Understanding Degenerative Disc Disease

LEXINGTON, Ky. (March 24, 2015) -- Back and neck pain is a common problem that affects millions of Americans. In fact, roughly 80 percent of people suffer from this type of pain at some point in their lives.

One of the most common causes of back and neck problems is a disorder known as degenerative disc disease. Despite its name, this health problem is not actually a single disease, but a condition that develops as a consequence of aging.

As we grow older, the discs in the spine become weaker. You've probably heard that roughly 60 percent of the adult body is actually water -- your spinal discs may actually be up to 80 percent water when you're young! However, the discs dry out as we age, which means their ability to absorb shocks is diminished.

Additionally, everyday activities and physical activities such as sports may cause tears in the outer core of the discs. This is common and mostly unavoidable. Unlike other bodily tissues, the discs are unable to repair themselves due to poor blood supply.

All of these factors combine to cause degenerative disc disease, but everyone experiences this problem in a different way. Some people never show symptoms. However, for most people the symptoms start with a major injury followed by sudden pain, a minor injury followed by sudden pain, or pain that starts gradually and gets progressively worse.

Pain from degenerative disc disease is often more noticeable when you're seated, because the discs are bearing much more load than when you're standing. Additionally, pain may get worse with bending, lifting, or twisting. Some people find that walking, running, or even lying down alleviates pain.

Additionally, pain may not be just localized to the back or neck – it can also affect the lower back, buttocks, thighs, or even the arms and hands.

If a doctor suspects you have degenerative disc disease, he or she diagnoses you through a physical examination. This includes checking nerve endings, checking muscle strength, and checking for pain with your range of motion. A CT scan, MRI, or discogram might be used to better view damage to the disks.

Treatment can begin with self-care. This includes improving posture, resting, wearing a brace and performing exercises that strengthen the back. Your doctor may prescribe medications to reduce pain and swelling.

For most, these treatments help to reduce pain. However, surgery may be necessary for others, especially if degenerative disc bulges out and starts pinching on nerves or spinal cord, or causes instability in the spine.

Surgery is considered only when non-surgical options offer no improvement in symptoms and when reasonable correlation can be made between patient's symptoms and findings on diagnostic imaging.

Surgical options include discectomy and decompression of nerve roots, spinal fusion surgery or artificial disc replacement. Many of these can be performed with a minimally invasive approach, leading to faster recovery. Ask your doctor if you are a candidate for minimally invasive spine surgery.

Dr. Rasesh Desai is an orthopaedic surgeon at UK HealthCare.

This column appeared in the March 22, 2015 edition of the Lexington Herald-Leader