Disc Degeneration: Common, Yet Misunderstood

While degenerative disc disease (DDD) is a tremendously frightening term, it is an overwhelmingly common spine condition. Its prevalence correlates roughly with age, insofar that 40 percent of people qualify for DDD at the age of 40, and about 80 percent qualify at 80. Nearly all of us eventually struggle with DDD if we live long enough – and the leading cause is, simply put, time itself.

Our bodies deteriorate over time, through so-called “wear and tear.” We can slow this deterioration through certain habits and protective factors. There are factors outside of our control – such as individual activities, where we were born, what we ate, and genetics – that help determine the severity and timing of disc degeneration.

However, it is usually a slow and gradual process, not one typically accompanied by overwhelming pain or debilitating symptoms. While DDD is technically a disease, it is more accurate to describe it as a natural consequence of aging. An additional risk factor that may exacerbate or help explain certain nerve and soft tissue pain in the back.

Understanding Disc Degeneration and DDD

The diagnosis of DDD involves the health of our intervertebral discs. These are fluid-filled sacs that act as shock-absorbing cushions between the rigid, bony joints that make up our spine, and they are there from birth, starting very soft and watery and gradually becoming more challenging and drier with age. At a certain point, increased pressure and stress eventually causes these discs to become thinner and more brittle, and thus more prone to injury or damage.

If at least one of our discs qualifies as “deteriorated,” to the point that it causes pain symptoms in the surrounding area, we have degenerative disc disease. It is essential to note the difference between a degenerating disc and degenerative disc disease. You can have a deteriorated or degenerated disc but no pain. Nearly 90 percent of men and women may experience disc degeneration after age 50. However, only once symptoms present themselves is that it requires a medical diagnosis and appropriate treatment. The lower back and neck are the most common areas of disc degeneration.

As a result, neck, arm, buttock, and leg pain are some of the most common symptoms of degenerative disc disease. Once a disc is considered deteriorated through aging and injury, it cannot readily repair itself. There’s relatively little blood flow to the disc. However, there’s also little innervation – which means the actual deterioration does not hurt. Instead, it’s because their lack of support leads to the development of other issues in the area, including inflammation, nerve compression, or the mechanical consequences of an unstable and shifting spinal column, leading to peripheral nerve pain, among other problems.

Not Necessarily a “Disease”

The textbook definition of a disease is a “disorder of structure or function,” one that produces symptoms and usually is not immediately tied to an injury (though it might correlate with one). However, when we think of diseases, we tend to think of infectious or contagious illnesses or conditions that occur because of lifestyle choices or genetic predisposition.

Degenerative disc disease does not discriminate and occurs in most of us as we age, even if there are factors that exacerbate or protect against it. That does not mean it spells doom for the diagnosed patient or immediately describes incurable back pain. On the contrary, the diagnosis of DDD can often lead to treatment that significantly reduces or eliminates pain and dramatically improves patients’ quality of life. While aging is still inevitable, there are plenty of ways to make it more comfortable.

Degenerative, But Not Progressive

The degeneration described in DDD refers to the status of the intervertebral disc – not the disease itself. As people become more aware of progressive disorders, the idea of a degenerative illness evokes similar fears – but they are two vastly different concepts. A progressive illness or disease is a condition that continues to become worse over time.

Unlike remitting or relapsing infections, wherein symptoms come and go, progressive diseases usually involve continuous deterioration. Examples include ALS, cystic fibrosis, and Alzheimer’s. DDD is not a progressive disease in this sense. While it is inevitable and cannot reverse aging, symptoms do come and go in many cases.

Furthermore, there are ways to either eliminate pain symptoms or address severe issues with artificial discs or spinal fusion solutions. Thankfully, surgery is very rarely warranted or necessary, and most cases of degenerative disc disease can be treated effectively without the need for an invasive procedure.

DDD Can Be Treated Without Surgery

There are certainly cases where a person’s discs have been damaged to the point that they cannot lead a pain-free life without more severe intervention. In other cases, surgery is warranted because the lack of stability in the spine due to disc degeneration significantly puts the patient at risk of paralysis or severe pain in the future. But in most cases, pain caused by degenerative disc disease can be managed through:

• Physical therapy. As our shock-absorbers fail, it is essential to develop the means to compensate for them. Stronger muscles can protect the spine from excess stress, and exercise can lead to fat loss, which further takes a load off the spine. Improper form or excessive loads can also damage the discs; however, so caution and an appropriate exercise program are advised.
• Non-opioid painkillers. Non-steroidal anti-inflammatory drugs may help when the pain is caused by inflammation after a disc has become herniated or begun bulging. Inflammation leads to swelling, which can lead to peripheral nerve pain. Bringing the swelling down can reduce symptoms.
• Nerve blocks. Another way to combat severe or acute pain after a disc injury is through a nerve block. This is a non-invasive treatment wherein a doctor injects a corticosteroid or an anesthetic into the area around the injured or deteriorated disc. The relief can last anywhere from a few hours to a few days.

Degenerative disc disease may be one of the “perks” of aging. It can often be managed through medication, exercise, and effective home remedies whenever pain flares up, from hot-and-cold therapy to active rest and stretching. However, if your condition is accompanied by sharp, severe, or chronic pain, you will want to consider other, more invasive treatment options. Be sure to discuss your options with your doctor and ask for individual advice.