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Degenerative disc disease (DDD) describes the natural breakdown of an intervertebral disc of the spine. Despite its name, DDD is not considered a disease, nor is it progressively degenerative. On the contrary, disc degeneration is often the effect of natural daily stresses and minor injuries that cause spinal discs to gradually lose water as the anulus fibrosus, or the rigid outer shell of a disc, weakens. As discs weaken and lose water, they begin to collapse. This can result in pressure being put on the nerves in the spinal column, causing pain and weakness.
Spinal disks are like shock absorbers between the vertebrae, or bones, of your spine. They help your back stay flexible, so you can bend and twist. As you get older, they can show signs of wear and tear. They begin to break down and may not work as well.
Nearly everyone’s disks break down over time, but not everyone feels pain. If worn-out spinal disks are the reason you’re hurting, you have degenerative disk disease.
While not always symptomatic, DDD can cause acute or chronic low back or neck pain as well as nerve pain depending on the location of the affected disc and the amount of pressure it places on the surrounding nerve roots.
The typical radiographic findings in DDD are black discs, disc space narrowing, vacuum disc, end plate sclerosis, and osteophyte formation.
DDD can greatly affect quality of life. Disc degeneration is a disease of micro/macro trauma and of aging, and though for most people is not a problem, in certain individuals a degenerated disc can cause severe chronic pain if left untreated.
Common signs include pain that:
*Is in your lower back, buttocks, or upper thighs
*Comes and goes. It can be nagging or severe, and can last from a few days to a few months.
*Feels worse when you sit, and better when you move and walk
*Feels worse when you bend, lift, or twist
*Gets better when you change positions or lie down
Some people have nerve endings that penetrate more deeply into the anulus fibrosus (outer layer of the disc) than others, making discs more likely to generate pain. In the alternative, the healing of trauma to the outer anulus fibrosus may result in the innervation of the scar tissue and pain impulses from the disc, as these nerves become inflamed by nucleus pulposus material. Degenerative disc disease can lead to a chronic debilitating condition and can have a serious negative impact on a person’s quality of life. When pain from degenerative disc disease is severe, traditional nonoperative treatment may be ineffective.
In some cases, degenerative disk disease can lead to numbness and tingling in your arms and legs. It can also cause your leg muscles to become weak. This means the damaged disks may be affecting the nerves near your spine.
The term, degenerative disc disease is a slight misnomer because it is not technically a disease, nor is it strictly degenerative. It is not considered a disease because degenerative changes in the spine are natural and common in the general population.
There is a disc between each of the vertebrae in the spine. A healthy, well-hydrated disc will contain a great deal of water in its center, known as the nucleus pulposus, which provides cushioning and flexibility for the spine. Much of the mechanical stress that is caused by everyday movements is transferred to the discs within the spine and the water content within them allows them to effectively absorb the shock. At birth, a typical human nucleus pulposus will contain about 80% water. However natural daily stresses and minor injuries can cause these discs to gradually lose water as the anulus fibrosus, or the rigid outer shell of a disc, weakens.
This water loss makes the discs less flexible and results in the gradual collapse and narrowing of the gap in the spinal column. As the space between vertebrae gets smaller, extra pressure can be placed on the discs causing tiny cracks or tears to appear in the anulus. If enough pressure is exerted, it’s possible for the nucleus pulposus material to seep out through the tears in the anulus and can cause what is known as a herniated disc.
As the two vertebrae above and below the affected disc begin to collapse upon each other, the facet joints at the back of the spine are forced to shift which can affect their function.
Additionally, the body can react to the closing gap between vertebrae by creating bone spurs around the disc space in an attempt to stop excess motion. This can cause issues if the bone spurs start to grow into the spinal canal and put pressure on the spinal cord and surrounding nerve roots as it can cause pain and affect nerve function. This condition is called spinal stenosis.
For women, there is good evidence that menopause and related estrogen-loss are associated with lumbar disc degeneration, usually occurring during the first 15 years of the climacteric. It has a potential role of sex hormones in degenerative skeletal disorders.
Degenerative disc disease can also occur in other mammals besides humans. It is a common problem in several dog variants and attempts to remove this disease from dog populations have led to several crosses, such as the Chiweenie.
The stress of everyday movements and minor injuries over the years can cause tiny tears in the outer wall, which contains nerves. Any tears near the nerves can become painful. And if the wall breaks down, the disk’s soft core may push through the cracks. The disk may bulge, or slip out of place, which is called a slipped or herniated disk. It can affect nearby nerves.
The most common of degenerative disc disease causes is aging. As you grow older, the protein and water makeup of your cartilage changes. That makes your spinal discs more fragile, subjecting them to more wear and tear.
The more damage they take, the more likely it is that you’re going to start feeling pain in your back. The sooner you go to your doctor and get diagnosed, the better.
Inflammation is another cause that you need to be aware of. As the disc deteriorates, the inflammatory proteins can leak out into the spinal column itself.
They cause swelling and muscle tension in the spinal structures, creating more pain in the area. In fact, inflammation can be seen as the cause of many different back and spinal issues.
There is some evidence to suggest that you can inherit a predisposition to developing a degenerative bone disease or disc disease. A study indicated that if you have a parent or grandparent with the disease, then you could be more likely to develop it yourself. However, the scientists behind the study say that this may be down to environmental reasons, rather than genetics, and more research needs to be done.
Diagnosis of degenerative disc disease will usually consist of an analysis of a patient’s individual medical history, a physical exam designed to reveal muscle weakness, tenderness or poor range of motion, and an MRI scan to confirm the diagnosis and rule out other causes.
In the begining the doctor prescribe some pain killers & physiotherapy. Degenerative disc disease treatment can sometimes include steroid shots. These are most commonly administered into the epidural space in your back, or a nerve or muscle, depending on where the pain is. Your doctor would be able to tell you if this treatment is right.
Finally, if these methods aren’t working, then your doctor may recommend surgery. This can be done to remove the damaged part of the disc, taking the pressure off your back and relieving pain. If the disc is particularly damaged, then they may even remove it entirely and insert an artificial one.
Traditional approaches in treating patients with DDD-resultant herniated discs oftentimes include discectomy — which, in essence, is a spine-related surgical procedure involving the removal of damaged intervertebral discs (either whole removal, or partially-based). The former of these two discectomy techniques involved in open discectomy is known as Subtotal Discectomy (SD; or, aggressive discectomy) and the latter, Limited Discectomy (LD; or, conservative discectomy). However, with either technique, the probability of post-operative reherniation exists and at a considerably high maximum of 21%, prompting patients to potentially undergo recurrent disk surgery.
New treatments are emerging that are still in the beginning clinical trial phases. Glucosamine injections may offer pain relief for some without precluding the use of more aggressive treatment options. In the US, artificial disc replacement is viewed cautiously as a possible alternative to fusion in carefully selected patients, yet it is widely used in a broader range of cases in Europe, where multi-level disc replacement of the cervical and lumbar spine is common. Adult stem cell therapies for disc regeneration are in their infancy, however initial clinical trials have shown cell transplantation to be safe and initial observations suggest some beneficial effects for associated pain and disability. Investigation into mesenchymal stem cell therapy knife-less fusion of vertebrae in the United States began in 2006.
Researchers and surgeons alike have conducted clinical and basic science studies to uncover the regenerative capacity possessed by the large animal species involved (humans and quadrupeds) for potential therapies to treat the disease. Some therapies, carried out by research laboratories in New York, include introduction of biologically-engineered, injectable riboflavin cross-linked high density collagen (HDC-laden) gels into disease spinal segments to induce regeneration, ultimately restoring functionality and structure to the two main inner and outer components of vertebral discs — anulus fibrosus and the nucleus pulposus.
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If you’ve been diagnosed with degenerative disc disease, and not been treated properly, then you’ll be living with it for life. The good news is that there are options for treating the symptoms. Many people today live their normal lives with the disease, using a combination of treatments that help them manage the symptoms.
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.