal or tissue abnormalities including fracture, disc herniation or collapse, and nerve compression.
Why an MRI Scan is Important
The best way for a physician to properly diagnosis a herniated disc in your spine is through magnetic resonance imaging (MRI), which will produce detailed, two-dimensional pictures of your spine, organs, muscles and soft tissue. This detailed view gives your physician the “full picture,” which leads to a more accurate diagnosis and a more effective treatment plan. MRI scans are used regularly to diagnose neck and spine conditions.
If you have never had an MRI scan, there are a few things you should know:
- You won’t be subjected to radiation, and you won’t feel any pain
- Only the “problem area” is scanned
- The results are extremely accurate
If your physician requests an MRI scan to confirm a diagnosis, you will lie down in an MRI machine (which resembles a large tube) for up to an hour while the designated areas of your back are scanned. It will feel a bit tedious, but you should not experience any discomfort.
The radiologist and your physician will evaluate the images of the damaged disc as well as the muscles and tissues around it; often, the cause of the herniation can be determined as well. From there, you and your physician will decide if a conservative treatment plan is most appropriate, or if surgery represents the most effective solution.
If you have had an MRI and conservative treatment has not worked, our pain experts can help you determine if you are a candidate for our procedure with a free MRI Review. After this outpatient procedure, most patients are able to resume light activities the very next day.
More about Degenerative Disc Disease
Even if you have genetically inherited risks for degenerative disc disease, you can take preventative measures that reduce your chances of developing problems.
Establish an Exercise Routine
You can promote ongoing disc health by establishing an exercise routine that doesn’t place a heavy strain on your back or neck. Moderate activities that commonly help in preventing degenerative disc disease (DDD) while also helping you avoid unnecessary strain include simple stretching, going for walks and taking part in guided, skills-appropriate Pilates or yoga classes. Several types of licensed professionals can help you set up a program that meets your needs and keeps you safe, including certified personal trainers, chiropractors and physical therapists.
Maintain Good Posture
Poor posture can substantially add to the everyday strain placed on your spine. Over time, this strain can make it more likely that natural disc degeneration will lead to pain or other symptoms. Basic good posture includes such things as sitting without crossing your legs, keeping your back erect while standing and sleeping on your side rather than on your stomach. When lifting objects (even if they don’t seem heavy to you), essential posture tips include bearing the load with your leg muscles instead of your back muscles, flexing your knees and maintaining an erect spine position instead of hunching forward or arching backward.
You can greatly improve your degenerative disc disease prevention efforts by maintaining your body weight within a healthy range for your height and age. People who carry enough excess weight to qualify as overweight or obese substantially add to the amount of daily strain placed on their spines and spinal discs. In turn, this added strain can increase the pace of degenerative change and make related symptoms more likely to occur. Quitting smoking will also help you avoid DDD. Habitual cigarette use will reduce the moisture content of you spinal discs and increase your exposure to age- or injury-related disc damage.
If you have a job that repeatedly exposes you to significant back stress, you may need to modify your daily work routine to keep to your DDD risks under control. People affected by the brittle bone disease osteoporosis need to follow all prescribed treatments for that condition in order to prevent the possibility of degenerative disc disease symptoms.
What are the causes of Degenerative Disc Disease?
Degeneration in the discs of the spine is a natural occurrence that progresses with age, but some people have more severe degeneration due to genetics, lifestyle, or injury. Each cushioning disc in your back contains a gel-like interior surrounded by a tough covering. Typically, problems begin when there are tears in the tough covering and scar tissue forms. This scar tissue has less structural integrity than the healthy tissue, and over time repeated tearing or scarring in more than one place can cause the entire disc to weaken. When the disc weakens, it begins to lose its water content and the ability to properly cushion and protect your spine. Weakness can also cause the disc to tear, bulge, or herniate and compress a nerve root, causing pain.
Degenerative disc disease (DDD) has several potential causes, although most people are affected by natural, age-related changes in their cushioning spinal discs.
Age-Related Causes of DDD
Each spinal disc has an inner core and an outer layer. The inner core, called the nucleus pulposus, has a high water content and provides the cushioning effect needed to properly protect your spine from trauma and everyday stress and strain. The outer layer — called the annulus fibrosus — is a resistant, cartilage-based material that restrains the nucleus pulposus and allows the disc to maintain its normal shape.
As you grow older, your discs naturally undergo changes in their composition that make them more susceptible to damage. Chief among these changes is loss of water content in each disc’s inner core. This water loss leads to a reduction in the height of your discs; in turn, a reduction of disc height increases the odds that two or more vertebrae in your back will shift their position, rub against each other and destabilize your spine. Unfortunately, the body can respond to these changes by producing growths of new bone tissue (called bone spurs) between neighboring spinal bones. In turn, bone spurs can significantly restrict your back mobility and push against your spinal nerve roots or your spinal cord.
Age-related degeneration also affects your discs’ outer layers. Under the stress of increasing pressure, these fibrous coverings can develop small partial tears in their surfaces. Due to lack of blood flow, the body can’t heal these tears very efficiently. This means that each repaired tear makes the overall disc weaker and more likely to produce problems.
Back injuries are another potential cause of DDD. If you sustain such an injury (which has typical sources that include motor vehicles accidents, contact sports and poor posture during strenuous movements), you may experience changes in your spine health that lead directly to the onset of disc degeneration. However, most people affected by injury-related problems already have age-related issues that make their discs weaker than usual.
Some people inherit a tendency toward disc degeneration through their family bloodlines. This typically means that they have greater chances of experiencing damaging disc change during middle age or even before reaching middle age. You may have inherited problems if multiple family members have received a DDD diagnosis in the past.
Cigarette Smoking and DDD
Among its many other harmful effects on your health, habitual cigarette smoking decreases the amount of water contained in the inner cores of your spinal discs. This lack of moisture doesn’t directly cause degenerative disc disease; however it can increase your rate of age-related disc change and expose you to DDD symptoms at an earlier age.
What is the treatment like for Degenerative Disc Disease?
Most physicians will first recommend a conservative approach, such as hot/cold compresses, medication, exercise or physical therapy. They could also recommend epidural steroid injections (ESI), selective nerve root block injections (SNRB), or a combination of the two. These injections are usually performed in a series of three: a physician injects an anti-inflammatory, typically a mix of steroid and local anesthetic, into the problem area. If symptoms persist, a minimally invasive procedure might be an option for long term relief. If your degenerative disc disease has caused a bulging/ herniated disc, you may be a candidate for a minimally invasive laser spine procedure. If disc degeneration has caused bone-related issues such as bone spurs, is more severe or if spine stability is compromised, a minimally invasive spine surgery such as a fusion or disc replacement might be an option to relieve your symptoms.
Most people with the symptoms of degenerative disc disease (DDD) benefit from nonsurgical options that doctors commonly call “conservative” treatment. However, some people only improve after undergoing surgery.
Your doctor may recommend that you rest you back for a short amount of time if you experience a significant flare-up of your gegenerative disc disease. This temporary measure can take some of strain off your back or neck and give your muscles a needed break. However, if you rest for too long (any longer than a maximum of three days), you can actually worsen your overall back health by decreasing your normal muscle tone.
Medications used for degenerative disc disease treatment come in both nonprescription and prescription form. The typical nonprescription choice is a nonsteroidal anti-inflammatory drug (NSAID), such as aspirin or ibuprofen, which also reduces pain levels. Some people have more prominent pain symptoms and receive a stronger prescription NSAID.
During bouts of severe pain, a person with DDD may temporarily receive a prescription opioid (narcotic) painkiller. Additional medication options include muscle relaxers and nerve-blocking shots called epidural steroid injections (ESI’s).
Exercise and Physical Therapy
Although not a quick fix, in the long term a properly guided course of exercise or physical therapy may provide the relief you need from your DDD symptoms by improving strength and resilience in your back muscles and abdominal muscles.
If you are not fond of exercising, think of this: many spine surgeries, including minimally invasive procedures, include post-operative instructions with physical therapy or exercises to help you recover. If you start physician-guided stretches now, you can get a head start on pain relief and even improve your recovery if you have a procedure.
Your doctor can recommend exercises that work best for your particular circumstances. Potentially effective physical therapy techniques include back bracing, a course of posture improvement and treatments that include applications of a heat source, applications of a cold source, ultrasound therapy and massage. A well-trained physical therapist can also devise a safe and effective exercise routine that decreases your DDD-related pain without creating a new set of back problems.
Additional Conservative Options
Some of the lifestyle modifications that help prevent DDD symptoms can also help you after symptoms arise. For example, managing your weight can help you find pain relief, and can also improve the success of a spine procedure. Additional New Year’s resolutions to make include quitting smoking (which also helps with spine procedure recovery), finding a job that doesn’t require repetitive back stress, and finally listening when you are told to “lift with your legs.”
Degenerative Disc Disease Surgery
Degenerative disc disease surgery often includes a procedure called a spinal fusion, which requires removal of a damaged disc and use of a bone graft to fill in the resulting gap in the spinal column. Spinal fusion is frequently accompanied by another surgical procedure called a laminectomy.
However, there are much less invasive and extensive surgical options available for many affected individuals.
For example, we can treat DDD pain symptoms with a modern, minimally invasive approach that gives our partner physicians the crucial advantage of pinpointing the exact source(s) of chronic back pain in advance.
The procedure, which relies on a guided laser and other tools, is then designed to shrink the bulges and seal the cracks of the degenerative disc. This treatment can halt or slow continued degeneration and the inflammatory process which is causing pain and other symptoms.
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Benefits To Our Degenerative Disc Disease Treatment
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Incisions made are 5 millimeters or less in length, allowing for minimal scar tissue and less infection risk