Patient education: Degenerative disc disease (The Basics)

What is degenerative disc disease? — Degenerative disc disease is a condition that affects discs in the spine (backbone). The spine is made up of:

●Vertebrae – These are your "back bones." They sit on top of one another like a stack of coins. Each bone has a hole in the center. When stacked, the holes in the bones form a hollow "tube" that protects the spinal cord.

●Discs – Rubbery discs sit in between each of the vertebrae to add cushioning and allow movement.

●Spinal cord and nerves – The spinal cord is like a highway of nerves that connects the brain to the rest of the body. The spinal cord runs through holes in the vertebrae. Spinal nerves branch out from the spinal cord and pass in between each of the vertebrae (figure 1). From there, they connect to the arms, legs, and organs. (This is why problems in the neck or back can cause arm pain, leg pain, or bladder problems.)

Over time, the discs between the vertebrae wear down. This is called "disc degeneration." It is a normal part of aging. Most people have some amount of wear on their discs after age 40.

Not everyone has problems because of disc degeneration. But in some cases, the disc wears down enough that the vertebrae start to rub together. The nerves of the spinal cord can also become pinched. These problems can cause pain or other symptoms. Doctors use the term "degenerative disc disease" when disc degeneration causes symptoms.

Certain things can make degenerative disc disease more likely to happen. These include:

●Older age

●A previous injury to the back or neck, such as from falling or a car accident

●Being overweight or obese

●Working a job that is very physical

What are the symptoms of degenerative disc disease? — The most common symptoms are neck and back pain. The pain might also:

●Get worse with movement, or when you have to be in 1 position for a long time

●Come and go

●Shoot into your arms or legs

In addition to pain, you might also have:

●Tingling or numbness in 1 or both arms or legs

●Weakness or stiffness in 1 or both arms or legs

Will I need tests? — Maybe. Your doctor or nurse will start by learning about your symptoms and doing an exam. Possible tests include:

●Imaging tests – Imaging tests create pictures of the inside of the body. You might have an X-ray, CT scan, or MRI, or a test called a "discogram." A discogram uses special dye and imaging to look at the discs in your spine.

●Tests to check how your nerves are working, such as electromyography ("EMG")

●Lab tests

How is degenerative disc disease treated? — The main goal of treatment is to manage your pain and other symptoms. Treatment can include:

●Physical therapy – This involves working with a physical therapist (exercise expert). They will show you exercises to strengthen your back and reduce your pain.

●Medicines to relieve pain – These can include over-the-counter pain relievers, muscle relaxers, or steroids that you take by mouth.

●Steroid injections – This is when steroid medicines are injected near your discs to reduce pain.

●Radiofrequency neurotomy – This is a procedure to "burn" some of the nerves near your damaged disc. This prevents the pain signals from the nerves from reaching your brain.

●Using braces for your neck or back

●Using assistive devices – Some people need to use devices like a cane or walker to help them move around.

Most people with degenerative disc disease do not need surgery. But if other treatments have not helped, you might be able to have "spinal decompression surgery." This is a type of surgery that takes pressure off of the nerves in your spine. There are different types of procedures. Your doctor or nurse can talk to you about what your options are.

Can degenerative disc disease be prevented? — You can't prevent disc degeneration. But there are things you can do to help prevent neck and back pain. For example, you can:

●Use good posture when sitting or standing – Hold your head up, and keep your shoulders down.

●Stay active.

●Lift with your legs instead of your back.

●Keep your neck in line with the rest of your body when you sleep.

Is there anything I can do on my own to feel better? — At home, to try to ease your pain, you can:

●Ice – Put a cold gel pack, bag of ice, or bag of frozen vegetables on the painful area every 1 to 2 hours, for 15 minutes each time. Put a thin towel between the ice (or other cold object) and your skin.

●Exercise – Gentle activities like walking, swimming, or using an exercise bike can strengthen the back muscles and help with pain. Some people also find that tai chi or yoga help.

●Stretch – Gentle stretching can help you feel better.

●Maintain a healthy body weight – Being overweight can make your symptoms worse. Talk to your doctor or nurse about whether losing weight could help, and how to do it safely.

Some people also find that these help their symptoms:

●Spinal manipulation – This is when a chiropractor, physical therapist, or other professional moves or "adjusts" the joints of your back. If you want to try this, talk to your doctor or nurse first.

●Acupuncture – This is when someone who knows traditional Chinese medicine inserts tiny needles into your body to block pain signals.

●Massage – A massage therapist massages the muscles and other soft tissues in your back.

When should I call the doctor? — Call for advice if you have:

●Pain that gets worse

●Numbness in your leg or arm that is new or worse than it was before

●Trouble controlling your bladder or bowels that you didn't have before

More on this topic

Patient education: Low back pain in adults (The Basics)
Patient education: Herniated disc (The Basics)
Patient education: Spinal stenosis (The Basics)

Patient education: Low back pain in adults (Beyond the Basics)