Low back pain is one of the leading causes of disability and missed work days. It is also one of the most common reasons that people see their doctor. One of the most common causes of low back pain, and one of the most misunderstood causes, is degenerative disc disease.
What Is Degenerative Disc Disease?
Degenerative disc disease is not actually a disease, but rather it is an age-related condition that is caused by the natural wear and tear on the spinal discs. Over time, the discs between the vertebrae of the spinal column deteriorate, or break down. This deterioration causes instability in the spine and is responsible for several different symptoms, with pain generally being the primary concern for those suffering from the condition.
Levels of pain can range from mild discomfort (low level chronic pain) to severely debilitating acute pain. DDD can also cause pain that radiates down the leg, leading to weakness and numbness. Over time, it can also lead to other conditions in the body, like osteoarthritis. The areas that are generally the most susceptible to disc degeneration are the ones that endure the most motion and stress, namely the neck and lower back.
Over time, it is very common to experience some degeneration of the spinal discs, but not everyone will experience pain along with it. The discs in your spine act as shock absorbers between your vertebrae and, as these shock absorbers get worn down with age, it is natural for the spine to lose some of its flexibility. When we lose this flexibility, our discs are more susceptible to tears and ruptures with even simple movement like twisting or straining. This can cause a herniated disc. Generally most people don’t have symptoms from herniated discs, but if you are experiencing severe pain, then it is a good idea to see your healthcare provider. Disc herniations can be serious and, although it is very rare, they can even cause paralysis.
What Causes Degenerative Disc Disease?
Degenerative disc disease is part of our body’s natural aging process but there are genetic, health, and lifestyle factors that can potentially accelerate this process. Things like intensive physical labor, repeated heavy lifting, family genetics, and obesity can all put additional strain on our discs, causing them to experience wear and tear faster than they otherwise would. People often wonder if major traumas can trigger DDD. While DDD rarely starts from major traumas like car accidents, some experts believe that sudden injuries like falls can cause herniated discs and thereby start the degeneration process.
There are also certain things that can happen to our discs to change their structure or damage them prematurely. Our spinal discs consist of a tough outer wall that surrounds a soft inner core. Sometimes changes can occur that compromise the structure of our discs.
Cracks: Tears in our disc walls can cause the soft core to push through and press on the nerves of the spine, causing pain. This is called a bulged or herniated disc and it can happen from the smallest movements or even minor injuries as we get older.
Dehydration: Yes, this is a thing! Your back can get dehydrated! (See our blog on dehydration and low back pain.) Because our discs are made mostly of water, when we are dehydrated our discs shrink and lose some of their ability to absorb shocks.
Diagnosing Degenerative Disc Disease
When it comes to deciding what is DDD and what isn't DDD, unfortunately there seems to be some disagreement among doctors. Often the symptoms of DDD are intermittent and accumulate over the years, with some non-specific symptoms, so it can be difficult for doctors to track the degeneration over time, and they can sometimes miss diagnosing the condition.
Doctors will generally rely on the following to try and make a definitive diagnosis:
Medical history (pain severity over time, its impact on functioning)
A physical examination of the spine
Imaging tests such as an MRI (it can show tears, herniated discs or disc dehydration)
Signs of Degenerative Disc Disease
Degenerative Disc Disease doesn’t always cause pain, although that is one of the main symptoms that ends up driving sufferers to consult with their healthcare provider. So, while pain is one of the main symptoms, here are some other symptoms that may indicate that you have degenerative disc disease:
Pain that comes and goes.
Pain that feels worse when you sit, and feels better when you are moving about.
Pain that gets better when you lie down or change a position.
Pain that feels worse when you twist, bend or lift things.
Pain that is mainly located in your lower back, glutes or upper thighs.
Sharp, stabbing pains (can be in the hands, shoulders, arms or hips and glutes).
Muscle spasms (can be acutely painful and highly debilitating)
Stages of Degenerative Disc Disease:
Stage 1: Individuals might start to experience some episodes of acute pain. There isn’t much damage to the structure of the spine yet, but some imbalance might be starting to occur. There might be some dehydration of the discs and maybe even some bulging and tearing.
Stage 2: Increasing episodes of pain. The spine is losing some of its stability as the discs start to thin and become more rigid. No changes to the vertebrae yet.
Stage 3: Because the discs have been dehydrated for some time now they aren’t giving the vertebrae the cushioning and support that they need. Bony spurs start developing on the edge of the vertebrae as they start to experience friction. The spurs start putting pressure on the spinal cord and this starts causing more intense and long lasting experiences of pain.
What Can You Do To Prevent Degenerative Disc Disease?
Luckily there is some good news when it comes to degenerative disc disease. You can slow down disc deterioration through some natural approaches to care. Most cases will not require surgery and there are some simple things that you can incorporate into your daily routine to slow down the progression of this disease.
Engaging in regular, low impact aerobic exercise can help slow down DDD. Exercises like swimming and walking not only help to relieve the pain by producing natural, pain-relieving endorphins, but they can also help manage body weight and increase your strength and mobility.
Your healthcare provider might recommend medication to help fight inflammation. Over the counter pain killers like ibuprofen and aspirin can help to relieve pain and reduce inflammation that can cause degenerative disc disease.
If you are experiencing a significant amount of inflammation and swelling in your back your doctor might recommend steroid shots. These are injected directly into the epidural space in your back, or directly into the muscles or nerves, depending on where the inflammation is happening.
Following a diet that is rich in anti-inflammatory foods can help reduce inflammation in the body that is often associated with DDD. Foods like berries, salmon, flaxseed, chia seeds and spinach are all full of antioxidants that can help slow down the aging process in our body. You can either speak to your healthcare provider or see a nutritionist to get more information on incorporating some of the delicious foods into your daily diet.
Your doctor may recommend a course of physical therapy in order to strengthen the muscles in your back or neck. Working with a physical therapist can not only help you address certain muscles, but it can also help keep your spine flexible.
As a last resort your doctor may recommend that you have surgery for your spine. A specific procedure, known as a discectomy, can take pressure off your nerves by removing the damaged part of the disc. If your degeneration is particularly advanced, surgeons can also fuse the bones in your spine after removing the disc to help stabilize the spine, or they can remove the disc and put in an artificial one.
While most of us will experience some sort of disc degeneration as we get older, it is good to know that there are some simple things that we can do in our daily lives to slow down this progression. Avoiding excess alcohol, not using products that contain nicotine, drinking lots of water, following a healthy diet, and staying active can have a dramatic increase on how fast, or slow, our discs experience wear and tear. By incorporating a few healthy habits into your daily routine could have huge benefits on your health in the future. After all, as they often say in yoga, you are only as young as your spine!