Degenerated discs are a common back problem. The spinal discs, soft, gelatinous cushions that separate the vertebrae, normally wear down during the aging process. Because the discs typically function as shock absorbers between the bones, allowing the spine to bend and twist, this deterioration, when extreme, can result in serious back pain. When degeneration occurs, some of the rubbery disc is worn away and the amount of room between the vertebrae gets smaller. As the disc space narrows, joints are placed under greater stress, resulting in further degeneration.
Risk Factors for Degenerated Discs
Although discs degenerate to a degree because of normal aging, there are risk factors that increase the likelihood of symptomatic disc degeneration. These include:
- Repeated heavy lifting
- Acute injury of the back
- Bone spurs
Symptoms of Degenerated Discs
The compression of the spinal nerves can cause symptoms that include tingling and numbness, muscle weakness, loss of balance or coordination problems and pain and stiffness. The back pain experienced is often worse when sitting, lifting, bending or twisting. Walking or lying down will typically help alleviate the pain.
Diagnosis of Degenerated Discs
In order to diagnose a degenerated disc, the doctor will take a medical history and perform a comprehensive physical examination, including a check for numbness or weakness and a test of reflexes to determine whether any muscular atrophy has taken place. Several imaging examinations may also be administered, including: X-rays are required to assess spine alignment, MRI scans to observe any compression of the spinal cord, and CT scans to evaluate the size of the spinal canal and visualize any bone spurs. A myelogram, which uses contrast dye for improved visualization during X-rays or CT scans, may also be administered.
Complications of Degenerated Discs
Degenerated discs can occur anywhere along the 26 vertebrae of the spine, but take place most frequently in either the lumbar region (lower back) or the cervical region (neck). In addition to resulting in pain, degenerated discs can result in complications including:
- Herniation or rupture of a disc
- Spinal stenosis, a narrowing of the spinal canal
- Bone spurs
Unfortunately, any of these complications may worsen the patient's condition.
Treatment of Degenerated Discs
In many cases, nonsurgical options can provide a patient with relief from a degenerated disc. Bed rest and anti-inflammatory medications may help decrease swelling and pain. If the affected disc is in the cervical region of the spine, a soft collar can limit the range of motion and alleviate the pressure on nerve roots. Physical therapy may be recommended to stretch and strengthen the muscles of the abdomen, back and possibly the neck. Epidural Injection of corticosteroids can help to reduce swelling and may greatly relieve pain in the affected area.
A relatively new form of minimally invasive treatment is intradiscal electrothermal therapy, during which a catheter with a heating coil is inserted through a needle into the affected disc. The heat strengthens the collagen fibers that hold the disc together, strengthening tissue while also destroying excess nerve fibers. Intradiscal electrothermal therapy is often successful in decreasing damage and pain.
If the patient's back pain does not respond to these conservative treatments, surgical intervention may be required. Several possible procedures may be considered to resolve the problem. If the disc has become herniated or ruptured and is pressing on a nerve, a discectomy may be required to remove the disc entirely. The removed disc may be replaced by a synthetic disc that can restore shock absorption and improve mobility between vertebrae. In more severe cases, spinal fusion surgery may be recommended. This involves removing the disc and fusing the nearby vertebrae to increase stability in that region of the spine.