Degenerative disc disease is an age-related condition where intervertebral discs lose their structural integrity, leading to pain and dysfunction.
It is more common in older adults as repetitive stress contributes to the loss of mechanical integrity of discs, leading to inflammation which can cause both local and referred pain. Disc degeneration may lead to tearing of the outer disc layer and the inner gel-like nucleus pulposus extruding into the spinal canal, placing pressure on adjacent nerves, leading to inflammation and a variety of symptoms. Furthermore osteoarthritis of the joints in the spine (facet joints) combined with degenerate discs can lead to slippage and rotation of adjacent vertebrae, which can cause curvature of the spine. This is known as scoliosis or may be described as adult spinal deformity.
What are the symptoms of degenerative disc disease?
Symptoms of degenerative disc disease can vary, but they typically include chronic back pain that may worsen with movement or prolonged sitting and relief with rest. Some individuals may experience radiating pain, numbness, or muscle weakness if degenerative changes cause compression of nerves in the spinal canal.
How is degenerative disc disease diagnosed?
Following a thorough clinical assessment, you will be referred for an XR and possibly other imaging which may include an MRI scan or CT. This will demonstrate the degree of disc degeneration, any associated spinal deformity, and the presence of nerve compression.
What are the treatment options for degenerative disc disease?
Management is bespoke and depends upon the severity of the condition. Non operative treatment includes physical therapy, anti-inflammatory and anti-neuropathic medications, and lifestyle modifications. In some cases, epidural steroid injections may be used to manage symptoms.
Surgical treatment depends upon the key symptoms and structural causes. Smaller surgical interventions such as microdiscectomy and decompression may help to relieve pain caused by pressure on nerves. Slippage or rotation of adjacent vertebrae may need to be realigned and stabilised in order to restore the natural shape of the spine. This is typically achieved by performing fusion surgery, by placing screws and rods into the spine, removing the intervertebral disc and replacing it with a fusion ‘cage’. There are several different ways to achieve this, explained under spinal fusion surgery in the ‘treatments’ section.
