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  Degenerative Disc Disease


Above: The top left image shows healthy vertebrae and discs, and the pictures below illustrate the gradual process of disc degeneration.
Degenerative Disc Disease is a gradual process that occurs as we age. Gradually the water and protein content of the body’s cartilage changes. Sometimes this process is accelerated due to heavy occupational demands such as repetitive bending and twisting, heavy lifting or accident and injury. These changes can result in weaker and thinner cartilage. Because both the discs and the joints (facet joints) are composed of cartilage, these areas are subject to wear and tear over time (degenerative changes). This gradual deterioration of the discs between the vertebrae (back bones) is referred to as degenerative disc disease. These changes usually occur long before you can see them on X-rays or other imaging techniques.

What is happening is the progression of wear and tear of the discs and the weakening of protein (collagen) of the outer band of the disc (annulus fibrosis) causing a structural and biomechanical change of the disc. Furthermore, water and proteoglycan (PG) content decreases. PGs are molecules that behave like super sponges and can bind and attract water hundreds of times their own molecular weight. “Disc desiccation” is a term used to describe the proteoglycan content decreasing and loss of water in the discs (dehydration). This very well may be a term you read on your MRI report.

This process severely affects the “shock absorbing” properties of the discs as they “compress” under normal pressure. These changes usually occur at the same time as the annulus fibrosis degenerates and generally leads to the disc’s inability to handle mechanical stress.

Because the lumbar spine carries a large portion of the body’s weight, degeneration of the disc tissue makes the disc more susceptible to herniate and can cause local pain in the affected area. Disc degeneration can sometimes lead to disorders such as spinal stenosis (narrowing of the spinal canal), spondylolisthesis (forward slippage of the disc and vertebra) and retrolisthesis (backward slippage of the disc and vertebra).

Lumbar Degenerative Disc Disease Pain and Symptoms
Although symptoms vary from person to person, most patients with lumbar degenerative disc disease will experience low-grade, continuous, tolerable pain that will occasionally intensify for a few days or more. Pain symptoms can vary, but generally include:
  • Pain centered on the lower back, although it can radiate to the hips and legs.
  • Worsening pain when standing or walking, as the discs experience a heavier load.
  • Pain that is exacerbated by certain movements, particularly bending or twisting.

Although degenerative disc disease is relatively common in aging adults, it seldom requires surgery. When medical attention is warranted, the majority of patients respond well to non-operative forms of treatment like spinal decompression therapy, chiropractic care, and/or physical therapy.

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