Degenerative Disc Disease (DDD)
As we age, changes in our physiology and general wear and tear can affect our spine. Your discs (the little cushions that separate the vertebrae and act as shock absorbers) are particularly vulnerable to age-related degeneration.
These discs act as spacers between the vertebra bones and help the bones of the spine deal with the pressures of walking, running, and movement. They can manage this job because they are filled with a jelly-like substance called nucleus pulposus in a very rugged disc-shaped casing.
Degenerative disc disease (DDD) is a general term used to describe these degenerative and often age-related changes in the discs. Technically, DDD is a syndrome and not a true “disease.”
What is Degenerative Disc Disease (DDD)?
Discs serve a valuable and unique purpose in the body, but if they are damaged, rupture, become brittle or misshapen, they lack the ability to repair themselves. People with DDD have discs that may have become:
Dried out (less fluid inside and less ability to absorb shock)
Flattened (providing less spacing)
Stiff (less cushioning power)
Bulging out or otherwise misshapen
Broken open (ruptured or herniated)
In some cases of DDD, the nucleus pulposus inside the disc can leak out. If this substance comes in contact with nearby nerves, it can irritate them and cause considerable pain. Since the spinal column is the “nerve center” of the body, ruptured discs are very likely to irritate nearby nerves.
Degenerative disc disease may be challenging to diagnose because the symptoms may come on gradually and be dismissed at first, particularly in seniors who expect random aches and pains as a normal part of growing older.
The pain of degenerative disc disease may be mild to severe. In some people, it is a dull ache, but in others the pain can be incapacitating. The pain is typically localized to the area affected, that is, if the degenerative disc disease occurs in the lower back, the pain will be in the lower back. In some cases, people with degenerative disc disease may find pain relief by lying down.
In more severe cases, there may be numbness, tingling, “pins and needles,” or weakness in the arms and hands or legs and feet.
By far the most common cause of degenerative disc disease is aging. Even if there is no direct damage to the disc, the stiffening and wear of tissue in all parts of the body can cause sufficient stress on the disc to cause it to flatten or microscopic tears to occur. Degenerative disc disease can also occur in response to repetitive stress on the spine.
Degenerative disc disease (DDD) of the cervical spine can also lead to cervical radiculopathy. In this case, the disc is not only damaged, but the nearby bone may start to grow bone spurs as well. These bone spurs can sometimes block or put pressure on nearby nerves. It is also possible for an injury or accident to lead to cervical radiculopathy.
Anyone can develop cervical radiculopathy, but it is more common in adults than children. Since disc disorders tend to be more common in the elderly, cervical radiculopathy is more common in seniors.
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Degenerative disc disease is usually diagnosed after a physical examination, medical history, and certain tests, which can include:
CT or MRI scan
Myelogram (a contrast scan)
The treatment of degenerative disc disease will depend greatly on your overall condition, the severity of your symptoms, the location of the problem, and your own preferences.
Conservative treatment may include bed rest, activity restrictions, and pain relievers.
Anti-inflammatory medications, physical therapy or epidural steroid injections may be recommended in some patients.
Surgery, including minimally invasive procedures, may be appropriate for certain patients.
Interventional Pain Management Treatments
VIA-Disc – This is an “off-the-shelf” injection of allogeneic disc material that has been proven in a Phase III clinical trial to repair damaged and degenerative discs.
Biacuplasty – This procedure uses a type of radiofrequency ablation (RFA) inside degeneratve discs to heal painful nerves. This is an outpatient procedure and takes just minutes to perform.
Microdiscectomy – In some cases, the inflammation in and around the affected nerves is too great for an epidural injection. In these cases, it may be necessary to remove some of the damage material around the nerve(s).
There are actually several types of surgeries that can be helpful to relieve the pain and other symptoms of degenerative disc disorders. They include:
- Minimally invasive interbody fusion
- Artificial disc replacement
Minimally invasive interbody fusion removes the damaged disc and then joins the two vertebrae together using an implantable device (the “interbody”) as a spacer and stabilizer. It can be performed with only a small incision and may be done on an outpatient basis in appropriate candidates. In other cases, the damaged disc is removed and replaced with an artificial disc to provide support and spacing. A discectomy refers to the removal of the disc which may be followed by fusion. Laminectomy is a procedure in which part of the bone of the vertebra is removed in an effort to relieve compression on the nerves.
Many people with degenerative disc disease have found relief in treatment, but not all patients are candidates for surgery.
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Our doctors at the Ainsworth Institute of Pain Management are experts in using the most cutting edge and advanced methods for treating degenerative disk disease. Call and schedule an appointment today with one of our board-certified pain management doctors and find out what treatment options would best suit your symptoms.