Frequently Asked Questions
- What is degenerative disc disease (DDD)?
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Dr. Kambiz Hannani
Los Angeles, CAWhen a disc ages or loses its ability to cushion the spine properly, the disc is called degenerated. Degenerated discs show up as dark discs on MRI scans and usually cause significant pain when discography is performed. Discography involves injecting dye while a patient is awake to obtain clearer x-ray images. Most degenerated discs cause no pain in the general population. Unfortunately, a small number of degenerated discs can cause severe back pain. Many minimally invasive procedures are available to treat these discs.
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Dr. Andrew Glass
Someras Pt., NJDegenerative disc disease, or DDD, is the collective term used to describe a specific state that a disc can be in, either as result of injury or injuries, or due to progressive "wear and tear". DDD can involve one or multiple discs in the back. Typically, DDD results in bulging of the disc with loss of height of the disc. The vertebral bones are therefore closer to one another. The internal chemical and fluid structure within the disc can be altered, and this can usually be identified on a test such as an MRI. DDD can cause back pain, leg pain or both.
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Dr. Reginald Knight
Seattle, WANatural process of disc degeneration. Treatment for DDD often includes moderate rest, exercise, non-steroidal anti-inflammatory medications (NSAIDS), altering your activities and possibly a spinal fusion.
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Dr. Dennis G Crandall
Mesa, AZA degenerative disk has lost its normal water content and has a decreased ability to serve as a compressible cushion between the vertebrae. The spine becomes stiffer as a result.
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Dr. Theodore A Belanger
Charlotte, NCDegenerative disc disease involves narrowing of the disc space on an x-ray. It signifies that a disc is worn out and is acting less effectively as a shock absorber. This condition may be worsened or sped up by excessive repetitive lifting, smoking tobacco, truck-driving or genetic factors. Most people with degenerative discs experience little or no back pain. Occasionally, treatment with activity modification, physical therapy and or medication is used to treat backaches. Pain is very rarely severe and requires surgery to be considered.
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Dr. Sylvain Palmer
Mission Viejo, CAWhen discs age they loose water and become dried out and brittle. This is like a rubber band that you leave out in the sun. Once it is dried out if you pull on it it won't stretch but it will break instead. This makes discs easier to injure even with normal activities.
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Dr. Jeffrey C Wang
Los Angeles, CADegenerative disc disease is basically arthritis of the disc. The disc serves as a "cushion" between the bones of the spine. With age, stress and strain, these discs can become arthritic and "wear out." In this situation, these discs are termed degenerative. The first line of treatment is conservative treatment, which often includes anti-inflammatory medications, physical therapy and a back education class to strengthen and stabilize the spine. Patients learn how to prevent placing great amounts of stress on the back and how to lift properly, which can protect the back. In patients where the conservative treatment fails, we will often have to perform a fusion where we remove the disc and the arthritis and fuse one bone to its adjacent segment to alleviate the stress and the painful disc.
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Dr. W. Christopher Urban
Glen Burnie, MDDegenerative disc disease is a disorder of the intervertebral disc that involves both structural and inflammatory changes of the disc. As the intervertebral disc ages, it becomes dehydrated and looses its ability to act as a shock absorber for the spine. This condition can cause back or leg pain.
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Dr. Thomas Zdeblick
Madison, WIDegenerative disc disease is simply the finding of a disc becoming narrow on x-ray. As the disc narrows, bone spurs often grow up around the disc. A narrow disc can be painful as it does not have the same ability to absorb shocks as a normal disc does. The treatment for degenerative disc disease often begins with physical therapy and exercises aimed at strengthening the muscles surrounding the spine. Also the avoidance of repetitive jarring activities and the use of anti-inflammatory medication are helpful. Should these treatments not work, surgery may be indicated.
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Dr. Sean Salehi
Chicago, ILDegenerative disc disease is the reactive changes that occur in vertebrae secondary to a degenerative disc.
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Dr. Jorge E Isaza
Baton Rouge, LABy definition, degenerative disc disease is the normal wear and tear of the disc that occurs with the aging process. The majority of the people with degenerative disc disease will have no pain or intermittent discomfort as they go through life. Early degenerative disc disease is considered pathologic in nature, since it can cause restrictions on the patient's life and their ability to perform the normal activities of daily living.
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Dr. Rick Sasso
Indianapolis, INDDD is not necessarily a disease, but rather a normal aging process through wear and tear on the spine resulting in dehydration of the disc. It is essentially arthritis of the spine. A very conservative treatment for DDD is physical exercise with a focus on strengthening and conditioning the abdominal and back muscles. Another treatment is anti-inflammatory medications that typically have good results. If exercise and medications do not work often a brace is prescribed.
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Dr. Robert S Pashman
Los Angeles, CADegenerative disc disease refers to the loss of loss of hydration in the disc and weakening of the annulus fibrosus (outer lining of the disc). Trauma may cause the annulus to tear and disc material to leak out and press on a nerve. Degenerative disc disease is very common but is not always symptomatic.
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Dr. Sebastian Lattuga
Rockville Centre, NYDDD is a common condition affecting millions of people. Its condition that affects the intervertebral discs, where the disc material begins to degenerate or wear out. This results first in a loss in disc space height and then as the condition progresses ultimately it can lead to a near total loss of all disc material. The consequence of this is it can cause chronic back pain in some people.
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Dr. Eung-Jun Cha
Bedford, INMeans the disc has degenerated to the point of usually needing surgery.
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Dr. John S Shiau
Staten Island, NYDegenerative disc disease is basically the wear and tear of your disc, degeneration meaning that the disc has broken down. Degenerative disc disease can be caused by some type of trauma that speeds up the process of degeneration; people who smoke usually have a higher incidence of degenerative disc disease and almost all people as they get older get degenerative disc disease. It is part of the ageing process. But really the root cause of degenerative disc disease is wear and tear on that disc.
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Dr. Mark Rosenthal
Baltimore, MDDegenerative disc disease is a deterioration of the discs that hold the spine together. It can follow trauma, infection, or just be part of the aging process. It can lead to back pain, and as it worsens, it can pinch the nerves causing pain and weakness of the legs.
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Dr. Donald D Dietze Jr.
Covington, LADegenerative disc disease is felt to be the fatigue of the disc to function as a joint over time due to repetitive wear and tear to hold our bodies up and perform work.
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Dr. Kenneth A Pettine
Loveland, COI absolutely hate this term since people who have this do not have a disease. I believe this is a gross misnomer of a typically normal aging process. With age, discs typically become dried out or desiccated and this can be diagnosed with an MRI scan. Unfortunately, when a disc is observed on an MRI scan to be dried out it is often characterized as being degenerated and a patient with several discs is diagnosed as having degenerative disc disease. Again, I must emphasize this is absolutely not a disease. It is not contagious or transferable. The fact that people who have dried out discs have symptoms of back pain is secondary to the processes we have already discussed. This includes the fact the outer portion of the disc is heavily enervated and a patient who has a disc not functioning normally often has an instability of that portion of the spine which results in symptoms of chronic back pain.
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Dr. Jeffrey Goldstein
New York, NYWhen discs age they lose water and become dried out and brittle. This is like a rubber band that you leave out in the sun. Once it is dried out if you pull on it won't stretch but it will break instead. This makes discs easier to injure even with normal activities or secondary to trauma. Many patients live for years with degenerative discs that do not cause pain until there is some sort of injury.
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Dr. Randy Davis
Glen Burnie, MDAlthough discs deteriorate as a normal process of aging, the deterioration process can cause small tears in the periphery or the outer surface of the disc which can be painful for the patient. If patients have tried appropriate non-operative treatment, such as medication as well as physical therapy and still remain with symptoms, an MRI can be used to diagnose a degenerated disc and then other tests such as discogram may be used to prove whether or not the degenerated disc is the source of a patient's pain. The treatment for degenerative disc disease is always non-surgical, first involving the use of anti-inflammatory medicines, frequently physical therapy and appropriate exercise and back school instruction for all patients. If the patient then continues to fail to respond to non-operative therapy, there are a number of surgical options available which may or may not involve removal of a portion of the disc with or without an operation called fusion which is designed to stabilize the vertebrae together to prevent what is thought to be painful motion.
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Dr. Paul J Slosar
Daly City, CADegenerative Disc Disease (DDD) is an another term that is frequently used interchangeably with "bulging disc". All discs degenerate over time but a certain percentage will be painful. The patients that I see with LBP and disc degeneration on an MRI have Painful Degenerative Disc Disease. Most treatment for DDD is non-surgical: activity modifications, physical therapy, and occasionally medications. A few patients will have severe pain that is unresponsive to non-surgical treatment and may request surgical evaluation. Typically, if a patient comes to surgery for painful Degenerative Disc Disease then a lumbar fusion is the procedure most commonly offered. There have been substantial improvements over the last 5 years in the success rates and clinical results for lumbar fusions. Some day we may be able to provide fusions without taking bone from the patient's hip, which has traditionally been a very painful aspect of the operation.
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Dr. George Frey
Englewood, CODegenerative disc disease is the process of mechanical wear and tear on the disc itself. This is noted in most adults after about 30 years of age. The disc has a high content of water, which maintains it as a spongy, springy type of structure. The disc functions as a shock absorber, spacer and joint between vertebrae. This allows for controlled motion between vertebrae. When disc degeneration occurs, the disc begins to narrow and stiffen. The normal function as a shock absorber and spacer, as well as providing controlled motion between vertebrae, is lost. This directly causes inflammation and pain from that disc.
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Dr. Thomas Kleeman
Bedford, NHDisc degeneration is a natural consequence of aging. It is seen radiographically in about one out of five people in their twenties and in 100% of people by their sixties. The symptoms if any are mild and transient. Occasionally the condition becomes more of a disease than a natural process. This is often seen when the discs degenerate prematurely at a time when the patient is still young and active. The discs are subjected to more stress than would be expected in an older and more sedentary individual. The inflammation that is generated in the disc causes mechanical pain that is aggravated by activity and relieved by rest and lying down. As the disease progresses, fissures and cracks within the disc can lead to ruptures or herniations of disc fragments. There is no present treatment that can reverse the degenerative process. On the other hand the symptoms can be treated with anti-inflammatory medication, a brief period of rest, and progressive activity as the symptoms abate. Once the symptoms have subsided, there is evidence that participation in a regular exercise program may prevent or at least reduce the symptoms of recurrent flare-ups of back pain. Both aerobic and resistive exercises have been shown to be beneficial. Discs derive nutrition through physiologic motion. Exercise enhances spinal nutrition while a sedentary life may lead to accelerated degeneration.
The commentary above recounts the experiences of these physicians. Medtronic invited them to share their stories candidly. Keep in mind that results vary; not every patient's response is the same. Talk with your doctor to learn more about any products that are mentioned above.
It is important that you discuss the potential risks, complications and benefits of spinal surgery with your doctor prior to receiving treatment, and that you rely on your doctor's judgment. Only your doctor can determine whether you are a suitable candidate for this treatment.
