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Revolutionizing Spine Care…Changing Lives

WHEN YOUR CONDITION IS DEGENERATIVE DISC DISEASE (SPONDYLOSIS)

Degenerative Disc Disease (DDD), also known as Spondylosis, is a condition that usually occurs due to aging. As the term implies, it is the progressive deterioration of the discs between the vertebral bodies. Spondylosis (a different term than spondylolisthesis) is typically a degenerative condition of the joints of the spine and is also known as spinal osteoarthritis. The discs, joints, and ligaments of the spine are generally involved.

The discs lose their cushioning effect between the spinal bones, the ligaments become weaker or thicken, and the bones can develop bony growths or spurs. Aging and repetitive stresses to the spine are the primary causes of this degeneration, but they also can be present in younger adults who have had prior trauma. Not everyone will have symptoms (usually pain) as a result of spondylosis. If severe, spondylosis may cause pressure on nerve roots with subsequent pain or tingle in the arms or legs.

Spondylosis is a degenerative condition of spinal joints and is also known as spinal osteoarthritis. Discs, joints, and ligaments are usually involved. Discs lose their cushioning effect, ligaments become weaker or thicken, and vertebrae can develop bony growths or spurs. Spondylolisthesis occurs when there is an abnormal alignment of the spine when seen from the side or lateral view.

The vertebra above slides forward relative to the one below it. This misalignment may result from several causes, including trauma or degeneration. There may be abnormal spinal motion associated with this condition. Spondylolisthesis may result in back or neck pain, but extremities can be involved if the spinal cord or nerve roots are compressed or irritated.

Commonly, patients will complain of muscle spasms, thigh and/or buttock pain, and/or tight hamstrings. There are patients who have spondylolisthesis and do not have symptoms. Spondylolisthesis can be congenital (present at birth) or develop in adolescence or adulthood. The disorder may result from the physical stresses to the spine from physical activity, trauma, and general wear and tear.

In some individuals, the vertebra loses flexibility. Others experience bone spurs or disc bulging that can compress a nerve root, which can cause chronic pain, numbness, and weakness in certain body parts. This condition, however, can occur anywhere along the spinal column, with most cases occurring at the cervical region (degenerative disc disease of the neck) and at the lumbar area (lower back).

Spondylosis occurs with aging, as the shock-absorbing cushions termed intervertebral discs, lose fluid resulting in decreased flexibility of the spine, bulging, thinning, and lesser cushioning ability of the discs. Aside from the normal wear and tear as the individual ages, degenerative disc disease can also occur due to injury as a result of external trauma or repetitive stress on the vertebra. Other common factors that can contribute to the advancement of disc degeneration include obesity, smoking, and genetic factors.

Symptoms

Not everyone will have symptoms (usually pain) as a result of spondylosis. If severe, spondylosis may cause pressure on nerve roots with subsequent pain or tingle in the arms or legs. The most common clinical manifestation of degenerative disc disease is lower back pain that may or may not radiate to the upper part of the thighs. Some individuals who experience pain from Spondylosis describe morning pain as lower back stiffness or rigidity.

Diagnosing

Your doctor will first perform a physical exam to observe your posture, range of motion, and physical condition, noting any movement that causes you pain. A neurological exam may also be performed to test your reflexes and muscle strength. During the neurological exam, your doctor will test your sensation, reflexes, and muscle strength. Very commonly with spondylolisthesis, the neurological exam findings are relatively normal.

As your doctor develops the diagnosis, imaging tests may be performed. The best initial test for diagnosis of spondylolisthesis is an X-ray taken in the standing position, with the spine flexed and then extended. For further confirmation of spondylolisthesis, a CT scan may be ordered. If the slipped vertebra is suspected to be pressing on nerves, the doctor may order a myelogram or an MRI scan.

Treatments

Treatment varies with the severity of the spondylolisthesis. Most patients require only physical therapy combined with activity modification. If pain is arising from nerve root irritation, an epidural steroid injection may be considered. For cases with severe pain not responding to therapy, if the slip is severe or there are neurologic changes, the slipping vertebra might be surgically fused to the vertebra below it. It is important to discuss treatment options with your doctor in deciding which treatment, if any, may be best for you.

Non-surgical treatments for spondylosis include epidural injections, chiropractic care, pain management medications, and physical therapy. If the pain continues or there is evidence of a severely compressed nerve, surgery may be considered. Surgery for spondylosis involves two main components: eliminating what is causing pain and then fusing the spine to control movement.

Surgery may also include decompression, which means removing the tissue that is pressing on nerves. Spondylosis and disc degeneration causing functionally disabling pain that fails to improve with conservative treatment may be treated with fusion or disc replacement surgery. Every case is different. It is therefore very important to discuss treatment options with a spine specialist familiar with all types of spinal surgery in deciding which treatment, if any, may be best for you.

Frequently Asked Questions

Will exercise help?

Like unused rubber that gets brittle as it ages, bones and joints get fragile with immobility. Regular exercise is the key to prevent further damage and complication. However, exercise should be done with caution and to an extent that is comfortable and pain-free.

Exercise #1
  • Sit comfortably with both feet on the floor
  • Keep your neck straight
  • Bring the back of your head up
  • Feel the stretch of your neck
  • Repeat a few times
Exercise #2
  • Sit comfortably with both feet on the floor
  • Relax both of your shoulders and arms
  • Move your left ear towards your left shoulder as far as you can tolerate without lifting your shoulder
  • Return to starting position
  • Perform the same exercise on the right side
  • Repeat for few times as tolerated
Exercise #3
  • Sit comfortably with both feet on the floor
  • Relax both of your shoulders and arms
  • Keep your neck straight and look straight ahead
  • Gently turn your head to the right as far as comfortable (maintain your gaze straight and parallel to the floor)
  • Return to starting position
  • Perform the same exercise on the right side
  • Repeat for few times as tolerated
Exercise #4
  • Sit comfortably with both feet on the floor
  • Relax both of your shoulders and arms
  • Gently move your head down with your chin towards the chest as far as comfortable
  • Keep your back and neck aligned
  • Return to starting position
  • Repeat step 3 for few times as tolerated
Can Epsom Salts help to reduce my pain?

The Magnesium content present in Epsom salt works wonders in healing.  It aids in balancing the pH levels in the body. When pH levels are balanced, the stiffness can be minimized. It also helps in lessening the pain of DDD in your neck and shoulders.

To prepare for an Epsom salt treatment, take a couple of tablespoonful of Epsom salt and add water to make a paste. Apply it to your neck and shoulders. Keep it on for approximately 15 minutes, and then wash it off. However, if you have diabetes, cardiac or kidney problems, consult your doctor first prior to using this home management.

Why did i get this?

In most cases it is just the normal aging process.  It can certainly be affected by genetics and if your mother and father have problems with their back it is not unusual that you too will have problems with your back.

Is Degenerative Disc Disease a disease?

No, it really isn’t a disease in the typical sense, meaning that there is not a pill you can take to stop it, and it is not life-threatening.  It is more of a wear and tear process.

Will have to live it the rest of my life?

No, most patients usually will respond to an active exercise program, strengthening their core or trunk muscles, learning proper body posture and body mechanics, losing weight if they are overweight, and the use of anti-inflammatories in the vast majority of cases.

How common is Degenerative Disc Disease?

We know that 90% of individuals will experience 1 episode of low back pain and about a third of this 90% will have chronic intermittent back pain.  If one exercises and takes care of their spine, the pain-free intervals can actually be quite long and recovery from these episodes will be relatively shortened.  That’s why it is very important to practice good body posture and body mechanics and to do your exercises.

I have young children. Will they get Degenerative Disc Disease?

Unfortunately, we know that genetics does play a role in the conditions that our family gets.  While there has been research to determine what genes may be associated with Degenerative Disease, it is not clear-cut at the present time.  The most important thing is for all patients to be physically fit, of normal weight, and to practice good body posture and body mechanics.

Leaders in Advanced Spine Procedures

To find out whether you would benefit from artificial disc surgery, make an appointment to visit Texas Back Institute in the Dallas, TX, area for an evaluation. We always reserve surgery as a last resort, so we’ll seek to relieve pain first through conservative treatments such as physical therapy and pain management. If severe pain persists and it is determined that you would benefit from surgery, we can help you determine whether artificial disc replacement is right for you.

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