Brief Overview: Degenerative disc disease (DDD) refers to age-related changes in the spinal discs, the cushions between vertebrae. Over time, discs can lose water content, become thinner, and provide less shock absorption, leading to pain, stiffness, and sometimes nerve compression. It is a common cause of chronic back or neck pain in older adults.
Prevalence: According to an article on My Vanderbilt Health, “By the age of 20, 37 percent of people show disc degeneration on imaging,” Yang said. And the prevalence increases with each decade. “By the age of 50, we’re talking 80 percent of people have this degeneration on imaging,” Yang added. That number increases to 96 percent for octogenarians”
Etiology:
- Natural aging and wear-and-tear of spinal discs.
- Loss of disc hydration and elasticity.
- Small tears in disc fibers causing inflammation and instability.
- Can be accelerated by injury, repetitive strain, or genetics.
Risk Factors:
- Age
- Obesity
- Female
- Smoking
- Physically demanding jobs
- Prior back injury
Commonly Associated Conditions:
- Osteoarthritis of the spine
- Herniated disc
- Spinal stenosis
- Spondylolisthesis
- Chronic back pain
Common Medications:
- NSAIDs, Tylenol
- Muscle relaxers
- Steroids
- Steroid injections
Common Labs, Imaging, and Tests:
- MRI, X-ray, CT
- Electromyography (EMG)
Common Symptoms:
- Pain
- Numbness, tingling in arms or legs
- Weakness, stiffness in arms or legs
Common Treatments:
- Medications (see above)
- Physical therapy
- Stretching
- Heat/ice therapy
- Weight management
- Spinal manipulation
- Massage, acupuncture
- Neck, back braces
- Assistive devices like a cane or walker
- Radiofrequency neurotomy
- Surgery – spinal decompression
Physical Findings:
- Tenderness along the spine.
- Reduced range of motion in back or neck.
- Pain with forward flexion or prolonged sitting.
- Neurological changes (numbness, weakness, reflex changes) if nerve root involved.
- Antalgic gait (walking pattern altered due to pain).
Potential Complications and Contraindications:
- Chronic disability and reduced mobility.
- Progression to spinal stenosis or herniated disc.
- Depression or anxiety due to chronic pain.
- Risks from prolonged medication use (GI bleeding with NSAIDs, sedation with muscle relaxants, dependence with opioids).
- Surgical risks: infection, failed back surgery syndrome, hardware issues.
General Health and Lifestyle Guidance:
- Maintain a healthy weight to reduce spinal stress.
- Engage in low-impact exercise (walking, swimming, stationary cycling). Ask your healthcare provider what exercises are recommended for you.
- Strengthen core and back muscles through guided physical therapy.
- Avoid smoking and excessive alcohol use.
- Use good posture and ergonomics when sitting or lifting.
- Pace activities and take breaks to prevent pain flare-ups.
Suggested Questions to Ask Patients:
- Where is your pain located, and how long have you had it?
- What activities make your pain worse or better?
- Does your pain radiate to arms, legs, or buttocks?
- Do you have numbness, tingling, or weakness?
- How does pain affect your daily activities, sleep, or mood?
- What medications or treatments have you tried, and how effective were they?
- Have you had any imaging studies of your spine?
Suggested Talking Points:
- Disc changes are a normal part of aging, but not everyone with disc degeneration has symptoms.
- Conservative treatments like exercise, weight management, and physical therapy can greatly improve symptoms
- If conservative options don’t help, injections or surgery may be considered for relief.
- Staying active and keeping a healthy weight are some of the best ways to protect your spine.
Sources:
- https://www.uptodate.com/contents/degenerative-disc-disease-the-basics?search=degenerative%20disc%20disease&source=search_result&selectedTitle=1~63&usage_type=default&display_rank=1
- https://www.cedars-sinai.org/health-library/diseases-and-conditions/d/degenerative-disc-disease.html
- https://www.hopkinsmedicine.org/health/conditions-and-diseases/degenerative-disc-disease
- https://my.clevelandclinic.org/health/diseases/16912-degenerative-disk-disease#symptoms-and-causes
- https://my.vanderbilthealth.com/lumbar-degenerative-disc-disease-is-more-common-than-you-think/
This content was created with the assistance of AI. Any AI-generated content was reviewed by a Nurse Practitioner.