In the past, degenerative disc disease was primarily associated with aging. However, it is now widely observed across all age groups, particularly among young working adults whose inappropriate lifestyles accelerate disc degeneration, leading to various pain symptoms that disrupt daily life.
For individuals with mild degenerative disc disease, common symptoms include a dull ache in the lumbar region, which may radiate to the lateral back muscles and hips. Symptoms typically worsen with prolonged sitting, standing, walking, or long-distance driving but improve after 10-15 minutes of rest. In severe cases, disc herniation can compress nerve roots, leading to numbness, weakness in the limbs and feet, and symptoms along the affected nerve distribution.
Degenerative disc disease is often linked to patient activities and spinal usage, influenced by several factors:
Spinal disc changes generally begin in adolescence. With increasing age, strenuous spinal usage, and regular activities contribute to the degradation of proteoglycans in the central part of the intervertebral disc. This leads to the disc losing its water-retaining capacity, becoming dehydrated, and losing its elasticity and tensile strength, akin to a leaking gas-filled balloon.
Normally, the outer rim of the intervertebral disc consists of multiple interwoven fibrous layers. When these layers tear from within, the outer disc margin thins, similar to a car tire with torn plies. Under pressure or weight, the disc can bulge, creating pressure on surrounding nerve-rich tissues, causing localized back pain. If the disc protrudes along the spinal cord or nerve roots, it can also cause radiating pain in those areas.
In some instances, the fluid-filled nucleus of the disc, which absorbs weight, may cause the cartilaginous endplates above and below the disc to crack. As the body initiates repair processes, blood vessels and nerves grow into the damaged area, potentially increasing pain from applied weight or pressure.
Diagnosing degenerative disc disease requires a multifaceted approach. Initially, the physician will:
Given that symptoms of degenerative disc disease often mimic other conditions, further diagnostic tests such as blood tests, computed tomography (CT) scans, and magnetic resonance imaging (MRI) may be necessary for accurate and precise diagnosis.
Once localized back pain is diagnosed as degenerative disc disease, the physician will propose treatment options tailored to the individual patient's symptoms. The primary treatment approaches are categorized into two main methods:
Conservative management of disc degeneration involves medication, rest, and physical therapy, with ongoing monitoring. Should symptoms worsen or neurological deficits appear (e.g., increased pain, weakness, numbness, or bladder/bowel dysfunction), advanced imaging (CT/MRI) will guide further treatment planning.
If initial conservative treatment for disc herniation is ineffective, the physician will assess the lesion based on their experience and expertise to select the safest and most appropriate surgical method. Modern surgical techniques have significantly advanced, offering less invasiveness, improved safety, and smaller incisions compared to traditional open surgery. Surgical approaches include:
Procedures aimed at reducing internal disc pressure, such as using high-frequency waves, aspiration devices, or endoscopic techniques to remove part of the semi-liquid disc material.
Surgical removal of the semi-liquid disc material through microscopic approaches, minimally invasive incisions, or standard open incisions.
A procedure to fuse vertebrae via small incisions, often guided by CT imaging.
Surgical replacement of the degenerated disc with an artificial one.
Preventing degenerative disc disease applies to both the general population and individuals already diagnosed with the condition:
While disc degeneration is an age-related process and difficult to entirely prevent, avoiding risk behaviors serves as a strong defense against premature disc degeneration. Therefore:
Those diagnosed with degenerative disc disease should avoid activities that put stress on the spine, including heavy lifting or prolonged sitting without changing posture. This helps to mitigate symptom severity and prevent disease progression.
Some patients may be asymptomatic initially. However, disc collapse typically leads to back pain. If nerve compression occurs, pain intensifies, possibly accompanied by hip numbness and muscle weakness.
While there is no cure for degenerative bone disease, as it is a natural part of aging and bodily wear, its progression can be slowed, and symptoms alleviated through medication, physical therapy, surgery, and various alternative treatments.
Currently, there is no specific food or vitamin supplement proven to directly impact intervertebral discs.
Lumbar degenerative disc disease, involving degeneration of intervertebral discs and facet joints, can affect individuals of all ages, not just the elderly, especially those with risky behaviors like prolonged sitting or frequent heavy lifting. Therefore, regular self-monitoring is crucial. If back pain, leg numbness, or other spinal abnormalities are observed, prompt medical consultation for accurate diagnosis and appropriate treatment is advised. This will help patients return to normal or near-normal lives.
Ramkhamhaeng Hospital offers a team of expert physicians who provide close guidance and detailed, caring analysis for all diseases and symptoms. If you are experiencing unusual body signals, you can contact us to schedule an appointment immediately.
Reference:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7007629/
