To explain spine conditions like degenerative disc disease, orthopaedic spine surgeon Jerry Robinson, MD finds it easier to talk about knees.
“People have a good grasp on arthritis in the knee,” he says. “They understand wear and tear in knee cartilage. The same thing happens in your back,” says Dr. Robinson.
He uses that analogy to try to make people less afraid. “Too often, the spine is like this scary black box,” he says. “But it doesn’t have to be that way.”
About 80% to 95% of people with disc problems can improve after three months of conservative care.
“Just like not everyone needs a knee replacement, not everyone needs spine surgery,” he says. “There is a lot between doing nothing and having surgery.”
What Is Degenerative Disc Disease?
Discs separate the vertebrae of your spine, allowing your spine to flex, bend, and twist. They have a firm outer layer and soft, jelly-like core. Just as cartilage wears out and can tear, your discs can also experience wear and tear.
When that happens, it’s called degenerative disc disease. But despite its name, it’s not really a disease. To some degree, it’s what happens to everyone beginning around the age of 25, he says.
“If I randomly gave MRIs to everyone over 25, they would all have some degree of disc wear and tear,” Dr. Robinson says. “The hard part is knowing if the wear and tear is age-related or if something more serious is wrong.”
As we age, our spinal discs break down, or degenerate. These changes in our spinal discs can often cause back and neck pain. For example, if it’s harder to do a yoga pose than it used to be, that may be normal. If you’re in terrible pain while sitting at your desk at work, however, there could be an underlying issue.
Symptoms of Degenerative Disc Disease
“With disc problems, there is often an inciting incident. A patient will say, ‘I picked up a heavy box and suddenly felt pain ripple through my spine.,’ Dr. Robinson says. “When someone knows exactly what happened, it makes my job easier. But for many people, it’s chronic pain that comes and goes for 10 years.”
Some common symptoms include:
- Neck or back pain.
- Pain in the shoulders, arms, or fingers.
- Pain that worsens when you move, such as when you bend over, reach up, or twist.
- Pain in the hip, buttocks, legs, or feet.
- Numbness or tingling.
Joint pain usually hurts when you move, but with disc issues, the pain is often worse when sitting.
Dr. Robinson will often ask people to rate pain on a scale of one to 10, but it’s not a perfect method. “People tolerate different amounts of pain,” he says. “But if you aren’t tolerating it or don’t want to tolerate it, you should talk to your healthcare provider.”
Can You Prevent Degenerative Disc Disease?
Because degenerative disc disease is a condition of wear and tear, it’s more common in people ages 40 and above, according to Dr. Robinson.
People who sit a lot are at a greater risk, because sitting puts pressure on your discs. But sports injuries can also lead to disc problems.
Ultimately, no one is totally immune to degenerative disc disease. But Dr. Robinson suggests some things you can do to lessen your risk:
- Sit less. If you have a sedentary job, find ways to stand more. Alternate with a standing desk or take standing breaks.
- Move more. Walking, strength training, and core strength exercises all help keep your spine strong and flexible.
- Don’t smoke. There is a clear link between smoking and disc degeneration.
- Maintain a healthy weight. Less weight is less stress on your joints and your discs.
- Lift with your knees. Avoid bending or stooping when lifting objects — including light ones. Over time, even lifting little things improperly causes unnecessary wear and tear.
- Be intentional in small movements, too. Pay attention to all those little movements throughout the day. Try not to plop on the couch, suddenly twist to grab something, or bend too quickly when getting dressed.
Degenerative Disc Disease Treatments
There are several ways to treat degenerative disc disease, depending on the extent and severity of your pain. To start, Dr. Robinson may recommend nonsteroidal anti-inflammatory medicines (NSAIDS) or physical therapy.
“Ultimately, moving is what we are supposed to do, and I think doing so will help stretch, strengthen, and improve your back,” he says.
If a patient doesn’t respond to medications or physical therapy, then Dr. Robinson may suggest pain-relieving injections.
If your pain doesn’t improve with conservative treatments, surgery may be an option. “Surgery is only for when everything else has failed and your pain persists,” he says.
Fortunately, for people who do need surgery, there are many minimally invasive options.
Dr. Robinson is a double fellowship-trained orthopaedic spine surgeon, specializing in robotic and minimally invasive spine surgery. “Our advanced technology allows us to do surgery with more precision and make smaller incisions,” he says.
“Disc replacement procedures are getting better and better, and they allow you to maintain motion,” Dr. Robinson says. “Although not everyone is a good candidate for certain procedures, I’ll always walk through all the options with patients.”
“People shouldn’t be in chronic pain, and I want to help,” he says. “So, above all, don’t give up.”
Editor's Note: This article was originally published on , and was last reviewed on .