What is Degenerative Disc Disease?
Degenerative disc disease explained by Denver, Golden, Aurora, Boulder, Broomfield, Jefferson, and Littleton Colorado’s top pain doctors
The individual bones in the spinal column are called vertebrae. The human spine is composed of a stack of 24 vertebrae. There are cushions composed of cartilage between each vertebra that are called intervertebral discs. These discs are pliable and compressible and function as shock absorbers. They allow flexibility of the spine. Age and the activities of daily life can damage these discs, resulting in neck and back pain. Degenerative disc disease refers to damage that occurs to the intervertebral discs due to aging.
Disc degeneration is also associated with other complications, including:
- Osteoarthritis: Cartilage damage that occurs in the joints that is associated with a loss of the cushion between bones
- Herniated disc: Intervertebral discs are injured causing them to swell or rupture
- Spinal stenosis: Limitation of the flexibility of the spinal canal due to a narrowing of the spinal column
Degenerative disc disease may be associated with pain that radiates through the entire spine; however, it can be limited to the affected disc. Movement may increase the level of pain. Degenerative disc disease can be associated with a wide variety of specific pain symptoms. Patients may experience a localized stabbing pain, while others have more general and widespread pain. Degenerative disc disease patients may also experience lack of feeling and prickly sensations. Some patients experience pain that extends from their back to their extremities.
Causes of Degenerative Disc Disease
Studies have failed to identify the specific causes of degenerative disc disease. However, they do suggest the condition develops due to the normal effects of aging on the discs over time. There is some disagreement associated with that hypothesis, because the effects of normal activities on the discs cannot wholly account for the damage. However, most physicians believe that pain associated with degenerative disc disease is due to inflammation that causes compression and instability of the intervertebral discs. This is thought to cause reflexive muscle spasms that may account for this pain.
In addition to age, a history of smoking and ethnicity may also be factors in the degeneration of intervertebral discs. Furthermore, degenerative disc disease tends to run in families, indicating that there may be a genetic component.
Treatments for Degenerative Disc Disease
There are a variety of therapeutic modalities for relieving the pain associated with degenerative disc disease. However, patients that are not experiencing severe symptoms are encouraged to use conventional or self-administered therapies, such as physical therapy. The use of targeted exercises, routine stretches, and low-impact aerobic conditioning often benefits patients with degenerative disc disease. The alternating application of cold and heat can also relieve the pain and discomfort.
Patients can often achieve pain relief with over-the-counter pain relievers or non-steroidal anti-inflammatory drugs (NSAIDs). These medications reduce inflammation in the affected intervertebral disc and relieve the pain associated with the inflammation. Oral corticosteroids, such as prednisone and cortisone, are also administered to relieve the discomfort and inflammation of the affected area.
Physicians may prescribe an opioid medication for patients that do not respond to conservative therapies. Opioids, such as morphine, have been employed for many years to provide decreased perception of pain, decreased reaction to pain, and increased pain tolerance. Opioids have proven to be effective for the short-term relief of sudden-onset, severe pain. However, the extended application of these drugs for managing pain is contraindicated because they are addictive and often abused.
Chronic or severe pain can be addressed by other types of treatment, such as epidural steroid injections, which often successfully relieve the chronic pain associated with degenerative disc disease. TENS units, which deliver a very mild electrical stimulation to the affected area, can also provide relief for patients with degenerative disc disease. In addition, evidence suggests that spinal cord stimulation can provide patients with a significant reduction in their pain. For spinal cord stimulation, physicians implant a device near the spinal column to send electrical impulses that disturb the transmission of pain signals from the nerves within the spine.
Another treatment, biofeedback training, can help patients manage the pain associated with degenerative disc disease by teaching them relaxation and coping skills. Complementary therapies can also provide relief for patients with degenerative disc disease. For instance, acupuncture can be beneficial when administered in combination with other types of pain treatment.
Spinal discs can become inflamed and irritated with age, leading to pain in the back and neck. There are several treatment options for relieving the pain associated with degenerative disc disease. Conventional self-administered treatments are initially recommended for managing pain. However, patients with persistent or severe pain due to degenerative disc disease should consult a physician for more aggressive methods of treatment.
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