Degenerative Disc Disease

Degenerative disc disease (DDD) is a condition in which the disc loses support and stability. It is also sometimes called lumbar spondylosis or arthritis. The disc is the cushioning between the vertebral bones. It consists of an outer layer of rings of cartilage (annulus) and an inner layer of gel (nucleus). Healthy discs have a large content of water that acts like a hydraulic cushion.

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Causes

Most discs will degenerate naturally with aging. Everyone 40-50 years old will have some degeneration in their discs, although it does not necessarily cause pain in most people. Others will have underlying DDD that will activate by an injury or trauma to the back.

Symptoms

Back pain is the main symptom. This can especially occur with sitting. It can be aggravated by lifting, bending, or standing for long periods of time. Leg pain can also occur in advanced stages of degeneration if there is pressure or irritation of the spinal nerves.

Diagnostics

  • History and physical examination
  • X-rays: Show narrowing of the disc and bone spurs
  • MRI or CT scan: May show osteophytes (bone spurs), disc bulging, or annular tears
  • Neurologic testing: EMG/nerve conduction testing

Treatment

The name implies that this is a disease. Although it cannot be cured, it can be managed in most cases, like any other disease (such as diabetes or high blood pressure). Treatment options your doctor may recommend:

Medications

To reduce inflammation, either over the counter or prescription NSAIDs (non-steroidal anti-inflammatory drugs).

Spinal Injections

Corticosteroid (cortisone) injections reduce inflammation within the spinal canal and reduce irritation of the nerves. People with mild to moderate DDD can have long-term relief from these injections.

Bracing

To help stabilize the spine in more severe cases.

Physical Therapy

To strengthen the core muscles and back muscles to help stabilize the spine.

Surgery

Surgery is always a last resort, but may be elected in advanced cases or if nerve damage occurs. Options include disc replacement or minimally invasive fusion.

Lowcountry Orthopaedics’ Spine Team

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