Degenerative disc disease: Causes and treatment
What Is Degenerative Disc Disease?
In degenerative disc disease (DDD), the discs that separate your spine's bones, or vertebrae, start to breakdown, or degenerate. The discs provide cushion between the vertebrae, absorb shock, and allow your spine to bend. When they start to break down, you can experience back pain along with other symptoms.
DDD can occur in any area of the spine, but the condition is most common in the cervical (top) and lumbar (bottom) sections. Your symptoms may vary based on where the breakdown is occurring on your spine.
Depending on the severity of symptoms, DDD can cause disability and significantly impact your daily life. However, a variety of treatment methods have been shown to improve symptoms.
The most common symptom associated with DDD is pain. This pain can come and go, or it can be long-lasting, or chronic. You might feel pain in your back or neck, especially when you sit down, bend, twist, or lift items.
In some cases, the degenerated disc will slip out of place in the spine (herniate) and press against your nerves. This can cause pain, weakness, or numbness in your back, arms, or legs. It can also lead to sciatica, or pain that travels from your lower back down your leg.
Over time, DDD may lead to more severe symptoms, including:
Each part of your spine may be at different stages of degeneration at once, which can impact your symptoms. For example, if the degeneration is happening in the lumbar section of your spine, you may only feel pain in your lower back.
DDD occurs when the discs that separate your spine's bones start to breakdown, or degenerate. Aging is the most common cause of the condition as disc degeneration is a natural symptom of your body getting older.
As you age, your discs can dry out and begin to break down. Most people over the age of 40 experience some degeneration. However, not all people who have degeneration experience pain.
You can also experience DDD due to injury from sports or daily activities. When a disc tears, it can't repair itself, so it may be more likely to break down.
Risk FactorsSome social and environmental factors such as smoking or working in jobs that require heavy lifting may play a role in the onset of DDD, but genetic factors likely have a bigger impact.
Research shows variations in certain genes, such as genes that control collagen production and the immune response, may make some people more likely to develop DDD than others.
Collagen strengthens connective tissues including skin, bone, cartilage, tendons, and ligaments. It contributes to the structure of discs in the spine and helps make them more stable. A lower production of collagen could make the discs more likely to slip or breakdown.
People with more reactive immune systems may be more likely to experience inflammation and dehydration of the spinal discs.
A healthcare provider can use several tests to diagnose DDD, many of which help rule out similar conditions that might be causing your symptoms.
Your healthcare provider may prescribe one or a combination of the following tests:
Treatment for DDD may consist of a range of methods, including:
If you have DDD, your treatment plan may include care from several healthcare professionals, including but not limited to:
Since DDD can cause disability and impact daily life, you may find seeking mental health care is beneficial to your overall well-being. Specifically, therapists trained in cognitive behavioral therapy (CBT) can help you cope and adjust to life changes.
Many causes of degenerative disc disease cannot be prevented. However, making certain lifestyle changes may help reduce symptoms and prevent flares.
Your healthcare provider may recommend:
These changes have been shown to provide additional improvements in quality of life for people with DDD when used in combination with treatment methods above.
There are several conditions associated with DDD, some of which may make it more likely for you develop DDD. These include, but are not limited to:
Many of the lifestyle changes for preventing flares of DDD overlap with lifestyle changes for managing and preventing these related conditions.
People with DDD can experience pain and limited mobility that can make it difficult to accomplish daily tasks. The condition may worsen with age, although the rate at which disc degeneration progresses can be unpredictable.
However, with a comprehensive treatment plan, people with DDD can lead a healthy life. Treatments like physical therapy and medications can help maintain mobility and manage pain. Getting mental health care and implementing lifestyle changes can help you cope and improve your quality of life.
In addition, new research on biological therapies shows promise. Researchers are looking for improved ways of treating the pain associated with DDD to offer more treatment options in the future.
How Are Osteoporosis And Degenerative Disc Disease Related?
Osteoporosis is a loss of bone density. Degenerative disc disease is the wearing down of a disc in your spine. Degenerative disc disease may be more common in people with osteoporosis.
Osteoporosis is when your bone density is lower than typical. It's very common, especially in women older than 50 years of age. It's estimated that about 6% of men and 21% of women older than 50 years of age worldwide have osteoporosis.
Degenerative disk disease (DDD) is the breakdown of the soft disk between each of your vertebrae. It's also very common, and it's estimated that about 400 million people receive a diagnosis of a degenerative disk each year worldwide.
Some evidence suggests that osteoporosis may be associated with an increased risk of DDD. Read on to learn more about the connection.
Osteoporosis is a loss of bone mineral density that puts you at risk of bone fracture. About 70% of your bones are made up of minerals, primarily calcium and phosphorous.
Your body is constantly breaking down and building new bone tissue. Osteoporosis develops when your body breaks down bone faster than it builds it.
DDD is the breakdown of the disks between your vertebrae. These disks help absorb force on your spine and provide space for nerves to exit your spinal cord.
It's normal for your disks to wear down with age. Estimates vary, but DDD has been reported in upwards of 35% of people who are 20 years old and 95% of people who are 80 years old.
Your spinal disks help transmit force between your vertebrae. The part of your vertebrae that contacts your disks are called the endplates. These endplates supply your disks with essential nutrients.
Whether osteoporosis increases the risk of disk degeneration remains debated. Theoretically, osteoporosis may weaken your endplates and compromise the ability of your disks to get nutrients.
In a 2019 study, researchers found a significant correlation between osteoporosis and endplate damage in 156 people with DDD. According to the researchers, their study shows the first evidence linking osteoporosis and endplate damage in human subjects.
Here's a look at some of the differences between osteoporosis and DDD.
Osteoporosis and DDD are both largely silent, meaning that they often don't cause symptoms.
OsteoporosisOsteoporosis usually doesn't cause symptoms unless you fracture a bone. Spinal fracture might cause:
Learn more about osteoporosis symptoms.
Degenerative disc diseaseMany people with evidence of DDD on imaging don't have symptoms. When symptoms do appear, they usually occur due to pinching of the nerve root.
Symptoms may include:
Treatment options for osteoporosis and DDD include the following.
Osteoporosis treatmentMedications are the primary treatment for osteoporosis. The main prescription medications used as treatment for osteoporosis are bisphosphates. These medications slow your rate of bone breakdown.
Bisphosphates include:
Other prescription medications for osteoporosis include:
Nonprescription treatments for osteoporosis include things like:
Learn more about osteoporosis treatment.
Degenerative disc disease treatmentDDD doesn't usually need treatment unless you have symptoms. Treatment may include:
If these treatments aren't effective, a doctor may recommend an artificial disk replacement.
Osteoporosis often has good outcomes if found early. It can lead to chronic pain, problems with your posture, and reduced quality of life if you develop fractures.
Many people with DDD don't have symptoms or can manage their symptoms with home treatment. Some people may need surgery to reduce chronic pain.
Here are some frequently asked questions people have about osteoporosis and DDD.
How can I prevent osteoporosis?Ways you can prevent osteoporosis include:
You may be able to slow the progression of DDD by:
Approximately 10 million people older than 50 years of age in the United States have DDD. Studies have reported that more than 60% of people older than 40 years of age have signs of DDD.
Osteoporosis and DDD are both common. Osteoporosis is when your bone mineral density drops lower than normal. DDD is when one or more of the disks between your vertebrae start to break down.
Some evidence suggests that osteoporosis may increase your risk of DDD by damaging the endplates of your vertebrae. Researchers are continuing to examine the connection.
A Comprehensive List Of Conditions Secondary To Lower Back Pain
Lower back pain can contribute to many other physical and mental health conditions. Complications may depend on the cause of the back pain but include pain in other areas, arthritis, depression, and sleep issues.
Lower back pain is one of many common conditions that can result from physically demanding professions such as military service. There are many possible secondary conditions that can occur if you don't properly treat or manage your lower back pain.
Read on to learn what the research says about which secondary conditions may have a link to your lower back pain.
There's a strong link between lower back pain from conditions like herniated discs or degeneration of joint tissues and severe types of arthritis that may otherwise simply happen as you age.
Osteoarthritis is especially common as a complication of injury, wear and tear, or degeneration that happens along with lower back pain and its various causes.
Experts have suggested lower back pain linked to arthritis is a factor in several secondary conditions, including insomnia and reduced mobility.
A 2021 study suggests that some specific types of long-term, untreated lower back pain can greatly increase your risk of major depressive disorder (MDD). Your risk may be higher if you experience any other disabilities or stress due to financial hardship.
Lower back pain can cause erectile dysfunction (ED) in a number of different ways.
A pinched nerve from inflammation due to lower back pain and injury can reduce sensation in your genital area. This can make it harder for your penis to be properly stimulated into an erection.
Feelings of depression or lifestyle changes that result from lower back pain can also lead to ED.
Inflammation from lower back pain and injury can put pressure on the nerves around your spine, including your sciatic nerve.
When your sciatic nerve is compressed, pain can spread into your hips and legs. This kind of hip pain can worsen if you sit for long periods of time. Walking or other daily activities may also trigger it.
Myelopathy happens when you experience pain related to compression of your spinal cord. It's a possible complication of spinal injuries or degeneration in your spinal discs from injuries or arthritis.
People with lower back pain can have inflammation that results in myelopathy and increased pain from spinal compression. Even though pain might start in your lower back, the pain can spread to other parts of your spine.
Your neck and lower back are the top and bottom sections of your spine. It's understandable that pain in one area can lead to pain in the other. Low back pain can affect your posture and movement, which could lead to neck pain.
A 2018 research review identified low back pain as a common risk factor for new neck pain.
Lower back pain can make it difficult to exercise or do daily activities. Over time, your inability to exercise can lead to obesity.
Obesity can also put strain on your lower back, worsening your back pain.
Some causes of lower back pain, such as a herniated disc, can cause paralysis if left untreated.
Paralysis can start simply as tingling, numbness, or weakness in your legs along with lower back pain. These can sometimes be early symptoms of disc degeneration, herniation, or injury, which can lead to paralysis over time.
Persistent genital arousal disorder (PGAD) happens when people with vulvas experience sudden feelings of sexual arousal without any obvious stimulation or cause. This can result in uncomfortable and unwanted tingling and even nerve pain in your genitals, including your clitoris.
A 2020 case study suggests a link between lower back pain caused by an injury and PGAD, although the link isn't well understood. Treatments for lower back pain appeared to also reduce the severity of PGAD.
Plantar heel pain can result from inflammation or degeneration of the ligaments at the bottom of your foot. Back pain may alter the way you walk, putting stress on these ligaments and causing inflammation and pain.
A 2018 study found a significant link between untreated lower back pain and plantar heel pain. The researchers also suggested that treating low back pain could help improve symptoms of plantar heel pain.
Lower back pain is commonly due to nerve pain or nerve damage. It's often a result of a pinched nerve from a herniated disc or degeneration in your spinal joints.
This kind of pain can often spread from your lower back into your hips, legs, and feet.
Pain in your lower back can affect how freely your spine can move and rotate. This can cause other parts of your body to compensate for the loss of freedom of motion. Your shoulder muscles often bear some of this responsibility, which may lead to overexertion.
A 2021 research review noted a link between chronic low back pain and sleep disorders like insomnia. Researchers also found that the worse someone's pain, the more it affected their sleep.
But the relationship also goes both ways, so the problems can build on each other. Poor sleep can often worsen back pain you already have.
Lower back pain can affect pelvic nerves that help you control your bladder. Loss of sensation or muscle weakness from lower back pain can make you feel like you have to pee a lot or lose control of your bladder function.
Lower back pain and frequent urination can sometimes indicate that you have kidney stones or a kidney infection. These conditions can also affect how often you pee or how well you can control your pee.
Lower back pain has many causes that can result in secondary conditions if the cause is left untreated.
Understanding the link between your lower back pain and other conditions that may have developed can help you get the treatment you need and the right insurance coverage for all of the conditions you're experiencing.
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