Degenerative Disc Disease and Spinal Degeneration
There are many names for this condition, they include:
- Degenerative disc disease
- Spinal Degeneration
- Lumbar spondylosis
- Changes of age
- Facet syndrome or arthropathy
- "Wear and tear"
These are lots of names for more or less the same thing and some of them sound alarming. The fact is that degenerative disc disease and changes af age are common - in fact NEARLY ALL of us will, in time, get these changes in our spines. It's as inevitable as getting grey hair and wrinkles; it's going to happen.
Rarely are these changes serious - normally the changes occur quite gradually and cause no serious ill effects. As we age the discs in our lower back naturally become dehydrated and thinner, this can show on a scan or X-Ray as narrowing of the disc space.
X-Ray of a lumbar Spine from the side
MRI scans show a characteristic narrowing of the disc with a reduction in fluid levels (see diagram below)
MRI scan of a lumbar Spine from the side
In addition to changes in the discs the facet joints become less smooth; they develop changes on the joint surfaces where the cartilage, instead of being smooth, slippery and shiny becomes a bit scuffed and worn.
Sometimes in response to these age changes the body tries to generate more stability by growing more bone, not always exactly where we want it. These bony growths are called osteophytes. They are nothing to worry about unless they are either irritating a nerve causing leg symptoms (such as those described in the nerve root irritation section) or unless they are closing down the space in the spinal canal and restricting the spinal cord (spinal stenosis).
The only time degenerative disc changes become a serious problem is when they cause compression of the spinal cord or a nerve root irritation see this section on identifying serious problems.
What Investigations are Useful for Degenerative Disc Disease?
X-rays and MRI scans are often arranged. However, it is really important to understand is that there is rarely any relationship between these changes on X-ray and symptoms. It is also good to know that these changes are very common see this page for more information on MRI scans.
A recent study (1)actually shows that people with back pain who are told the results of their MRI scans have a lesser sense of well-being. I'm sure that is because when someone points out that you have degenerative disc disease or spinal degeneration it becomes frightening.
Lots of my patients who come to see me with this are fearful of movement because they associate degenerative changes with instability and wearing away. It makes senses to them to keep still in order to prevent more wear and tear on their joints. Actually, keeping still is the worse thing you can do for this, as movement is the thing that gives the joints nutrition and helps improve day to day activities.
What is the Best Treatment for Degenerative Disc Disease?
Physiotherapy treatment for this condition involves encouraging stiff areas of the spine to move more normally and using exercises to train the muscles that help to support and stabilse the lower back.
References
1. Modic M, Obuchowski N, Ross J, Brant-Zawadzki M et al
Acute low back pain and radiculopathy: MR imaging findings and their prognostic role and effect on outcome. Radiology, Nov 2005, vol. 237, no. 2, p. 597-604
Understand more about degenerative disc disease by checking the anatomy section.
