Oh, my aching back

by Judah Donaldson, APRN, FNP

Degenerative disc disease (DDD) is a common condition that affects the spine, leading to pain, stiffness, and reduced mobility.

Despite its name, DDD is not actually a disease but rather a natural process of aging that causes the intervertebral discs to wear down over time. While it can be a source of chronic discomfort, many treatment options are available to help manage symptoms and improve quality of life.

What is degenerative disc disease?

Your spine is made up of a series of bones (vertebrae) separated by soft, cushion-like discs. These discs act as shock absorbers, allowing the spine to bend, twist, and move smoothly. Over time, these discs can lose their flexibility and hydration, leading to changes that cause pain and stiffness.

As the discs deteriorate, they may:

• Lose hydration – Healthy discs contain a high-water content, but as they dry out, they become less effective at absorbing shock.
• Develop small tears – Tiny cracks or tears in the outer layer of the disc can lead to pain and inflammation.
• Collapse – When a disc loses height, it can cause the vertebrae to come closer together, increasing stress on the joints and nerves.

These changes can contribute to chronic pain, stiffness, and reduced movement in the spine.

Symptoms

DDD can affect any part of the spine but is most common in the lower back (lumbar spine) and neck (cervical spine). Symptoms can vary depending on the location and severity of disc degeneration.

Common symptoms include:

• Chronic, dull back or neck pain that worsens with movement or prolonged sitting.
• Pain that radiates into the arms (if in the cervical spine) or legs (if in the lumbar spine).
• Increased discomfort after bending, lifting, or twisting.
• Stiffness and reduced flexibility in the spine.
• Numbness or tingling if nerves are irritated or compressed.
• Pain relief when changing positions or lying down, as pressure on the disc decreases.

Causes & Risk Factors

While aging is the primary cause of degenerative disc disease, several factors can speed up the process or increase the risk of developing symptoms. These include the following:

• Age – Disc degeneration is a natural part of aging, usually starting in your 30s or 40s.
• Repetitive stress on the spine – Jobs or activities that involve heavy lifting, twisting, or prolonged sitting can contribute to disc wear.
• Obesity – Excess weight adds stress to the spine, leading to faster disc degeneration.
• Smoking – Reduces blood flow to the discs, which can accelerate deterioration.
• Genetics – Some people may inherit a predisposition to faster disc degeneration.
• Injury or trauma – A past injury, such as a fall or accident, can contribute to early disc wear.

Diagnosis

If you experience persistent back or neck pain, an orthopedic specialist may perform a thorough evaluation, including:

• Medical history and physical exam – Assessing symptoms, lifestyle, and previous injuries.
• Imaging tests – X-rays, MRI, or CT scans can help visualize disc height, hydration, and any damage to surrounding structures.
• Flexibility and strength tests – Checking for movement limitations and nerve function.

Treatment Options

Although DDD is not reversible, many treatments can help manage pain and improve mobility. The goal of treatment is to reduce discomfort, strengthen the spine, and prevent further deterioration.

Non-Surgical Treatments

Most cases of DDD can be managed with non-surgical options, including:

• Physical therapy – Exercises to strengthen the muscles supporting the spine and improve flexibility.
• Medications – Over-the-counter pain relievers like ibuprofen or acetaminophen can help reduce inflammation and discomfort. In some cases, muscle relaxers or prescription pain medications may be recommended.
• Heat & ice therapy – Alternating heat and ice packs can reduce inflammation and improve blood flow to the affected area.
• Lifestyle modifications – Maintaining a healthy weight, quitting smoking, and using ergonomic supports can help slow disease progression.
• Activity modification – Avoiding activities that strain the spine, such as prolonged sitting or heavy lifting, can help prevent worsening symptoms.
• Steroid injections – Corticosteroid injections may be used to reduce inflammation and provide temporary pain relief in severe cases.

Surgical Treatments

Surgery is considered only when conservative treatments fail, and symptoms significantly impact daily life. Common surgical options include:

• Spinal fusion – Two or more vertebrae are fused together to stabilize the spine and reduce pain.
• Artificial disc replacement – The damaged disc is replaced with an artificial one to maintain motion in the spine.
• Laminectomy or foraminotomy – Procedures to relieve pressure on compressed nerves if nerve-related symptoms are severe.

Surgery is typically a last resort and is only recommended when symptoms are severe and affect quality of life.

Living with degenerative disc disease

Managing DDD involves making long-term lifestyle adjustments to minimize pain and maintain mobility.

Tips for managing DDD at home:

• Stay active – Low-impact exercises like swimming, walking, or yoga help keep the spine flexible and strong.
• Practice good posture – Sitting and standing with proper posture reduces stress on the spine.
• Use supportive seating – Ergonomic chairs and lumbar supports can help maintain proper spinal alignment.
• Maintain a healthy weight – Reducing excess weight decreases strain on the spine.
• Strengthen your core – A strong core supports the spine and reduces pain.

When to see an orthopedic specialist

If you experience any of the following symptoms, it is time to seek professional care:

• Severe or worsening pain that does not improve with rest or medication.
• Numbness, tingling, or weakness in the arms or legs.
• Difficulty walking, standing, or completing daily tasks.
• Loss of bladder or bowel control (which could indicate a serious spinal condition).

Early intervention can help prevent further complications and improve your quality of life.

Degenerative disc disease is a natural part of aging, but it doesn’t have to mean constant pain or disability. With proper treatment, lifestyle adjustments, and expert care, most people can manage their symptoms and continue to live an active life.

If you’re experiencing persistent back or neck pain, consult an orthopedic specialist to explore your treatment options and develop a personalized plan for relief.