Pain from Degenerative Disc Disease
Generally, the pain associated with degenerative disc disease is thought to stem from two main factors:
1. Inflammation
The proteins contained within the disc space can cause a lot of inflammation, and as a general rule inflammation will cause pain.
- In the lumbar disc space, the low back pain can radiate into the hips. The associated pain can also travel down the back of the leg (also called sciatica, or radiculopathy), and possibly into the foot and toes.
- In the cervical disc space, the neck pain may be local or may radiate into the arm, shoulder and possibly into the hand (a cervical radiculopathy).
2. Abnormal micromotion instability
If the annulus - the outer rings of the intervertebral disc - degenerates and wears down, it is not as effective in resisting motion in the spine. This condition has been termed "micromotion" instability because it is usually not associated with gross instability
Common Symptoms of Degenerative Disc Disease
There are several symptoms that are fairly consistent for people with lower back pain or neck pain from degenerative disc disease, including:
- Pain that is usually related to activity and will flare up at times but then return to a low-grade pain level, or the pain will go away entirely
- The amount of chronic pain—referred to as the patient's baseline level of pain—is quite variable between individuals and can range from almost no pain/just a nagging level of irritation, to severe and disabling pain
- Severe episodes of back or neck pain that will generally last from a few days to a few months before returning to the individual's baseline level of chronic pain
- Chronic pain that is completely disabling from degenerative disc disease does happen in some cases, but is relatively
The goals for treatment of degenerative disc disease usually include a combination of three areas: pain control; exercise and rehabilitation; lifestyle modifications.
1. Pain Control
The focus of this part of treatment is on achieving enough pain reduction to enable the patient to pursue a specific exercise and rehabilitation program. Pain from a degenerated or collapsed disc is usually caused by both instability and inflammation, so both of these causes of pain should be addressed.
The operative solutions, a fusion or artificial disc, are extensive surgeries and patients are usually advised to make a serious effort with nonsurgical treatments for at least 6 months prior to considering surgery.
2 .Exercise and Rehabilitation
The goals of exercise are both to help the back heal and to prevent or reduce further recurrences of pain. For people with symptomatic degenerative disc disease, exercises are usually best done under the guidance of a physical therapist or other appropriately trained healthcare professional.
A side benefit of exercise is that it can also help reduce pain naturally, as it releases endorphins that serve as the body's natural pain reliever.
3. Lifestyle Modifications
The focus of this part of treatment is education and resources to help the patient develop a healthier lifestyle.
Often, people can make lifestyle changes that aim at both avoiding stress on the spine and supporting the spine through the right ergonomics and posture.
