What Is Degenerative Disc Disease?

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Degenerative disc disease describes a condition in which a worn disc causes pain. It often occurs due to the normal aging process in which the discs between the vertebrae in your spine wear down and become thinner.

The degenerative aspect of the disease describes the fact that the changes in the spinal discs are due to degeneration over time. Most discs become more fragile with age. More than 90% of people have some signs of the problem by the age of 60.

This article describes degenerative disc disease symptoms, causes, diagnosis, and treatment.

Types of Degenerative Disc Disease

Degenerative disc disease can occur at all points on the spine. A specific type of degenerative disc disease can be identified by the part of your spine that it affects:

  • Cervical degenerative disc disease: Affects the cervical spine—an area of the spine that consists of seven vertebral bones (C1–C7). Symptoms can include a stiff neck, pain, or nerve sensation between the shoulder blades.
  • Thoracic degenerative disc disease: Affects the thoracic spine—the area where your neck ends and your rib cage area begins. The 12 vertebral bones (T1–T12) begin just above your shoulders and end at the bottom of your rib cage. Symptoms can include pain in your mid- or upper back.
  • Lumbar degenerative disc disease: Affects the lumbar spine, which includes five vertebral bones (L1-L5). Symptoms can include lower back pain. Altered sensations include numbness, tingling, and muscle weakness in the lower back. Pain may radiate into the buttocks, back down the legs, and into the feet.

Degenerative Disc Disease Symptoms

Symptoms of degenerative disc disease can vary based on the extent and location of the damaged disc. The most common symptom is back pain in the lower back or neck, ranging from mild to severe. Symptoms can involve the following characteristics:

  • Pain that radiates to the arms, hands, buttocks, and/or thighs
  • Pain that feels more intense when sitting as a result of the increased load exerted on your discs when sitting
  • Pain that worsens when lifting, bending, or twisting
  • Pain that improves when walking, running, standing, or lying down
  • Pain that comes and goes, lasting from a few days to a few months before improving
  • Numbness and tingling in the hands and feet
  • Weakness in the leg muscles or difficulty lifting the front part of your foot when you walk (foot drop), which may suggest nerve root damage

Causes

Degenerative disc disease affects the discs positioned between your vertebrae or spinal bones. These discs support the bones and cushion movement. However, as these discs weaken over time, the disc's outer shell—or capsule—can become brittle or crack while the soft center, or nucleus, can leak fluid or bulge.

With disc degeneration, the disc tissue flattens and spreads sideways. It can also press on spinal nerves, causing the back pain or weakness that defines this condition. When the disc is damaged, it can't repair itself, so it starts to deteriorate.

The most common causes of disc degeneration include:

  • Age-related changes in the disc
  • Tears in the outer portion of the disc due to sports and daily activities
  • Injury

Four Stages of Degenerative Disc Disease

There are four stages of the disc degeneration process. They include:

  • Disc dehydration (loss of natural water content in the disc)
  • Disc fissures (tears in the outer core of the disc)
  • Neovascularization (ingrowth of blood vessels and nerves into the disc)
  • Bony changes (development of bone spurs without the protection of discs separating the vertebrae)


Diagnosis

The diagnosis of degenerative disc disease requires a comprehensive medical history and physical exam. Your healthcare provider will also ask questions about the type of pain you're experiencing, its location, and the factors that make it feel better or worse.

Your physical examination may involve an assessment of the following physical factors:

  • Mobility and flexibility of the spine and neck
  • Muscle strength in reaction to light resistance
  • Location of pain or tenderness
  • Sensory changes in your feet or hands
  • Tendon reflexes
  • Motor skills when walking
  • Assessment of symptoms such as fever, rapid weight loss, or an abnormal heartbeat that could indicate problems in other parts of your body

Based on the results of your physical examination, your healthcare provider may use one or more of the following tests to make an accurate diagnosis:

  • X-rays: Though X-rays do not show the discs or other soft tissue, this imaging can help your healthcare provider examine your spine's bone structure to identify or rule out other causes of your symptoms. X-rays are taken when symptoms indicate the possibility of fractures, infections, or tumors.
  • Magnetic resonance imaging (MRI): Magnetic resonance imaging (MRI) allows your healthcare provider to examine a detailed image of your skeleton, including your discs and the soft tissue surrounding them. These images provide information on the water loss in a disc and other changes. An MRI also shows how degenerative disc disease affects the spinal nerves and spinal canal.
  • Computed tomography (CT) scans: Computed tomography (CT) scans show detailed images of bone structures in your spine. Your healthcare provider may use a CT scan for diagnosis if you have a metal implant, pacemaker, or other implanted device that prevents you from having an MRI.
  • Electromyogram: An electromyogram measures the electrical signals in your muscles and nerve cells. It can help diagnose the cause of weakness or numbness in your arms or legs. In degenerative disc disease, this may result from a herniated disc that is compressing a nerve or part of your spinal cord.

Treatment

There is no one best treatment for degenerative disc disease. Treatment can vary based on the extent of your symptoms and the location of the damaged disc. It focuses on relieving symptoms, reducing further degeneration, and strengthening the muscles that support your back to help you return to normal activity as soon as possible.

Conservative Treatment

The first step in treating degenerative disc disease involves conservative treatment, which can involve one or more of the following strategies that don't involve surgery:

Rest

Rest can help your back feel better by taking the pressure off your spine and the muscles surrounding it. However, bed rest for longer than two or three days can make the problem worse by weakening back muscles. You may benefit from short periods of rest combined with brief periods of modified activities or exercises designed to reduce your pain.

Ice and/or heat

Using ice application to reduce pain and inflammation and/or heat application to increase blood flow and relax muscles and pain may help your symptoms. Limit applications to 20-minute intervals.

Medication

The following medications can reduce pain and inflammation when used properly:

Steroid injection

An epidural steroid injection can relieve the pain of irritated nerve roots, reduce inflammation, and decrease swelling from a bulging or herniated disc. These injections include a combination of the steroid cortisone and a local anesthetic administered through the back into the epidural space.

Physical therapy

A treatment plan involving physical therapy may include or more of the following types of therapy:

Exercise

Regular exercise can strengthen the back muscles that support your spine. It can also reduce your risk of falls and injuries and reduce back strain by strengthening your abdomen, arms, and legs. When you perform the right exercises safely, the release of endorphins can reduce existing pain.

Surgery

Though conservative treatments are effective in most cases, you may need surgery for degenerative disc disease under the following circumstances:

  • Symptoms did not respond to conservative treatment
  • A structural abnormality that surgery can correct
  • Spinal cord compression as a result of disc changes
  • Chronic severe pain

Depending on your condition, the following surgical technique may treat degenerative disc disease:

  • Discectomy: A discectomy is a surgery for treating a herniated, or bulging, disc. The procedure involves removing the disc and bone spurs compressing the spinal cord and/or surrounding nerve roots that branch off from it. This allows the spinal cord and nerves to move freely in the spinal canal with rapid pain relief.
  • Spinal fusion: Spinal fusion corrects spine deformities by fusing two or more vertebrae, so they heal into a single, solid bone. This eliminates motion between the treated vertebrae and restores stability, thereby preventing painful movements.
  • Disc replacement surgery: Disc replacement surgery is similar to other joint replacement techniques. The procedure removes degenerated discs and replaces them with artificial discs that simulate the discs' natural movements. This technique can preserve the spine's mobility without pain.

Prognosis

Though degenerative disc disease is not life-threatening, there is no cure for the condition. When disc degeneration begins, there is no stopping or reversing it. However, most people can undergo treatment for degenerative disc disease pain without surgery or disc replacement.

If left untreated, the condition can lead to permanent damage and debilitating pain. The result can affect your quality of life and interfere with your ability to perform normal activities. The following problems can occur without treatment:

Coping

Degenerative disc disease is a chronic condition. Symptoms may come and go often, regardless of the type of treatment administered. Establishing and maintaining a treatment program that includes exercise and a healthy lifestyle can help you obtain good results.

The following strategies can help reduce disc degeneration:

  • Quit smoking: Nicotine and tobacco products can promote disc degeneration and interfere with the bones' ability to heal.
  • Lose weight: Being overweight or obese adds extra stress to your spine and discs, which may accelerate disc degeneration.
  • Protect emotional well-being: Psychotherapy can help you manage the anxiety and depression that may occur as a result of chronic pain.

Summary

Degenerative disc disease is a problem that occurs when the discs between the vertebrae in your spine wear down and become thinner. It most often happens as a result of aging.

The problem reduces the flexibility and height of the disc. Though these changes don't always cause symptoms, they can often make the spine unable to perform its normal functions without pain. Pain occurs when your body changes due to disc damage to cause bone-on-bone movement, bone spurs, or a compressed spinal cord.

Most people benefit from conservative treatment. Surgery can often provide long-term relief for severe symptoms.

13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Anna Zernone Giorgi

By Anna Giorgi
Anna Zernone Giorgi is a writer who specializes in health and lifestyle topics. Her experience includes over 25 years of writing on health and wellness-related subjects for consumers and medical professionals, in addition to holding positions in healthcare communications.