© Capital Neurosurgery 2018

What is degenerative disc disease?

 

Degenerative disc disease is one of the most common causes of low back pain.  Disc degeneration is a natural part of ageing and over time all people will exhibit changes in their intervertebral discs.  However, not everyone will develop symptoms.

 

While the degeneration will progress, the low back pain and other symptoms do not always get worse with this progression.  Although low back pain from this disease usually gets better over time, some patients can develop chronic back pain.

 

What causes the pain?

 

The lumbar disc has a firm tough outer layer and a “jelly like” centre. This soft centre contains a great deal of inflammatory proteins.  If any of these proteins leak out of the disc and come in contact with a nerve root it can create pain down the leg.  If the tough outer layer becomes damaged or worn down it does not work as an effective stabiliser. The combination of inflammation and instability can cause muscle spasm in the lower back. With continued disc degeneration all the inflammatory proteins in the centre of the disc disappear, and the disc will become stiffer. If affected individuals can effectively manage their pain and maintain their mobility the natural history is quite favourable in that many individuals will improve over time without specific treatment.  It is not  clear why some degenerative discs are painful and some are not.

 

                                                                       Types of pain

                                                                       Chronic low back pain with intermittent episodes of severe acute  low back pain

                                                                       Severe episodes will generally last from a few days to a couple of months                                                                                                      when there is a return of chronic low back pain

                                                                       There may be leg pain, numbness and tingling

 

                                                                       Symptoms

                                                                       Low back pain generally made worse with sitting

                                                                       Certain types of activity will usually worsen the low back pain, especially                                                                                                         bending, lifting and twisting

                                                                       Walking may actually feel better than prolonged sitting or standing

                                                                       Frequent position changes are usually more comfortable

 

Treatment options

Specific exercise programmes

Hot and/or cold packs

Analgesic and anti-inflammatory medications

Steroid injections

Physiotherapy, chiropractic or massage treatment may be beneficial

Surgery may be considered if the patients pain cannot be controlled or

patient is becoming  disabled