Degenerative Disk Disease

Degenerative disk disease occurs when the cushioning in your spine begins to wear away. The condition is most common in older adults. After age 40, most people experience some spinal degeneration. The right treatment can lead to pain relief and increased mobility.

Overview

What is degenerative disk disease?

Degenerative disk disease is when your spinal disks wear down. Spinal disks are rubbery cushions between your vertebrae (bones in your spinal column). They act as shock absorbers and help you move, bend, and twist comfortably. Everyone’s spinal disks degenerate over time and is a normal part of aging.

When the cushions wear away, the bones can start to rub together. This contact can cause pain and other problems, such as:

• Adult scoliosis, where the spine curves.
• Herniated disk, also called a bulged, slipped, or ruptured disk.
• Spinal stenosis, when the spaces around your spine narrow.
• Spondylolisthesis, when vertebrae move in and out of place.

How common is intervertebral disk degeneration?

Almost everyone has some disk degeneration after age 40, even if they don’t develop symptoms. It can lead to back pain in about 5% of adults.

Who might get degenerative disk disease?

Degenerative disk disease is most common in older adults. Some factors increase your risk of developing degenerative disk disease, including:

• Acute injuries, such as falling.
• Obesity.
• Biological sex, with women being more likely to experience symptoms.
• Smoking.
• Working a physically demanding job.

Symptoms and Causes

What are the symptoms of degenerative disk disease?

The most common symptoms of degenerative disk disease are neck pain and back pain. You may experience pain that:

• Comes and goes, lasting for weeks or months at a time.
• Leads to numbness or tingling in your arms or legs.
• Radiates down your buttocks and lower back.
• Worsens with sitting, bending, or lifting.

What causes degenerative disk disease?

Spinal disks wear down as a normal part of aging. Especially after age 40, most people experience some disk degeneration. However, not everyone experiences pain.

You might have pain if your spinal disks:

• Dry out: Your disks have a soft core that mostly contains water. As you get older, that core naturally loses some water. As a result, disks get thinner and don’t provide as much shock absorption as they used to.
• Tear or crack: Minor injuries can lead to small cracks in your spinal disks. These tears are often near nerves. Tears can be painful, even when they are minor. If the outer wall of your spinal disk cracks open, your disk may bulge out of place, known as a herniated disk, which may compress a spinal nerve.

What does degenerative disk pain feel like?

Degenerative disk pain:

• Can happen in the neck or lower back.
• May extend into the arms and hands or into the butt and legs.
• Can be mild, moderate, or severe.
• May start and stop.
• Can get worse after certain activities such as bending, twisting, or lifting.
• Can get worse over time.

DIAGNOSIS AND TESTS

How is degenerative disk disease diagnosed?

To diagnose degenerative disk disease, your healthcare provider may start by asking you about your symptoms. Questions may include:

• When does the pain start?
• Where do you feel pain?
• What activities cause the most pain?
• What activities decrease the pain?
• Did you have an injury or accident that led to pain?
• Do you have other symptoms, such as tingling or numbness?
• How far can you walk?

Your healthcare provider may use imaging scans such as X-ray, CT or MRI. These tests can show your healthcare provider the state and alignment of your disks. Your provider may also conduct a physical exam to check your:

• Nerve function: Your provider may use a reflex hammer to check your reactions. Poor or no reaction could mean you have damaged or compressed nerves.
• Pain levels: Your provider may touch or press on specific areas of your back to measure your pain levels.
• Strength: Muscle weakness or shrinking (atrophy) could mean you have nerve damage or degenerated disks.

MANAGEMENT AND TREATMENT

How is degenerative disk disease treated?

Usually, your healthcare provider will recommend noninvasive treatment options first. Your treatment may include:

• Physical therapy: Participating in strengthening and stretching exercises with a trained healthcare provider.
• Medications: Taking nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxers, or steroids.
• Steroid injections: Injecting medicine near your spinal nerves, disk, or joints to reduce inflammation and pain.
• Radiofrequency neurotomy: Using electric currents to burn sensory nerves and prevent pain signals from reaching your brain.

Can I treat degenerative disk disease at home?

Some people find pain relief through at-home remedies. At-home treatments may decrease pain for a short time. But they are not a long-term treatment for severely degenerated disks. You may try:

• Exercise: Low-impact activity such as walking or swimming can strengthen back muscles and relieve some pain.
• Hot and cold therapy: Alternating ice packs and heating pads every 10 to 15 minutes up to three to four times per day may reduce soreness and inflammation.
• Stretching: Gentle yoga and stretching throughout the day may improve posture and relieve tension.

Do I need surgery for degenerative disk disease?

Many patients do not need surgery for degenerative disk disease. But if you have tried multiple nonsurgical treatments and have persistent pain and/or weakness, surgery may be a good option.

Or your surgeon may use one of a few types of spinal decompression surgery:

• Diskectomy: Removing part of a spinal disk to relieve pressure on your nerves.
• Foraminotomy: Expanding the opening for your nerve roots by removing tissue and bone.
• Laminectomy: Taking out a small portion of bone from your lower spine (lamina).
• Osteophyte removal: Removing bone spurs (osteophytes).
• Spinal fusion: During this procedure, your surgeon connects two or more vertebrae to improve stability.

PREVENTION

How can I prevent degenerative disk disease?

You can prevent or slow the progression of spinal degeneration through lifestyle changes. Some of these include:

• Achieving and maintaining a healthy body weight.
• Avoiding or quitting smoking.
• Exercising regularly to increase strength and flexibility.

OUTLOOK / PROGNOSIS

What is the outlook for people with degenerative disk disease?

Many people use nonsurgical and at-home treatments to manage pain long-term. If you have mild to moderate back pain, you will need to continue treatment to keep the pain at bay.

Most people who have surgery for degenerative disk disease experience long-term pain relief. Even after surgery, you need to continue exercising and stretching to keep your back strong and healthy.

Does degenerative disk disease increase my risk for other conditions?

Degenerated disks can increase your risk of developing other spinal conditions. Common spine problems include:

• Osteoarthritis.
• Scoliosis.
• Spinal stenosis.
• Spondylolisthesis.
• Spondylolysis.