Degenerative Disc Disease (DDD) also called Disc Disease is a condition in which the structural changes brought about in the discs between the vertebral column can manifest in loss of function & various symptoms.
SIGNS & SYMPTOMS OF DDD
- Lower back pain
- Upper neck pain
- Pain radiating to the arms & shoulders
- Tingling in the fingers
- Pain radiating to the hip joint
- Pain radiating to the buttocks, thighs or legs
- Tingling or weakness in the knees
- Pain can worsen on movements like sitting, lifting, bending, etc.
- Impact on the quality of life.
COMPLICATIONS
- Facet joint malalignment
- Arthritis
- Scoliosis, sideways curve of the spine.
- Cervical hyperlordosis, inward curving of the cervical vertebral spine.
- Thoracic hyperkyphosis, excessive convex curvature of the back.
- Lumbar hyperlordosis
- Spinal stenosis
- Vertebral foramen stenosis
- Radiculopathy, pinched nerve.
- Herniated disc.
CAUSES & RISK FACTORS OF DDD
- Intervertebral discs are filled with water & their role is to absorb shocks & provide cushioning to the daily activities that can put stress on the back.
- In DDD, daily stress & minor injuries can lead to loss of water from these discs.
- The gradual water loss can lead to narrowing of the gap between the vertebral column & weakening of the shell of the disc.
- Thus in DDD, along with the drying out of the discs, daily stress & injuries can produce cracks in the discs & eventually lead to leaking of the nucleus material in the disc.
- This leads to damage to the nerves in the spinal cord & pain.
- The closing gaps can lead to the joints in the spine to produce bone spurs, which when growing in the spinal canal will cause damage to the spinal root & disruption of function.
- In women menopause & loss of estrogen is a contributing factor for DDD.
- Also use of hormonal drugs is a risk factor.
- Some other risk factors are;
- Genetics
- Being involved in sports, combat sports, weight lifting, Olympic sports etc.
- Lifting of heavy weights & labor.
- Musculoskeletal diseases.
- Poor posture & obesity.
- Smoking.
DIAGNOSIS
- Physical examination & noting of indicative symptoms like back pain, radiating pain, etc.
- X-Ray & MRI for analysis of the damage to the spine & its nerves, to generate images of the spine & to rule out possibility of any other condition.
- Histologic examination of the fragments of discs, to rule out any other condition, than DDD.
TREATMENT OF DDD
- Pain management by using anti-inflammatory drugs like aspirin.
- Epidural steroid injection for relief from symptoms.
- Glucosamine injection
- Using a traction to relieve pressure & straightening of the back.
- Physiotherapy
- Various surgical procedures like facetectomy, anterior cervical discectomy, laminoplasty, etc.
- Cell replacement therapy.
PREVENTION
- Back exercises
- Staying hydrated
- Not lifting heavy weights
- Diet that is adequate in calcium.