Degenerative Disk Disease

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KEY POINTS

• Degenerative disk disease means that the cushions between the bones of your spine break down.
• Treatment helps control symptoms and may include exercise, medicines, wearing a brace, or surgery.
• Try to keep a healthy weight. Losing some weight can reduce the stress on your joints. Eat a healthy diet, and ask your healthcare provider if there are any limits on your exercise. If you smoke, try to quit. Learn ways to protect your back when you lift or move heavy objects.

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What is degenerative disk disease?

Disks are rubbery cushions between the bones of the spine (vertebrae). Normally, disks act as shock absorbers to cushion the bones in your spine from each other as you move. Degenerative disk disease means that these cushions break down over time.

What is the cause?

The exact cause of this disease is not known. Things that may cause or contribute to degenerative disk disease are:

• Aging. As you get older, the disks may dry out, develop small tears, and become unstable. Symptoms are usually not noticed until middle age.
• Too much wear on joints. Obesity, bad posture, and overuse can cause extra wear on joints.
• Injuries to joints from sports or accidents
• Pressure. Heavy lifting or sports can put pressure on joints and damage the cartilage.
• Genes you have inherited. Genes are inside each cell of your body and are passed from parents to children. They contain the information that tells your body how to develop and work. A family history of degenerative disk disease can increase your risk.

What are the symptoms?

Degenerative disk disease usually develops over several years, and may not cause symptoms at first. Symptoms may include:

• Pain that gets worse when bending, lifting, twisting, or sitting, and gets better when walking or lying down
• Pain in your neck, lower back, buttocks, or thighs
• Weakness, numbness, or tingling in the hands, feet, or legs

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

• X-rays
• MRI: A powerful magnetic field and radio waves are used to take pictures from different angles to show thin cross sections of the spine.
• CT scan: A series of X-rays is taken from different angles and arranged by a computer to show thin cross sections of the spine.
• Diskogram or discogram: An X-ray is taken after an injection of contrast dye into a disk in your spine to check for the cause of back or neck pain.

How is it treated?

There is no cure for degenerative disk disease, but treatment can help relieve symptoms.

Medicine

• Nonprescription pain medicine, such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), may help relieve pain. NSAIDs are available in pills, creams, and patches. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take these medicines for more than 10 days.
  • Acetaminophen may cause liver damage or other problems. Unless recommended by your provider, don't take more than 3000 milligrams (mg) in 24 hours. To make sure you don’t take too much, check other medicines you take to see if they also contain acetaminophen. Ask your provider if you need to avoid drinking alcohol while taking this medicine.
  • NSAIDs, such as ibuprofen, naproxen, ketoprofen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age.
• Steroid medicine may be prescribed to decrease pain and swelling. It can be given as a pill, cream or ointment, or shot. Using a steroid for a long time can have serious side effects. Take steroid medicine exactly as your healthcare provider prescribes. Don’t take more or less of it than prescribed by your provider and don’t take it longer than prescribed. Don’t stop taking a steroid without your provider's approval. You may have to lower your dosage slowly before stopping it.

Surgery

• If your pain is not getting better with treatment, you may need surgery such as:
  • Diskectomy or discectomy: Surgery to remove all or part of a disk which may be pressing on a nerve
  • Spinal fusion: Surgery to stabilize the bones in the spine with a piece of bone or ceramic, which is held in place with plates, screws, or rods. This is usually done after the disk is removed.
  • Disk Replacement: A metal, or metal and plastic disk may be used to replace the disk that is causing problems.

Other treatments

• Your healthcare provider may recommend physical or occupational therapy to treat pain and help you have better use of your joints.
• Heat treatments, including ultrasound help make your muscle and joints more flexible and lessen pain and swelling.
• Transcutaneous electrical stimulation (TENS) uses electrodes placed on your skin to stimulate nerves and help block pain.
• Your provider may recommend a neck or back brace to help your body maintain good posture and relieve pain.

How can I take care of myself?

• Follow the full course of treatment prescribed by your healthcare provider.
• Try to keep a healthy weight. If you are overweight, lose weight. Losing some weight can reduce the stress on your joints.
• Keep your muscles strong so that they can help support your spine better. Walking and swimming are examples of good exercise for strengthening and protecting your spine.
• Protect your back.
  • When you need to move a heavy object, don't face the object and push with your arms. Turn around and use your back to push backwards so the strain is taken by your legs.
  • When you lift a heavy object, bend your knees and hips and keep your back straight. If you do a lot of heavy lifting, wear a belt designed to support your back. Avoid lifting heavy objects higher than your waist.
• Eat a healthy diet. Ask your provider about the benefits of talking to a dietitian to learn what you need in a healthy diet.
• If you smoke, try to quit. Talk to your healthcare provider about ways to quit smoking.
• Ask your healthcare provider:
  • How and when you will get your test results
  • If there are activities you should avoid and when you can return to your normal activities
  • What symptoms or problems you should watch for and what to do if you have them
• Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.