Degenerative Disc Disease
Everything about the causes, symptoms, and most effective treatments for degeneration of the discs located between vertebrae.
Symptoms and Causes
Degenerative disc disease is one of the most common spinal conditions, in which intervertebral discs progressively deteriorate. As a result, the cushioning between vertebrae decreases, and the bones experience greater stress with each impact. This condition can cause severe pain that may become disabling.
There are three types of degenerative disc disease, depending on the affected region:
- Cervical disc disease: affects the vertebrae in the neck, mainly C5, C6, and C7.
- Thoracic disc disease: the least frequent type, affecting the thoracic spine, particularly segments T10-T11 and T11-T12.
- Lumbar disc disease: affects the lower spine, most commonly vertebrae L4, L5, and S1.
The prognosis of degenerative disc disease is variable, as numerous factors influence its progression. Although it cannot be reversed, treatments can help slow its advancement and alleviate symptoms to improve patients’ quality of life.
Symptoms
The most characteristic symptoms of degenerative disc disease include:
- Pain: can be dull and constant or sharp and stabbing. It often radiates to other areas depending on the type of disease:
- Cervical disc disease: neck, shoulder blades, arms.
- Thoracic disc disease: upper back, sides, chest.
- Lumbar disc disease: lower back, buttocks, legs.
- Inflammation
- Muscle stiffness
- Limb weakness
- Numbness in the arms or legs
- Tingling sensation
- Reduced hand dexterity
- Difficulty walking
Causes
Degenerative disc disease may result from the following factors:
- Natural aging: intervertebral discs lose hydration, reducing flexibility and shock absorption capacity.
- Spinal trauma
- Vertebral injuries
- Congenital malformations: curved spine, fused vertebrae
Risk Factors
The risk of developing degenerative disc disease increases in the following situations:
- Age: more common in individuals over 50 years.
- Obesity or overweight: discs are subjected to higher-than-normal pressure.
- Smoking: tissues are damaged due to reduced oxygen supply.
- Sports or occupations involving heavy lifting or repetitive spinal movements
- Sedentary lifestyle: weakens back muscles, increasing injury risk.
- Genetic predisposition
Complications
The most common complications of degenerative disc disease include:
- Herniated disc: part of the intervertebral disc displaces and presses on a nerve or the spinal cord.
- Spinal stenosis: the interior space of the spinal canal is too narrow.
- Osteoarthritis: degeneration of vertebral joints.
- Spinal instability: damage to discs and vertebrae leads to hypermobility in some joints.
Prevention
It is not always possible to prevent degenerative disc disease. However, adopting a healthy lifestyle can reduce the risk:
- Maintain a balanced diet.
- Keep an appropriate weight.
- Strengthen core muscles.
- Avoid smoking.
- Maintain proper posture when sitting or lifting.
Which Specialist Treats Degenerative Disc Disease?
Degenerative disc disease is diagnosed and treated primarily by traumatology and orthopedic surgery specialists. In some cases, neurosurgery may also be involved.
Diagnosis
Diagnosis of degenerative disc disease includes several procedures:
- Medical history: review of patient’s medical and family history, lifestyle, and reported symptoms.
- Physical examination: evaluation of the spine, muscle strength, flexibility, sensation, reflexes, and spinal range of motion.
- X-rays: allow visualization of intervertebral disc wear.
- Magnetic resonance imaging (MRI) or computed tomography (CT): provide detailed images of vertebrae, discs, and surrounding structures to assess damage.
Imaging tests help classify the degree of disc degeneration:
- Mild disc disease: minimal damage; pain does not interfere with daily activities.
- Moderate disc disease: discs show some dehydration and slight loss of height. Usually accompanied by stiffness and more intense pain requiring lifestyle modifications.
- Advanced disc disease: clear disc degeneration with significant height loss. Pain radiates to other areas and affects quality of life.
- Severe disc disease: severe disc damage with associated bone changes. Symptoms are serious and often disabling.
Treatment
Treatment of degenerative disc disease is tailored according to disease severity, symptom intensity, and patient needs:
- Medication: pharmacological treatment with analgesics or anti-inflammatory drugs to relieve moderate pain and inflammation.
- Corticosteroid injections: reduce swelling and severe pain, though effects are temporary.
- Rhizolysis: nerve function blockade to prevent pain signal transmission.
- Physiotherapy: stretching and strengthening exercises to support the spine.
- Occupational therapy: assists patients in adapting their routine to manage symptoms and improve quality of life.
- Surgery: indicated in severe or persistent cases:
- Discectomy: removal of the entire disc or the portion pressing on a nerve or spinal cord.
- Spinal fusion: two or three vertebrae are joined. Pain relief and stability are achieved, but some mobility is lost.
- Disc arthroplasty: the damaged disc is replaced with an artificial disc.
