Degenerative disc disease is when discs along the spine shift causing pain to the neck or back. Because this movement happens naturally as the body is worn down, it is one of the most common reasons people experience pain.
Every person ages differently and, unfortunately, most of us will experience some back pain as we get older. While chronic back pain might seem like a normal part of aging, it can be a warning sign that something is wrong. The most common cause of chronic, persistent back pain is Degenerative Disc Disease (DDD).
Degenerative Disc Disease is a treatable condition that occurs when the discs along your neck and spine shift. This happens naturally as the discs are worn down, reducing their ability to absorb shocks and pain. DDD can result in chronic pain or sharp, unexpected pains.
Each of your vertebrae is protected by a spinal disc. These discs work as shock absorbers along your spine, allowing you to bend over, twist, and stretch without pain. As you age, these shock absorbers can start to break down and become less effective, leading to chronic back pain and body aches, or DDD. Fortunately, there are multiple options to help you address this condition.
Degenerative Disc Disease isn’t a disease in that it can be spread from person to person, but a normal condition caused primarily by aging factors. The rate at which your spinal discs break down will depend on many factors, like your genetics and lifestyle. One common cause of this condition is the drying out of spinal discs which impacts the shock absorbing-abilities of the disc. Think about how you can squeeze and fold a wet sponge without damaging it, but a dry sponge is stiff and easy to break in half. When your spinal discs dry out, they become brittle and can cause back pain.
Cracks in your spinal discs can be another root cause of DDD. These can occur through everyday movements or as a result of stress you put on your back. Even small cracks can cause back pain when these tiny tears hit sensitive nerves. If the crack is severe, the disc could break down and potentially slip out of place, causing a condition known as a herniated disc.
Because each body is unique, people experience DDD in different ways; some people never experience pain or other symptoms related to this condition, even if their discs are in poor shape. Others may experience intense and persistent pain as their nerves respond to tears or the drying of the discs.
Common symptoms of DDD include:
Another sign of DDD is that pain may travel or vary based on the location of the sensitive discs. For example, if you experience DDD in your lower back, you are more likely to experience tingling or numbness in your legs. If your neck is affected by DDD, the pain may travel down your arms.
How long patients experience pain from DDD also varies: a flare-up can last for a few days, and chronic pain can last for months. The pain often gets worse when you move and it can be hard to find comfortable positions to relax or sleep in.
If you are experiencing low-level back pain that occasionally leads to severe flare-ups, then you may have Degenerative Disc Disease (DDD). If you have not already, the first critical step to eliminating spinal disease and pain is to speak with your doctor who may order additional tests or refer you to a specialist.
Each doctor that you meet with should review your medical history and consider your lifestyle and goals. They will ask about any history of back pain and will document how frequently this pain occurs, how severe your pain is, and what causes it. This review of your medical history might also include questions about your lifestyle, including your diet and exercise habits.
After reviewing your medical history, if they suspect you have DDD, the doctor will conduct a physical exam to check your spinal discs and test your range of motion to understand when your pain is triggered. Your doctor will also feel along your spine to catch any abnormalities that could be causing you pain.
Finally, your doctor may request an imaging test (like an MRI) to get a clear look at your disks and see if there is any disc degeneration and identify tears that may be causing your pain.
The amount of wear on your discs doesn’t always correlate to your pain. A patient may have severe degeneration but minimal pain so your doctor will ask about your medical history and your pain levels.
One of the main challenges of degenerative disc disease is determining the amount of damage to the padding in the spine. Patients can feel pain even if their spinal discs are in good condition, which may indicate they don’t yet need surgery to repair the damage. While avoiding surgery can be considered good news, it can also be disappointing for patients who wish there was an immediate solution to their pain. Because DDD presents in a unique way to each patient, it’s important for your doctor to create an individualized course of action for your case.
There are ways to treat DDD without surgery, such as heat therapy to reduce tension in your muscles and ice treatments to reduce inflammation, both of which can be paired with pain medications to treat your pain.
To qualify for spinal surgery, most patients must have experienced at least six months of chronic neck or back pain that has not been relieved by nonsurgical interventions like physical therapy, oral analgesics or corticosteroids, heat, and maximum tolerated activity. Your doctor may recommend a physical therapist to meet with to see if your DDD is treatable without surgery.
When you discuss your DDD, ask your doctor about your exercise and mobility goals and how you can continue to stay mobile and active. Your spine specialist may be able to manually adjust the spine to reduce pressure or suggest a physical therapist to work on your movement. It’s important to talk to your doctor before you continue or increase your physical activity, as you could potentially aggravate your DDD and cause severe damage to your discs.
Medical professionals are constantly looking for new ways to reduce patient pain. By seeking help for your DDD, you may gain access to a new treatment option that helps you live life to the fullest.
One of the most frequently asked questions about degenerative disc disease is whether or not the condition is hereditary and researchers have determined that DDD is genetic. Researchers have studied degeneration in multiple generations and with twins to understand how spinal discs wear down and how pain varies by person. Research into the genetic code that causes painful DDD is still in its beginning stages, but it explains why some people experience higher levels of pain than others.
While DDD may have some genetic causes, lifestyle factors can also cause or worsen this condition. For example, “text neck” is a condition named for people who are constantly looking down at their phones. This creates stress on the spine and can lead to neck and shoulder pain. Even someone with strong genetics who might not otherwise be prone to DDD could start to exhibit symptoms because of their lifestyle.
If you are a patient who has DDD, know that genetics may play a role in the amount of pain you experience, but there may be other lifestyle factors that contribute to the severity of your condition.
If there is a significant amount of damage to your spinal discs, your doctor may recommend a surgical treatment plan. At this point, it’s critical that you select the right spinal surgeon for your unique case – and to determine which type of degenerative disc disease surgery is right for you. Your surgeon may perform a discectomy on the affected area to remove the diseased disc that is causing your pain.
A discectomy is a process of removing a spinal disc from your body. Your surgeon will remove any disc material that is diseased, no longer in its proper location, or parts of your disc that are torn or resting on your nerves. Once the disc is removed, there will not be any padding protecting your spinal bones from touching each other, and leaving your back as-is would cause additional damage and pain, so your surgeon will then most likely use one of two key procedures to stabilize your spine:
After surgery, the doctor may recommend a course of physical therapy, which will help you learn how to move again while allowing medical professionals to track your recovery, ensure you have a strong range of motion, and that you aren’t being limited by painful disc flare-ups. For most ADR patients, recovery is faster than for spinal fusion patients.
Dr. Todd Lanman understands firsthand how limiting it is to live with painful degenerative disc disease. With over 30 years of experience helping patients eliminate their pain and restore mobility to their spine, Dr. Lanman is also a 3- time recipient of artificial discs himself. Dr. Lanman recently launched the ADR Spinal Restoration Center in Los Angeles as a complement to his successful practice in Beverly Hills, Lanman Spinal Neurosurgery, that will allow him to expand his ability to help patients from around the country and abroad to live a mobile, pain-free life. If you are struggling with symptoms of DDD, reach out to us at frontdesk@spine.md to schedule a comprehensive consultation to get to the root cause of your pain and determine the best plan for your unique case.