Degenerative disc disease (also called DDD) refers to low back pain and neck pain due to damaged spinal discs. These rubbery discs naturally wear down with age. In severe cases, the discs wear away completely.
Just because this is a natural part of aging doesn’t mean you shouldn’t seek treatment or invest in preventing DDD from worsening.
Below, I’ll talk about the symptoms, causes, diagnosis, treatments, and corrective exercises for degenerative disc disease.
What is degenerative disc disease (DDD)?
Degenerative disc disease (DDD) is a chronic inflammatory disease characterized by decreased spinal disc height, resulting in lower back (lumbar spine) pain. Routine wear and tear cause the disc between the joints to wear down over time.
The rubbery discs between the vertebrae act as shock absorbers, allowing flexing and bending. Each disc consists of an outer band called the annulus fibrosus, and an inner substance called the nucleus pulposus.
It’s important to note that degenerative disc disease isn’t a disease as it’s classically known. DDD is a condition characterized by pain that can range from nagging to debilitating.
To fully understand how DDD affects your body, let’s talk about how your joints work.
Joints are held together by tensegrity. Bones seem to float upon one another, held together by a network of ligaments, tendons, and muscles that provide equal amounts of tension. As we move, this tension allows that movement to be smooth and fluid.
Tensegrity is extremely important because joint surfaces would otherwise grind against one another. By floating on top of each other, the bones can freely move through a full range of movement.
When the space between joints decreases with age and wear and tear, this can lead to degenerative joint disease (commonly called osteoarthritis). In the lower back, this is called degenerative disc disease.
Is degenerative disc disease considered a disability? Yes, degenerative disc disease is considered a disability. DDD is one of the most common impairments for which the Social Security Administration receives disability applications.
However, receiving benefits may be difficult for DDD patients under the age of 50. Apply online at ssa.gov.
Can you live a normal life with degenerative disc disease? Yes, you can live a normal life with degenerative disc disease, but it will involve a lot of pain and/or pain management. The vast majority of people with DDD can manage their pain and avoid surgery.
This doesn’t mean you shouldn’t seek treatment. Untreated DDD may progress enough that it debilitates you and tanks your quality of life. You should seek a physical examination right away if you suspect you have DDD symptoms.
Symptoms of Degenerative Disc Disease
Common symptoms of DDD include:
- Lower back pain, may range from mild to severe
- Severe pain in the neck
- Chronic pain in buttocks and legs (sciatica)
- Chronic pain in arms and hands
- Increased pain when sitting
- Increased pain when twisting, turning, or lifting
- Weakness in leg muscles
- A decrease in pain with lying down or movement
Untreated DDD may lead to decreased mobility, blood clots in your legs, depression, and bone spurs.
If bone spurs (osteophytes) grow into the spinal canal, they can pinch the spinal cord and spinal nerve roots, which is called “spinal stenosis”.
Can you be paralyzed from degenerative disc disease? Yes, though this is extremely rare. In only the most severe cases, discs may degenerate in such a way that leads to paralysis. Degeneration in cervical spine discs is particularly worrisome.
Diagnosing degenerative disc disease may involve:
- Medical history
- Symptom checklist
- Physical exam
- MRI (magnetic resonance imaging)
- CT scan (computed tomography)
A doctor may require various tests or imaging to rule out other potential conditions.
The 8 most common treatments for degenerative disc disease:
- Chiropractic care — Chiropractic helps to support a wide range of motion for the spine and reduce overall inflammation. The primary goal of chiropractic for degenerative disc disease is to promote proper joint mechanics.
- Physical therapy — This popular treatment option often leads to improvements in pain, posture, and range of motion. A qualified physical therapist will guide you through exercises and stretches and other techniques to help strengthen your back muscles and relieve pain.
- Quit smoking — If you stop smoking, you may be able to slow or stop further degeneration. This is a must for treating DDD, but shouldn’t be your only treatment.
- Heat or cold therapy — Cold packs decrease the pain, and heat packs reduce the inflammation that leads to pain.
- Steroid injections — Epidural corticosteroid injections into specific areas around the spinal cord may lead to a strengthened spinal disc and pain relief. (Note: Facet joint injections may be steroid injections or local anesthetics for pain relief.)
- Over-the-counter medications — Acetaminophen (Tylenol) and NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Advil) may temporarily reduce pain related to inflammation and DDD. If possible, however, I recommend avoiding pharmaceuticals if at all possible. The FDA just released new guidelines on when to avoid aspirin and ibuprofen.
- Prescription medications — For some, over-the-counter medications aren’t enough, and doctors may prescribe stronger pain relievers. Again, I would not recommend this “treatment”.
- Surgery — For the most severe cases, surgical options include artificial disc replacement, discectomy, or spinal fusion. Surgery is not a good option for most people with DDD, unless it is accompanied with a herniated disc or spinal stenosis.
Like any medical condition, always ask a healthcare professional for medical advice before starting a new treatment for DDD.
At Action Spine & Sports Medicine, treatment for degenerated discs often focuses on restoring proper function, not only to the specific joint but also to the structures surrounding it.
The primary objective is to restore the balance of tensegrity within the joint. Addressing the tonic (or spasm) changes in the supporting musculature often alleviates symptoms.
The first target is usually restoring proper function within the multifidus muscle. Because of the depth of the multifidus, functional dry needling is a great treatment strategy to accomplish this goal.
Other techniques like the Graston Technique or active myofascial release can assist in loosening the fascia surrounding the area as well.
Second, restoring proper joint movements with joint manipulation can restore overall functionality to the area. By allowing the joints to move more freely, there is less stress on all the soft tissue structures. Which means all systems can work together in better harmony.
Corrective exercises to help re-establish balance and functional strength in DDD patients are essential.
Examples of exercises and stretches for DDD:
- Various stretches, when you wake up and before any exercises
- Lower trunk rotation
- Pelvic tilt
- Water aerobics
- Hamstring stretch
- Stationary biking
While we may not be able to fix the permanent changes that happen with chronic overuse, we can often restore the function to the affected area and, as a result, return the individual to the healthy lifestyle they desire.
If you’re looking for corrective exercise programming in the Denver area, come to Action Spine & Sports Medicine. Click here to book an appointment.
What causes DDD?
The cause of DDD is when discs wear down. Because the discs have no access to blood supply, damaged discs cannot repair themselves.
What causes degenerative disc disease? Here are 5 causes of worn discs that lead to DDD:
- The disc dries out with age. Discs may start to wear down naturally in your 30s or 40s. Virtually everyone over the age of 60 has some level of disc degeneration.
- A single traumatic injury damages the disc, such as a car accident.
- Tears form in the outer portion of the disc from repetitive daily activities or sports.
- Obesity increases the risk of developing DDD at an earlier age.
- A sedentary lifestyle increases the risk of developing DDD at an earlier age.
Degenerative disc disease is a natural part of aging, but it doesn’t have to ruin your quality of life. Seek treatment, avoid risk factors, and learn the best prevention methods, and your back will thank you.
Dr. Cowin has worked with countless patients suffering from various stages of degenerative disc disease.
Click here or call us today at (720) 541-7098. Set up your appointment with Action Spine & Sports Medicine ASAP, here in the heart of Denver, CO.
Elmasry, S., Asfour, S., de Rivero Vaccari, J. P., & Travascio, F. (2015). Effects of tobacco smoking on the degeneration of the intervertebral disc: a finite element study. PLoS One, 10(8), e0136137. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4547737/