The ABC’s of Degenerative Disc Disease

One of the most common chronic physical conditions people are likely to suffer with is back pain.  In fact, According to Statistics Canada, “four out of five adults will experience at least one episode of back pain at some point in their lives”.  Furthermore, if you fall into the range of 30 to 50 years of age, chances are you, or someone close to you in the same age range, is suffering from back pain right now.

The symptoms and indications of a problematic spine are widely varied but can be narrowed down to the following: pain, muscle tension or stiffness, weakness in the legs or feet, or tingling or burning sensations, often traveling down the legs.  Pain can occur at any point of the spine, but because it bears the largest amount of weight and physical stress, the most common spot affected is the lower back.

Back pain is generally mechanical in nature, which means it’s caused by a stress, strain or trauma to the muscles or bones.  Less common, back and neck pain can be a result of an underlying medical condition.  One such condition is commonly known as Degenerative Disc Disease (DDD), although DDD is not actually a disease but, in most cases, a preventable condition which begins after either a sudden or repetitive trauma to the spine and if untreated and as the spine ages can be a debilitating painful condition.  In fact, many people develop some degree of the condition over time. However, not everyone will experience related symptoms.

What Exactly is Degenerative Disc Disease?

Spondylosis, more commonly known as Degenerative Disc Disease, (DDD), is a condition marked by damage to the intervertebral discs; gel-like cushions that separate each vertebra, or segment, of the backbone or spine. The main function of the discs is to absorb shock as we move about our day and take part in physical activities. The discs consist of a gel-like substance called the nucleus surrounded by a capsule of tight elastic fibers called the annulus which contain nerve endings. This intricate structure (vertebra + discs) permits flexible, yet completely stable, support of the body and provides protection to the spinal cord and nerve roots in the case of trauma and injury.

Damage to the discs, over time, causes the spine to weaken and in many cases leads to degenerative disc disease. The problem is that discs have a minimal blood supply. This means they are not supplied with sufficient nutrients and oxygen to completely heal once they are damaged, although sometimes the condition can stabilize and some non-interventional improvement is possible.  

More often than not, however, once a spinal disc degenerates, it loses its ability to properly function as part of the spinal joint. This decrease in function can in turn lead to stiffness and severe neck and/or back pain. Oftentimes, the pain also radiates through the body’s extremities such as the back of the head, trunk, shoulders, arms, hands, legs, and feet, making DDD a very difficult condition to cope with.

Types and Stages of Degenerative Disc Disease

DDD’s severity can be described by their location as well as on a continuum of stages of deterioration:

• Cervical disc disease: degeneration of discs occurs in the neck region of the spine
• Thoracic disc disease: degeneration of discs occurs in the mid-back of the spine.
• Lumbar: degeneration of discs occurs in the lower back of the spine.

Degenerative Disc Disease Stage 1

The first sign of disc degeneration is that the spine loses its normal balance. There may be some damage to spinal curvature which in turn affects posture. Joints and nerves become stressed and begin to age more quickly. In some cases, there is a lessening of overall energy and even a slight loss of height.  At this stage, however, there may be surprisingly little pain or discomfort.

Degenerative Disc Disease Stage 2

As the condition deteriorates, there is a greater degree of disc decay, the discs become narrower and bone deformations (bone spurs) appear.  The changes in posture become more marked and spinal canal narrowing may also begin. At this stage, pain and discomfort are more evident and height may continue to decrease. Interestingly, people in stage 2 begin to exhibit not only more overall exhaustion but also a lowered ability to cope with stress.  

Degenerative Disc Disease Stage 3

By the time a patient reaches stage 3, their posture is markedly affected. There is even greater disc thinning and also can experience moderate to severe nerve damage and formation of scar tissue. In more advanced cases, further bone deformation occurs. At this stage of DDD, there is also an obvious deterioration of the overall physical and/or mental condition of the patient and a profound loss of energy.

Degenerative Disc Disease Stage 4

By this stage of DDD, damage to the spine is severe.  Discal thinning is at its maximum, or worse, completely gone. Postural imbalance is acute and motion and flexibility are extremely limited. Patients often suffer profound nerve damage, while permanent scar tissue forms and bones may begin to fuse. Stage 4 DDD is marked oftentimes by severe pain and more advanced degrees of physical and / or mental deterioration.  There is also an ongoing loss of height and energy levels continue to drop.  Stage 4 DDD is usually considered irreversible.

Treatment for Degenerative Disc Disease

Once a proper diagnosis is made, treatment for degenerative disc disease runs the gamut from non-invasive, conservative therapies with proven success such as the High Performance Healing SystemTM , which involves the combination of Non-Surgical Spinal Decompression along with Class IV Laser and Disc Renewal PlusTM,  to more complicated surgical procedures such as laminectomies and fusion. Ultimately the purpose of any type of treatment is to prevent or reduce stress on the discs in order to lessen or relieve pain and to help maintain normal function of the spine.

For milder cases of DDD, most protocols involve a combination of self-administered treatments, such as learning proper posture, weight loss, stretching, resting, applying hot or cold packs, replacing vigorous activity with walking, biking or swimming, and in some instances wearing a support brace.

To help relieve the pain on a more permanent basis, the treatment regimen might also include chiropractic treatments, physiotherapy, acupuncture, and massage.  These treatments are important because not only do they help relieve pain, they may also help reduce future flare-ups by improving function and increasing flexibility and strength, thus lessening the pressure on the spine.

The use of medications in combination with more conservative self-treatments is indicated in more serious cases.  Typical medications for DDD include non-steroidal anti-inflammatory drugs and pain relievers such as ibuprofen and acetaminophen, muscle relaxants, spinal injections such as cortisone or even nerve blocks, and sleep aids.  It is very important to remember, however, that no medication should be taken without first consulting with a qualified medical professional.

Many sufferers of DDD have also found relief with non-surgical treatments like Class IV Laser in conjunction with non-surgical Spinal Decompression which help to revitalize the damaged disc and even reduce nerve pressure caused by the thinning discs. In more extreme cases, a spinal cord stimulator can be implanted permanently to supply a low intensity impulse to a specific location on the spinal cord.

Finally, when all other methods of relief have been exhausted without adequate results and when the pain is so severe that it is impossible for the sufferer to live a normal life, surgery might be an option.  There are different types of surgery depending on each individual’s situation.  Surgery can be beneficial in relieving pressure on the spinal cord or nerve root, in stabilizing a painful vertebral segment, in preventing or limiting nerve damage and in reducing deformity or curvature of the spine.

Back surgery remains a controversial option, however, because of its risks as well as inconsistent and often poor results and in some cases, it might actually worsen the condition.  Therefore, it is imperative to consult a reputable, experienced back surgeon who will be honest about whether or not a person is a good candidate for surgery and what exactly the chances are for success.

 

Life with Degenerative Disc Disease: What to Expect.

Although it may not seem so to someone who is suffering from DDD, the long term prognosis is in some cases is not too bad.  Some people can manage pain, lessen flare-ups, and in some cases even eliminate symptoms altogether over time. Although discs become thinner, stiffer and flexibility is reduced, by the time we reach 65 years of age – inflammatory proteins in the discs can lose their ability to aggravate pain.

However, if you don’t want to wait until then and see if your pain lessens, as it often doesn’t, there are things you can do to help prevent DDD from being worse than it has to be.  Making sure to include moderate daily exercise and strength training, good nutrition and plenty of sleep in your day to day life is a good way to help prevent the more painful and disabling symptoms of DDD.  

Here are some other small lifestyle changes that can help prevent painful DDD:

• Reduce stress.
• Avoid or quit smoking.
• Stay well hydrated.
• Reduce your alcohol consumption.
• Maintain a healthy weight through good nutrition and exercise.
• Invest on a good-quality supportive mattress.
• Change positions frequently throughout the day, especially if you spend a lot of time sitting down.
• With the help of a chiropractor, learn how to improve and maintain posture.
• Learn and practice using correct lifting techniques and avoid lifting overly heavy objects.

Although degenerative disc disease is statistically highly common, it is possible to avoid painful symptoms by simply committing to a healthier lifestyle and by being kind to our spines, and it is never too early to do so.  Get to know your body and make sure you seek advice at the first signs of non-typical back discomfort.  Early detection and treatment can definitely help you to maintain a healthy set of discs!