Degenerative disc disease is one of the most common causes of low back pain and neck pain, and also one of the most misunderstood.
Watch: Video: What Is a Degenerative Disc and the Degenerative Cascade?
Simply put, degenerative disc disease describes the symptoms of pain and possibly radiating weakness or numbness stemming from a degenerated disc in the spine. While the definition sounds simple, many patients diagnosed with degenerative disc disease are left wondering exactly what this diagnosis means for them.
Common questions often include:
- If I have this much pain in my thirties, how much worse will it become with age?
- Will the disease become a crippling condition? Will I end up in a wheelchair?
- Should I restrict my activities? Can I still play sports?
- Will the disease spread to other parts of the spine?
- Will the degenerated disc(s) cause any permanent damage?
- Is surgery inevitable?
Degenerative Disc Disease is a Misnomer
A diagnosis of "degenerative disc disease" is alarming to many patients because it sounds like a progressive, threatening disease. However, it is not really a disease, and it is not strictly degenerative.
For most people the term degenerative understandably implies that the symptoms will get worse with age. However, the term does not apply to the symptoms, but rather describes the process of the disc degenerating over time.
While it is true that the disc degeneration is likely to progress over time, the pain from degenerative disc disease usually does not get worse and in fact usually gets better given enough time. The degenerative cascade theory explains how this process works.
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Another source of confusion is probably created by the term disease, which is actually a misnomer. Degenerative disc disease is not really a disease at all, but rather a degenerative condition that at times can produce pain from a damaged disc.
Disc degeneration is actually a natural part of aging, and over time all people will exhibit changes in their discs consistent with a greater or lesser degree of degeneration. However, not all people will develop symptoms. In fact, degenerative disc disease is quite variable in its nature and severity.
- For lower back pain, see Lumbar Degenerative Disc Disease (DDD)
- For neck pain, see Cervical Degenerative Disc Disease
Medical Practitioners Disagree
Many patients are confused about degenerative disc disease because medical professionals are not in agreement about what the diagnosis means.
In practical terms, this means that few health professionals agree on what does and does not constitute a diagnosis of degenerative disc disease, or when a degenerated disc is the cause of the patient's pain. Even medical textbooks don't usually attempt to give an accurate description. Therefore, while many practitioners believe that degenerative disc disease is a common cause of low back pain and neck pain, few agree on the implications.
While much is up for debate, a few aspects of the condition are known. This article provides in-depth information about aspects of degenerative disc disease based on commonly accepted principles, such as how a degenerated disc causes pain, and common symptoms and treatments.
It is important to note that disc degeneration can lead to or hasten the onset of additional spinal conditions, such as:
- Spinal stenosis, a form of spinal degeneration that leads to nerve root or spinal cord pinching.
- Osteoarthritis in the spine, e.g. joint changes in the facet joints in the back of the spine that occur as a result of disc degeneration.
- Spondylolisthesis. If the facet joints degenerate enough, they can become mechanically ineffective, causing one vertebral body to slip forward on another.