for Patients

Degenerative Disc

Overview

Your spine is made up of bones called vertebrae. They aren't fused together. Instead, they are separated by strong, flat wafers called intervertebral discs. These discs are what allow your spine to bend while also acting as shock absorbers.

As you age, your discs age too. They lose fluid, which means they aren't as flexible or as shock absorbent anymore. This also means they shrink, putting your actual spinal bones - your vertebrae - closer together. This natural aging process is called degenerative disc disease (even though it is not a disease-related condition).

The disc is made up of two main parts: the firm outer layer, and the soft inner layer. When a disc is damaged, the outer layer can tear, causing the inner layer to bulge, leak or break off and place pressure on nerves roots in the spine, which can cause pain in other areas of the body. Even if the degenerative disc does not press on any nerves, you can still experience achiness in your back or neck. 

Most often, degenerative disc disease is found in discs of the low back and the neck.

While the term "degenerative" suggests that the condition gets worse over time, this is often not the case. While discs degenerate in everyone, the pain caused by this condition can be improved and even completely resolved.   Degenerative Disc Disease is common and present in many of us even those who may have never experienced back or neck pain. 

Degenerative Discs can also cause the facets to become more painful when more pressure is put on them as the disc collapses and begins to move abnormally.  This is referred to as lumbar facet syndrome.

Causes

  • Natural aging process (can be asymptomatic)
  • Degenerative disc disease can be more common in people who smoke.
  • Degenerative disc diseases can be more common in people who often do physical labor.
  • Trauma leading to a herniated disc can lead to degenerative disc disease

Symptoms

  • Low back ache
  • Pain, numbness or weakness in other areas of the body depending in where on the spin the disc has herniated. You may experience shooting or radiating pain in your arms, leg or neck
  • Loss of bladder and/or bowel control. If you have these symptoms, seek medical help immediately your nearest Emergency Room or hospital.
  • Muscle pain
  • Muscle spasms
  • Loss of range of motion

Diagnosis

First step toward diagnosis will be a physical exam by one of our physicians. A herniated disc can also be diagnosed by X-Ray, MRI or CT scan.

Treatment

We have several methods of treating herniated discs.

  • Physical Therapy. Often, herniated discs can be treated non-surgically by strengthening the muscles of the back and core through physical therapy and exercise. This treatment also includes stretching exercises and traction that help relieve pain.
  • Medication. We may prescribe anti-inflammatory medications to reduce the pain and swelling associated with a herniated disc.
  • If physical therapy alone does not relieve the pain, cortisone injections or epidural steroid injections by our specialty trained physical medicine and rehabilitation physicians will be directed to the pinched nerve or nerves in question.  Often a series of these may help to break the pain cycle. 
  • If pain still continues and a definite identifiable problem exists then surgery may be needed.  This is usually performed as an outpatient often using minimally invasive techniques by our Board Certified Fellowship and specialty trained surgeons who have had extensive experience with all types of spinal surgeries. 
  • Some surgical options for back pain due to degenerative discs may be a minimally invasive fusion or an artificial disc replacement.