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Degenerative Disc Disease
Degenerative Disc Disease
Degenerative disc disease (DDD) is part of the natural process of growing older. Unfortunately, as we age, our intervertebral discs lose their flexibility, elasticity, and shock absorbing characteristics. The ligaments that surround the disc, called the annulus fibrosis, become brittle and are more easily torn. At the same time, the soft gel-like center of the disc, called the nucleus pulposus, starts to dry out and shrink.
When DDD becomes painful or symptomatic; it can cause several different symptoms, including back pain, leg pain, and weakness. These symptoms can be caused by worn out discs that do not function as well as they once did. As the discs start to wear out, the entire lumbar spine becomes less flexible. As a result, people complain of back pain and stiffness, especially towards the end of the day.
When DDD causes compression of the nerve roots, the pain often radiates down the legs or into the feet, and may be associated with numbness and tingling. In severe cases of lumbar DDD, where there is evidence of nerve root compression, individuals may experience symptoms of sciatica and back pain, and sometimes even lower extremity weakness.
The diagnosis of DDD begins with a complete physical examination of the body, with special attention paid to the back and lower extremities. Your doctor will examine your back for flexibility, range of motion, and the presence of certain signs that suggest that your nerve roots are being affected by degenerative changes in your back. This often involves testing the strength of your muscles and your reflexes to make sure that they are still working normally. You will often be asked to fill out a diagram that asks you where your symptoms of pain, numbness, tingling and weakness are occurring or a questionnaire reporting the intensity and/or frequency of your pain.
A routine set of x-rays is also usually ordered when a patient with back pain goes to see a doctor. If DDD is present, the x-rays will often show a narrowing of the disc spaces between the vertebral bodies, which indicates that the disc has become very thin or has collapsed. In many situations, doctors will order a MRI or a CT scan (CAT scan) in order to evaluate the degenerative changes in the lumbar spine more completely. A MRI scan is very useful for determining where disc herniations have occurred and where the nerve roots are being compressed. A CT scan is often used to evaluate the bony anatomy in the spine, which can show how much space is available for the nerve roots.
Your doctor will be able to discuss with you what your diagnosis means in terms of treatment options . For most people who do not have evidence of nerve root compression with muscle weakness, the first line of therapy may include non-steroidal anti-inflammatory drugs and physical therapy . A soft lumbar corset is sometimes prescribed in order to allow the back to have a chance to rest. Surgery is offered only after physical therapy, rest, and medications have failed to adequately relieve the symptoms of pain, numbness and weakness over a significant period of time.
If you have back pain, leg pain, or weakness, talk to your doctor about appropriate treatment options. To find a doctor in your area, use our Find A Doctor locator.
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