CNY Orthopedic Sports Medicine, PC: Injury: Degenerative Disc Disease

Injuries and Conditions: Back & Spine: Degenerative Disc Disease

Overview
Degenerative disc disease is a condition of advancing age, and/or the result of the development of post-traumatic arthritis. This process is a deterioration or change in the consistency of the intervertebral disc, caused by a loss of water content in the disc (discs are 80% water) and a decrease in the height of the involved intervertebral disc. As a disc degenerates, it will lose height and supporting ligaments become loose. An increase in the motion of the spine as seen with twisting or sliding of one vertebrae or another creates tears in the vertebral ligaments and in the outer fibrous ring disc (annulus).
  • The disc is one of the first structures in the musculoskelatal system to be affected by degenerative changes.
  • Degeneration of a disc results in instability and an increase in the amount of motion between contiguous vertebrae. This increase in motion may cause one vertebrae to slip forward on vertebrae below. This slip of the disc is known as degenerative spondylolisthesis.
  • The low back (lumbar spine) and the neck (cervical spine) are the regions of the spine most frequently affected by degenerative changes in the disc.
  • An orthopedic surgeon diagnoses degenerative disc disease after completion of a detailed history and physical examination. The exam may also include imaging tests to confirm the diagnosis.


  • Signs and Symptoms
  • Symptoms usually develop slowly and gradually increase in intensity, although a single traumatic event may trigger the onset of persistent symptoms.
  • Pain is centered in the midline of the back, and may be associated with bending, lifting, stooping and twisting.
  • Pain is greater when sitting or standing than when lying down. Finding a comfortable position while sitting or standing may be difficult.
  • Pain will often radiate to the buttocks, pelvis, back of the hips and thighs, but will not radiate down the leg farther than the knee.
  • If compression of a nerve or the spinal cord is involved, symptoms may include a tingling sensation, numbness, and/or weakness in one or both legs.


     
  • Contact the Doctor if ...
  • Any of the signs and symptoms of degenerative disc disease or nerve compression are present.
  • Pain or weakness significantly increase, or if bowel and bladder dysfunction are present at any time.
  • Unexplained symptoms appear, or unexpected side effects are experienced from over the counter or prescription medications.


  • Common Causes of Injury
  • Degenerative changes associated with the aging process, result in the lose of water content and weakening of the disc. This weakening can cause the outer layer of the disc (the annulus fibrosus) to tear and allow for the extrusion of or herniation of the softer, central portion of the disc. A tear in the outer annulus fibrosus or supporting ligaments can be very painful.
  • Occupational activities can place a high level of pressure on the spine over an extended period of time. These activities may involve repetitive lifting of heavy objects and repetitive activities while standing (assembly line work).
  • Activities which repetitively place stress on the back includes sports such as soccer, golf, and tennis.
  • Traumatic injury to the spine that results in the development of post-traumatic arthritis.
  • Pre-existing conditions/ diseases of the spine which pre-dispose the spine to degenerative changes.


  • Expectations of Recovery
  • Recovery from degenerative disc disease, is dependent on the understanding of the condition and the realistic expectations of the patient. Through therapy and the use of pain management techniques, the symptoms may be controllable with non-surgical methods.
  • The goal of non-surgical treatment is to relieve pain and provide the patient with the ability to participate in normal daily activities, commonly referred to as ADL (Activities of Daily Living).


     

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