Over the years, every adult begins to exhibit symptoms of excretion and deterioration on the spinal column. Spinal discs are made of soft tissue and are placed between each of the bony vertebrae. Their function is to absorb any shock to the spine. While spinal disc degeneration occurs in almost all people, not everyone displays the symptoms.
DDD is not a true disease; it is described as a shift in the discs of the spine that affects people as they age. While a lot of people are affected by this disorder, there are several causes that can promote the likelihood of a person developing this condition.
DDD can take place at any portion of the spine as these discs absorb shock and promote flexibility and mobility.
It takes place mostly in the area of cervical spine (region around neck) and the lumbar part (near lower back), and occurs as a result of the disintegration of the soft tissue that shields the joints of the spine. This deterioration of tissue or commonly known cartilage can cause severe pain and also affect the nerves.
As an individual grows older, their bones structure and spinal discs get degenerated. Normally, disc space is composed of 80% just water, but as we age this water reduces and degeneration takes place.
Some people are hereditarily more prone to develop disc disease, while others are exposed to occupations that cause prolonged stress, as in the case of truck drivers as well as construction workers.
There are several things that a person can do in order to avoid extended degeneration. This can include exercise, a proper diet, maintaining an ideal weight, etc.; however, despite doing all of this, a person can still suffer from some amount of degeneration. This is normal in anyone as they grow older.
Degenerative Disc Disease May Lead To:
- Trauma: Trauma may lead to a herniated type of disc or degeneration in the disc, thus making it vulnerable to further damage. A herniated disc is one that expands abnormally causing it to rupture, thus resulting in a lot of pain and possible nerve damage. The covering of the disc known as annulus fibrosus contains nerve endings and is therefore sensitive to pain. The inside portion (nucleus pulposus) does not contain nerve endings. DDD can result in spinal arthritis as well as stenosis.
- Osteoarthritis: This is a disorder that is caused through the rapid progress of DDD and can affect how the spine perceives stress. The discs lose their ability to absorb shock and joints therefore begin to suffer greater stress and can degenerate. This causes a lot of pain to the sufferer.
Spinal stenosis: Spinal stenosis occurs when there is a constriction of the opening of the spine. This opening helps the area of spinal cord to maintain posture, thus when that space gets constricted, pain may occur in the region. As the discs deteriorate, the spinal column becomes shorter and this can cause the nerve roots to get impacted as they leave the spine.
Sufferers of DDD usually do not suffer from pain and are not even aware that they have the condition. According to research conducted in the 1990s, 40% of individuals over the age of 40 showed signs of DDD on their MRI scans but exhibited no symptoms of back ache (Boden et al., Spine).
In some cases, individuals suffer from crippling pain that restricts their mobility. This pain may reduce or can recur on an ongoing basis. The pain usually occurs in the lower back and then extends to the buttocks or even the back part of the patient’s legs.
For sufferers of the condition, sitting for prolonged periods of time can make the symptoms worse. When a person sits down, they place stress on the area called intervertebral disc space and this can affect the posture, thus increasing the pain.
Pain may increase as a result of a tear in the outside of a degenerated disc. This can cause the nerve ending to become inflamed and cause prolonged discomfort that can last for several days and then eventually fade away.
The best way to identify if a person is suffering from this disorder is a mix of physical check up as well as imaging tests. A Las Vegas pain management healthcare professional can take a look at your medical record from the past and then do a physical check up of your backbone.
In case further tests need to be conducted, an X ray or MRI can be done. The MRI is an excellent method to determine if DDD has occurred and can show tear if any in the outside of the disc and any resultant disc herniation.
In case a person does not respond to traditional therapy, they can undergo a discogram. A discogram helps identify the real source of the pain.
Conservative treatment includes:
- Ice along with/ or just Heat applications
- Anti-inflammatory medication
- Exercise routine
- Chiropractic method
- Spinal Decompression method
- TENS Unit
- Trigger Point related Injections
- Epidural Steroid related Injections
- Intra-Discal related Injections
- Facet Injections and even Radiofrequency Ablation treatment
- IDET which is known as Intradiscal Electrothermal Treatment and lastly
IDET was a widely used form of treatment in the past. After evidences of lack of desired results, it was no longer one of the recommended methods of treating DDD. In Nucleoplasty, a portion of the disc is removed so as to intradiscal pressure. This therapy has yielded success in some cases.
Injecting steroids into the disc has yielded some amount of success (Spine, 2004), while there are studies that are taking place to see if stem cells can be injected right onto the disc. Platelet rich plasma can also be examined for its suitability in the treatment of DDD. This is a rapidly developing field of pain treatments. While steroid injections can reduce pain, they do not necessarily help the disc to heal. Stem cell injections and even platelet rich plasma injections could help to fix the degeneration.
Spinal decompression treatment has also given good success in the treatment of DDD in nearly 85% of sufferers. Trigger point injections could also be helpful in people suffering from pronounced muscle palpitations.
Epidural injections and facet blocks are not recommended for treatment of DDD by themselves. For the most part, adjoining nerve roots may be affected and there could be arthritis problem of the face joints. In these cases, this treatment could help.
More than 75% of sufferers of DDD are usually able to get effective pain relief without surgical intervention. In extreme cases, elective type of surgery is possible to be done in which there is a spinal fusion or disc replacement conducted. This is applicable to a lumbar spine, while the discogram is done in advance so as to verify if it is the disc that is the source of the pain. Invasive procedures on the neck have historically yielded poor results.