Spinal discs are intervertebral structures that are made out of a hard outer shell and a gel-like nucleus. They provide cushioning for the vertebrae and act as shock absorbers for the spine.
Degenerative Disc Disease, or DDD for short, is a medical condition where the wearing out of the spinal discs leads to back pain. The wear and tear process is often attributed to aging, but there are other causes for it as well.
Some sufferers may not necessarily experience symptoms, but for those who do, the main concern is that of back pain. Depending on the cause of its onset, there are various treatment modalities that can help fix this condition.
It must be noted that DDD should not be confused with a herniated disc, which manifests in a different manner.
When it comes to DDD, the contents of the disc lose water and dry out (which is what is referred to as the degeneration of the disc), whereas in the case of herniated discs, the nucleus is not worn out. Rather, the outer shell presents a crack through which the nucleus bulges out of its place.
Causes
Various factors can lead to or increase a patient’s chances to develop disc degeneration. One of the most common causes of DDD is aging. Especially after the age of 60 when, discs tend to lose up to 20% of their water content and they become prolapsed (thinner). Because of the loss in cushioning provided by spinal discs, misalignment of the vertebrae, as well as back pain may occur.
In addition to aging, there are some risk factors to be consider, that may contribute to the onset of DDD. One of them is prolonged and irregular pressure that is applied on the discs due to the patient’s poor posture and bio-mechanical deformities (such as a short leg). Repeated strain on the back may cause discs to wear out at a faster rate.
Symptoms
The most common symptoms of DDD are pain and stiffness. Depending on the location of the damaged disc, the sufferer may experience neck pain (if the disc is located in the cervical spine), or back pain (if the damaged disc is located in the lumbar spine or thoracic spine). In some cases, it may also affect the arms or legs.
For instance, if the disc degeneration occurs in the lumbar spine, leg muscles might be affected.
Because in DDD the mass of the disc’s nucleus is reduced, this can lead to spinal misalignment. As a result, as the back muscles try to compensate for this misalignment, they may be placed under increased pressure, potentially leading to minor injuries in the muscles of the back. In time the sufferer can develop back muscle spasms from the muscles having to work too hard to stabilise the spine.
After the age of 60, DDD increases the chance for a person to develop bone spurs, which in turn can place pressure on the spinal cord, further aggravating any existing pain, or leading to a new onset of back or neck pain.
Treatment of Degenerative Disc Disease
In order to determine whether the cause of the sufferer’s symptoms can be attributed to disc degeneration, it is recommended that the patient seeks medical advice to receive a diagnosis from a specialist, who will carry out an initial physical exam (or examination) and additional tests (such as magnetic resonance imaging) if necessary.
With that being said, the treatment of DDD can be split into two categories: managing and treating the pain.
Management techniques typically involve the administration of anti-inflammatory medication or steroid injections.
Treatment modalities include mainly physical therapy and spinal surgery (such as spinal fusion).
It can safely be said that for the vast majority of spinal conditions surgery is neither necessary nor effective, as it almost always leads to long term complications and suffering for the patient, out of all proportion to the original condition. The use of metal rods, screws and plates and the cutting away of parts of the spine, even the heating of discs to cause them to shrink (IDET procedure) represent a rather crude approach to the treatment of spinal problems.
However, the bio-mechanical derangement in the spinal column and the normal function of the spine can be restored by mobilising the joints, to free them from constrictions and by correcting any actual or impending herniations.
Additionally, any fissures or cracks in the discs should then heal up over three months, but they must be made to heal in their proper place, which is why treatment is essential.
Following treatment, the patient is required to undertake regular and specific exercises to strengthen appropriate muscles.
Additionally, the person can engage in spinal decompression therapy to reduce the pain caused by disc degeneration and to facilitate healing.
