Degenerative Disc Disease

Definition

Degenerative disc disease is a wear and tear of the discs between spinal bones (vertebrae). Healthy discs act like cushions to protect the spine and help it stay flexible.

Degenerative Disc

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Causes

Degenerative discs may be caused be:

  • Drying out of discs due to the normal aging process
  • Tears in the outer portion of the disc from sports, heavy lifting, or physical work
  • Back injuries

Risk Factors

This problem is more common in older adults. Other things that may raise the risk are:

  • Having other family members with this process
  • Strain on the back from sports, heavy lifting, or physical work
  • Smoking
  • Obesity

Symptoms

Problems may be:

  • 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
  • Numbness and tingling into the legs
  • Weakness in the legs
  • Problem raising the foot at the ankle

Diagnosis

The doctor will ask about your symptoms and health past. A physical exam will be done. It will focus on the spine. Images of the spine may be taken with:

Your nerves may be evaluated. This can be done with an electromyogram and nerve conduction studies.

Treatment

There is no cure. The goal of treatment is to manage symptoms. First steps may include:

  • Supportive care, such as avoiding activities that cause pain and use of cold or warm compresses
  • Physical therapy to improve strength, flexibility, and range of motion
  • Medicines to ease pain, such as pain relievers and steroid injections

People who are not helped by first steps may need surgery. Choices are:

  • Artificial disc replacement
  • Spinal fusion to join two vertebrae together

Prevention

The risk of back problems may be lowered by:

  • Maintaining a healthy weight through diet and exercise
  • Staying active
  • Not smoking

RESOURCES:

North American Spine Society
http://www.spine.org
Ortho Info—American Academy of Orthopaedic Surgeons
http://www.orthoinfo.org

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://www.coa-aco.org
Canadian Orthopaedic Foundation
http://www.canorth.org

References:

Degenerative Disc Disease. Hospital for Special Surgery website. Available at: https://www.hss.edu/condition-list_degenerative-disc-disease.asp. Accessed February 17, 2021.
Deyo RA, Mirza SK. CLINICAL PRACTICE. Herniated Lumbar Intervertebral Disk. N Engl J Med. 2016 May 5;374(18):1763-1772.
Low back pain. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: https://orthoinfo.org/en/diseases--conditions/low-back-pain. Accessed February 17, 2021.
Lumbar disk herniation. EBSCO Dynamed website. Available at: https://www.dynamed.com/condition/lumbar-disk-herniation. Accessed February 17, 2021.
Madera M, Brady J, Deily S, et al. The role of physical therapy and rehabilitation after lumbar spinal fusion surgery for degenerative Disease: a systematic review. J Neurosurg:Spine.2017:26(6):694-704.
Shi WB, Agbese E, et a;. Performance of pain interventionalists from different specialties in treating degenerative disk disease-related low back pain, Arch Rehab Res Clin Trans. 2020; 2(3).
Last reviewed February 2021 by EBSCO Medical Review Board Laura Lei-Rivera, PT, DPT
Last Updated: 2/17/2021

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