Degenerative Disc Disease: Causes, Signs, 10 Things to Avoid

Degenerative disc disease (DDD) is a condition that refers to the gradual deterioration of the intervertebral discs in the spine. Intervertebral discs are soft, gel-like cushions that sit between the vertebrae (the bones of the spine) and act as shock absorbers, providing flexibility and allowing for movement of the spine.

As people age, the intervertebral discs may undergo wear and tear, losing their water content and elasticity. This process is a natural part of aging, but in some individuals, it can lead to degenerative disc disease. DDD can occur in any part of the spine, but it most commonly affects the lumbar spine (lower back) and the cervical spine (neck).

Degenerative disc disease (DDD) is a multifactorial condition, and its development is influenced by a combination of factors. Here are some common causes and contributors to degenerative disc disease:

Aging:

The natural aging process is a significant factor in the development of degenerative disc disease. As people age, the intervertebral discs lose water content and elasticity, making them more prone to wear and tear.

Genetics:

There is evidence to suggest a genetic predisposition to disc degeneration. If there is a family history of DDD, an individual may be more likely to develop the condition.

Trauma or Injury:

Past injuries or trauma to the spine can contribute to the development of degenerative disc disease. Accidents, falls, or other forms of physical trauma can accelerate disc degeneration.

Repetitive Stress:

Certain occupations or activities that involve repetitive stress on the spine may contribute to disc degeneration. This includes jobs that require heavy lifting, bending, or prolonged sitting.

Smoking:

Smoking is considered a risk factor for degenerative disc disease. It has been associated with accelerated disc degeneration, possibly due to its impact on blood supply and nutrient delivery to the intervertebral discs.

Obesity:

Excess body weight places additional stress on the spine, particularly the lumbar region. This increased mechanical load can contribute to the degeneration of intervertebral discs.

Poor Posture:

Incorrect body mechanics, poor posture, and inadequate ergonomics may contribute to spinal stress and increase the risk of degenerative disc disease.

Lack of Exercise:

Physical activity is crucial for maintaining spinal health. Lack of exercise can lead to weakened muscles, reduced flexibility, and poor circulation, all of which may contribute to disc degeneration.

Spinal Instabilities:

Conditions that cause instability in the spine, such as spondylolisthesis or other structural abnormalities, may contribute to accelerated disc degeneration.

Symptoms of Degenerative Disc Disease

The following are the symptoms of Degenerative Disc Disease:

1. Chronic Back Pain:

One of the hallmark symptoms of degenerative disc disease is chronic back pain. The pain is often localized to the affected region of the spine, commonly in the lumbar (lower back) or cervical (neck) areas. This pain may persist over an extended period and may vary in intensity.

2. Pain with Movement:

Individuals with degenerative disc disease often experience increased pain with certain movements. Activities such as bending, lifting, or twisting may exacerbate the pain. The discomfort can interfere with daily activities and reduce overall mobility.

3. Numbness and Tingling:

When degenerated discs compress spinal nerves, individuals may experience symptoms such as numbness and tingling. These sensations can radiate into the extremities, affecting the legs in cases of lumbar involvement or the arms in cases of cervical involvement.

4. Muscle Weakness:

Degenerative disc disease can lead to muscle weakness in the affected area. Weakness may result from nerve compression or irritation, impacting the ability to perform certain physical tasks and leading to a loss of muscle tone.

5. Pain Relief with Rest:

Some individuals with degenerative disc disease find relief from pain when at rest or lying down. However, this relief may be temporary, and the pain may return upon resuming activities or movement.

6. Pain Aggravation with Sitting:

Sitting for prolonged periods can worsen the symptoms of degenerative disc disease, particularly in the lumbar spine. Individuals may experience increased discomfort and stiffness, making prolonged sitting sessions challenging.

7. Stiffness in the Morning:

Many people with degenerative disc disease report stiffness and discomfort in the morning, which may improve as they move and engage in daily activities. Morning stiffness is a common characteristic of spinal conditions, including DDD.

8. Reduced Range of Motion:

As the intervertebral discs degenerate, the spine’s flexibility and range of motion may be compromised. This can result in a reduced ability to bend, twist, or turn, limiting overall physical activity.

9. Changes in Posture:

Individuals with degenerative disc disease may unconsciously alter their posture to minimize pain. This can lead to changes in the curvature of the spine, potentially causing additional strain on surrounding structures.

10. Pain Management Challenges:

Managing pain associated with degenerative disc disease can be challenging. Individuals may find that traditional pain management methods, such as over-the-counter medications or physical therapy, provide only temporary relief, necessitating a comprehensive approach to care.

Diagnosis of Degenerative Disc Disease

The diagnosis of degenerative disc disease (DDD) typically involves a comprehensive evaluation by a healthcare professional. The process may include the following steps:

1. Medical History:

The healthcare provider will begin by taking a detailed medical history. They will inquire about the patient’s symptoms, including the location, duration, and intensity of pain, as well as any factors that worsen or alleviate the symptoms.

2. Physical Examination:

A physical examination is conducted to assess the patient’s range of motion, flexibility, and neurological function. The healthcare provider may check for signs of muscle weakness, numbness, or tingling in the limbs, which could indicate nerve compression.

3. Imaging Studies:

To visualize the spine and assess the condition of the intervertebral discs, imaging studies are often ordered. Common imaging modalities include:

X-rays:

These provide detailed images of the bones and can help identify changes in disc height, bone spurs, or other degenerative changes.

MRI (Magnetic Resonance Imaging):

This imaging technique provides detailed pictures of the soft tissues in the spine, including the intervertebral discs, nerves, and surrounding structures. It is particularly useful for evaluating disc degeneration and identifying nerve compression.

CT (Computed Tomography) Scan:

CT scans can provide detailed cross-sectional images of the spine and are often used to assess bony abnormalities and the extent of degenerative changes.

4. Discography:

Discography is a diagnostic procedure that involves injecting a contrast dye into the intervertebral discs to identify specific discs that may be a source of pain. This procedure is typically reserved for cases where the diagnosis is unclear, and other imaging studies do not provide conclusive information.

5. Bone Scans:

Bone scans may be used to identify areas of increased bone activity, which can indicate changes in the spine associated with degenerative disc disease.

6. Neurological Evaluation:

In cases where nerve compression is suspected, a neurological evaluation may be performed to assess reflexes, muscle strength, and sensory function.

7. Blood Tests:

While blood tests are not typically used to diagnose degenerative disc disease directly, they may be conducted to rule out other conditions that could contribute to symptoms, such as inflammatory arthritis.

8. Pain Provocation Tests:

Certain maneuvers or positions may be used to provoke or reproduce symptoms, helping the healthcare provider identify the specific source of pain.

Degenerative disc disease (DDD) can lead to various complications, affecting an individual’s quality of life and daily functioning. Some of the potential complications include:

1. Chronic Pain:

Persistent and chronic pain is a common complication of degenerative disc disease. The pain can be localized in the affected area of the spine (such as the lower back or neck) and may significantly impact daily activities and overall well-being.

2. Reduced Mobility and Functionality:

As degeneration progresses, individuals with DDD may experience a gradual reduction in their range of motion and overall functionality. This can limit their ability to perform routine tasks, participate in physical activities, and maintain an active lifestyle.

3. Nerve Compression:

Degenerated discs can compress nearby spinal nerves, leading to symptoms such as numbness, tingling, and muscle weakness. In more severe cases, nerve compression can result in conditions like sciatica (compression of the sciatic nerve) in the lumbar spine.

4. Loss of Spinal Stability:

Advanced degeneration of intervertebral discs can contribute to the loss of spinal stability. This may result in conditions like spondylolisthesis, where one vertebra slips forward over another, potentially causing instability, pain, and further complications.

5. Impact on Daily Activities:

The chronic pain and reduced mobility associated with degenerative disc disease can make it challenging for individuals to engage in everyday activities, such as walking, standing, sitting for extended periods, or lifting objects.

6. Psychological Impact:

Living with chronic pain and physical limitations can have a significant psychological impact. Individuals with degenerative disc disease may experience stress, anxiety, depression, and a reduced overall quality of life.

7. Decreased Quality of Sleep:

Persistent pain and discomfort may interfere with sleep, leading to sleep disturbances or insomnia. Poor sleep quality can exacerbate other symptoms and contribute to a cycle of increased pain and reduced well-being.

8. Medication Side Effects:

The use of medications for pain management, such as analgesics or anti-inflammatory drugs, may be associated with side effects. Long-term use of certain medications can have implications for overall health, and patients may need to manage potential side effects.

9. Dependency on Pain Medication:

In some cases, individuals with degenerative disc disease may develop a dependency on pain medication if they rely on these drugs for long-term pain management. This dependency can have its own set of health concerns.

10. Impact on Mental Health:

Living with chronic pain and physical limitations can contribute to mental health challenges, including stress, anxiety, and depression. Addressing the psychological aspects of degenerative disc disease is an important component of comprehensive care.

Risk Factors of Degenerative Disc Disease

Several risk factors can contribute to the development of degenerative disc disease (DDD). While some factors are beyond an individual’s control, others may be influenced by lifestyle choices. Common risk factors include:

1. Age:

• Increased Risk: Aging is a primary risk factor for DDD. The natural wear and tear on intervertebral discs over time can contribute to degeneration.

2. Genetics:

• Increased Risk: There is a genetic component to disc degeneration. If there is a family history of DDD, individuals may have a higher predisposition to developing the condition.

3. Occupational Factors:

• Increased Risk: Jobs that involve repetitive lifting, bending, twisting, or other activities that strain the spine can increase the risk of disc degeneration.

4. Smoking:

• Increased Risk: Smoking has been associated with an increased risk of disc degeneration. It may affect the blood supply to the discs, limiting their ability to receive nutrients and recover from wear and tear.

5. Obesity:

• Increased Risk: Excess body weight puts additional stress on the spine, particularly in the lumbar region. This increased mechanical load can contribute to disc degeneration.

6. Inactivity:

• Increased Risk: Lack of regular physical activity can contribute to weakened muscles, reduced flexibility, and poor circulation, all of which may contribute to disc degeneration.

7. Trauma or Injury:

• Increased Risk: Past injuries or trauma to the spine, such as from accidents or falls, can accelerate the degenerative process.

8. Poor Posture:

• Increased Risk: Incorrect body mechanics, poor posture, and inadequate ergonomics may contribute to spinal stress and increase the risk of degenerative disc disease.

9. Gender:

• Varied Risk: Some studies suggest that men may be at a slightly higher risk for disc degeneration than women, but the overall impact of gender as a risk factor is not fully clear.

10. Genetic Factors:

• Increased Risk: Certain genetic factors may contribute to the development of degenerative disc disease. These factors can influence the composition and structure of the intervertebral discs.

11. Occupation:

• Increased Risk: Jobs that involve frequent heavy lifting, bending, or twisting may increase the risk of disc degeneration. Occupations with whole-body vibration, such as truck driving, may also be associated with an elevated risk.

12. Spinal Abnormalities:

• Increased Risk: Pre-existing spinal conditions or abnormalities, such as scoliosis or spinal instability, may increase the likelihood of disc degeneration.

13. Bone Density:

• Varied Risk: Some research suggests that low bone density may be associated with an increased risk of disc degeneration, but the relationship is complex and not fully understood.

Treatment of Degenerative Disc Disease

The treatment of degenerative disc disease (DDD) aims to manage symptoms, improve function, and enhance the individual’s overall quality of life. Treatment approaches for DDD can vary depending on the severity of symptoms, the specific affected area of the spine, and the individual’s overall health. Here are common treatment options:

1. Conservative Measures:

Physical Therapy:

Physical therapy can help strengthen the muscles supporting the spine, improve flexibility, and teach proper body mechanics. Therapists may also use modalities such as heat, ice, and ultrasound for symptom relief.

Pain Management:

Over-the-counter or prescription medications may be used to manage pain and inflammation. This can include nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, or analgesics.

Activity Modification:

Avoiding activities that exacerbate symptoms and adopting proper body mechanics can help reduce strain on the spine.

Weight Management:

Maintaining a healthy weight can reduce the mechanical stress on the spine, potentially slowing down the progression of degeneration.

Lifestyle Modifications:

Quitting smoking and incorporating regular exercise into the routine can positively impact spine health.

2. Medications:

Pain Medications:

Over-the-counter pain relievers (e.g., acetaminophen) or prescription medications (e.g., opioids) may be used for pain management.

Anti-Inflammatory Medications:

NSAIDs, such as ibuprofen or naproxen, can help reduce inflammation and alleviate pain.

Muscle Relaxants:

These medications may be prescribed to relieve muscle spasms and improve overall comfort.

3. Physical Interventions:

Epidural Steroid Injections:

In some cases, corticosteroid injections into the epidural space around the affected nerves may provide temporary relief from pain and inflammation.

Facet Joint Injections:

These injections target specific joints in the spine and may help relieve pain associated with degenerative changes.

4. Exercise and Rehabilitation:

Core Strengthening Exercises:

Strengthening the core muscles can provide better support to the spine and reduce stress on the intervertebral discs.

Low-Impact Aerobic Exercise:

Activities such as swimming, walking, or stationary cycling can improve overall fitness without placing excessive strain on the spine.

5. Bracing:

Supportive Braces:

In some cases, wearing a supportive brace may help stabilize the spine and alleviate symptoms during certain activities.

6. Complementary Therapies:

Chiropractic Care:

Spinal adjustments performed by chiropractors may help some individuals manage symptoms.

Acupuncture:

Some people find relief from DDD-related pain through acupuncture, an alternative therapy involving the insertion of thin needles into specific points on the body.

7. Surgical Interventions:

Discectomy:

Surgical removal of part or the entire damaged disc to relieve pressure on nerves.

Spinal Fusion:

Joining two or more vertebrae together to stabilize the spine and reduce pain.

Artificial Disc Replacement:

Replacement of the damaged disc with an artificial implant to maintain motion in the spine.

Surgery is usually considered when conservative measures fail to provide relief, and symptoms significantly impact the individual’s quality of life.

Prevention of Degenerative Disc Disease

While degenerative disc disease (DDD) is a natural part of the aging process, certain lifestyle choices and habits may help reduce the risk of developing or slow down the progression of DDD. Here are some preventive measures:

1. Maintain a Healthy Weight:

• Reasoning: Excess body weight places additional stress on the spine, particularly in the lumbar region.
• Action: Adopt a healthy diet and engage in regular physical activity to maintain an appropriate weight.

2. Exercise Regularly:

• Reasoning: Regular exercise helps strengthen the muscles supporting the spine, improves flexibility, and promotes overall spine health.
• Action: Include low-impact aerobic exercises, such as walking, swimming, or cycling, and incorporate core-strengthening exercises into your routine.

3. Practice Proper Body Mechanics:

• Reasoning: Using proper body mechanics when lifting, bending, or carrying heavy objects reduces the risk of spine strain and injury.
• Action: Lift with your legs, keep the object close to your body, and avoid twisting while lifting.

4. Avoid Smoking:

• Reasoning: Smoking has been linked to an increased risk of disc degeneration, likely due to its impact on blood supply to the intervertebral discs.
• Action: If you smoke, consider quitting. Seek support from healthcare professionals or smoking cessation programs.

5. Maintain Good Posture:

• Reasoning: Poor posture can contribute to spinal stress and increase the risk of degenerative disc disease.
• Action: Be mindful of your posture, especially when sitting for extended periods. Use ergonomically designed furniture and make adjustments to your workspace as needed.

6. Stay Hydrated:

• Reasoning: Proper hydration is essential for maintaining the water content of intervertebral discs, which act as shock absorbers.
• Action: Drink an adequate amount of water throughout the day to support overall spine health.

7. Engage in Regular Stretching:

• Reasoning: Stretching helps maintain flexibility and prevents muscle tightness that can contribute to spinal stress.
• Action: Incorporate stretching exercises into your daily routine, focusing on areas such as the hamstrings, hip flexors, and lower back.

8. Use Ergonomic Furniture:

• Reasoning: Ergonomically designed furniture and tools can help maintain proper body alignment and reduce strain on the spine.
• Action: Choose chairs, desks, and other furniture that support good posture and provide adequate lumbar support.

9. Limit Prolonged Sitting:

• Reasoning: Prolonged sitting can contribute to disc compression and stiffness in the spine.
• Action: Take breaks to stand, stretch, and move around regularly, especially if you have a desk job.

10. Manage Stress:

• Reasoning: Chronic stress can contribute to muscle tension and exacerbate symptoms of degenerative disc disease.
• Action: Practice stress-reducing techniques such as meditation, deep breathing exercises, or yoga.

11. Regular Health Checkups:

• Reasoning: Regular checkups with healthcare professionals can help identify and address potential risk factors for degenerative disc disease.
• Action: Schedule routine health checkups and screenings to monitor your overall health and well-being.

Frequently Asked Questions

Is Degenerative Disc Disease Hereditary?

• Yes, to some extent:
  • There is a genetic component to DDD.
  • A family history may increase the likelihood, but it’s not guaranteed.

Degenerative Disc Disease Therapies

• Various therapies are available:
  • Physical therapy to strengthen muscles.
  • Pain management with medications.
  • Injections for targeted relief.
  • Surgical options in severe cases.

Cervical Degenerative Disc Disease

• Affects the neck region:
  • Common in the cervical spine (neck).
  • Symptoms may include neck pain, stiffness, and radiating arm pain.

What Is the Best Pain Relief for Degenerative Disc Disease?

• Depends on the individual:
  • Medications like NSAIDs, muscle relaxants.
  • Physical therapy for strengthening.
  • Injections or surgery in severe cases.

Degenerative Disc Disease Self-Care

• Self-care is crucial:
  • Maintain a healthy weight.
  • Exercise regularly with low-impact activities.
  • Practice good posture and body mechanics.
  • Avoid smoking and manage stress.

Exercises for Degenerative Disc Disease

• Beneficial exercises include:
  • Low-impact activities like walking, swimming.
  • Core-strengthening exercises.
  • Gentle stretches to improve flexibility.

How I Cured My Degenerative Disc Disease

• Curing is subjective; managing is realistic:
  • Share personal experiences.
  • Emphasize a multidisciplinary approach.
  • Encourage consulting healthcare professionals for tailored advice.

Medically Reviewed by Dr. Ramesh Gaddam, MD

General Physician, Diabetologist, and Critical Care Specialist.