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Degenerative Disc disease

What is Degenerative Disc Disease

  • Degenerative disc disease refers to the deterioration of the spinal discs, which serve as resilient buffers between the vertebrae in the spinal column. These discs play a crucial role in absorbing shocks and facilitating comfortable movement, bending, and twisting. As part of the natural aging process, everyone experiences some degree of degeneration in their spinal discs. When these cushions deteriorate, the vertebrae may come into direct contact, leading to various issues, including adult scoliosis characterized by spinal curvature, herniated discs (also known as bulged, slipped, or ruptured discs), spinal stenosis marked by narrowed spaces around the spine, and spondylolisthesis, wherein vertebrae may shift in and out of alignment.
     

Risk Factors of Degenerative Disc Disease

  • Degenerative disk disease (DDD) is indeed more common in older adults, but it can affect people of any age. The factors you've mentioned can increase the risk of developing DDD:

    1. Acute injuries: Traumatic events like falling or accidents can accelerate the degeneration of spinal discs.

    2. Obesity: Excess weight puts additional stress on the spine and can accelerate the degeneration of intervertebral discs.

    3. Biological sex: While both men and women can develop DDD, research suggests that women may be more prone to experiencing symptoms, although the reasons for this are not entirely clear.

    4. Smoking: Smoking is associated with accelerated disc degeneration. Nicotine and other chemicals in cigarettes can impair blood flow to the spinal discs, hindering their ability to receive nutrients and repair themselves.

    5. Physically demanding jobs: Jobs that involve heavy lifting, repetitive motions, or prolonged sitting or standing can increase the risk of DDD due to the constant stress and strain placed on the spine.

    It's important to note that while thes e factors can increase the risk of developing DDD, they do not guarantee that someone will develop the condition. Additionally, maintaining a healthy lifestyle, including regular exercise, proper nutrition, and avoiding smoking, can help reduce the risk and mitigate the symptoms of degenerative disk disease.
     

Causes of Degenerative Disc Disease

As we age, it's natural for the spinal discs to undergo wear and tear. Beyond the age of 40, most individuals experience some degree of degeneration in these discs. However, not everyone feels the associated pain. Here's why you might experience discomfort due to changes in your spinal discs:

1. Loss of moisture: The soft core of spinal discs primarily consists of water. Over time, this core gradually loses its water content, causing the discs to thin out. Consequently, they become less effective at absorbing shock and providing support to the vertebrae.

2. Development of tears or cracks: Minor injuries or repetitive stress on the spine can result in small tears or cracks in the outer layer of the discs, known as the annulus fibrosus. These tears, often located near nerves, can induce pain even when they're minor. In more severe cases, if the outer wall of the disc ruptures, the inner core material can bulge out, forming what's termed a herniated disc. This bulge may exert pressure on spinal nerves, leading to further discomfort.
 

It's important to note that while disc degeneration is a common part of aging, not everyone experiences pain as a result. Various factors such as genetics, lifestyle choices, and overall spinal health can influence an individual's susceptibility to disc-related pain and discomfort. Maintaining a healthy lifestyle, which includes regular exercise, practicing good posture, and managing weight, can contribute significantly to supporting spinal health and reducing the risk of experiencing symptoms associated with disc degeneration.
 

Symptoms of Degenerative Disc Disease

  • People diagnosed with degenerative disc disease often lead active and generally healthy lifestyles, typically falling within their 30s or 40s. Recognizing the symptoms associated with this condition is crucial:

    1.     Pain exacerbated by sitting: Individuals with degenerative disc disease commonly experience heightened discomfort when seated, as the discs in the
    lower back bear approximately three times more load in this position compared to standing.
    2. Increased pain during bending, lifting, or twisting: Activities involving bending, lifting, or twisting motions often aggravate the pain associated with degenerative disc disease.
    3. Relief through movement: Walking or even running may provide temporary relief from discomfort, contrasting with prolonged periods of sitting or standing.
    4. Improved comfort with frequent position changes or lying down: Altering positions frequently or lying down often helps alleviate discomfort caused by degenerative disc disease.
    5. Episodic severe pain: Periods of intense pain come and go, lasting from several days to a few months before subsiding. This pain can range from persistent discomfort to debilitating episodes and may affect various areas such as the low back, buttocks, thighs, or neck, with potential radiation to the arms and hands.
    6. Numbness and tingling sensations: Individuals may experience numbness and tingling in their extremities as a result of degenerative disc disease.
    7. Muscle weakness or foot drop: Weakness in leg muscles or foot drop, indicative of potential nerve root damage, can occur in individuals with degenerative disc disease. Understanding and recognizing these symptoms is crucial for effectively managing degenerative disc disease and improving overall quality of life. Seeking medical evaluation and guidance is advisable for individuals     experiencing persistent or severe symptoms associated with this condition.

Diagnosis of Degenerative Disc Disease

  • When a patient exhibits symptoms indicative of degenerative disc disease, Dr. Vivek Badhe may prescribe several diagnostic tests to ascertain the extent of the condition:
    1. X-rays: While limited in their ability to visualize soft tissue such as discs, X-rays offer valuable insights into the bone structures within the spine.
    2. Magnetic Resonance Imaging (MRI): This imaging technique delivers highly detailed images of the discs, enabling surgeons to assess how degenerative disc disease impacts nerves and the spinal canal space.
    3. Computed Tomography (CT) scan: CT scans provide intricate images of the bone structures in the spine and serve as a viable alternative for patients who cannot undergo MRI scans due to factors like having a pacemaker or specific types of metallic implants. These diagnostic tools play a crucial role in helping surgeons formulate effective treatment plans tailored to each patient's unique needs.

Treatment of Degenerative Disc Disease

Treatment strategies for degenerative disc disease are tailored to the severity of the condition. In many instances, surgical intervention is not immediately necessary. Before contemplating surgery, physicians typically explore nonoperative approaches, which may include:

  • Heat and/or ice therapy

  • Modifications to daily activities

  • Oral pain relievers or steroid medications

  • Physical therapy focused on enhancing back/neck muscle strength and increasing flexibility and range of motion

  • Epidural injections containing steroids or pain-relieving medication

These nonoperative methods often effectively alleviate pain and discomfort associated with degenerative disc disease.
However, surgery might become necessary for certain patients, especially those who:

  • Have not experienced improvement with nonoperative treatments

  • Exhibit identifiable structural abnormalities amenable to correction

  • Face spinal cord compression due to disc changes, which may manifest as nerve deficits or loss of bladder and bowel control

  • Endure chronic severe pain

A common surgical procedure for alleviating pressure on the spinal cord and nerves is a discectomy, where the surgeon removes the affected disc and any accompanying bone spurs. This action creates space within the spinal canal, relieving pressure on the spinal cord and nerves.
In cases where removing the damaged disc leads to spinal instability, Dr. Vive Badhe may opt for an instrumented spinal fusion. During this procedure, metallic devices are utilized to stabilize the spine, followed by the implantation of bone either sourced from another part of the body or obtained from a bone bank. This encourages bone growth across the affected area, maintaining spinal stability over time.

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