Degenerative disc disease is one of the most common causes of low back and neck pain. De-generative disc disease refers to symptoms of back or neck pain caused by wear-and-tear on a spinal disc. In some cases, degenerative disc disease also causes weakness, numbness, and hot, shooting pains in the arms or legs (radicular pain). Degenerative disc disease typically con-sists of a low-level chronic pain with intermittent episodes of more severe pain. Disc degenera-tion is a natural part of aging, and over time everybody will exhibit some changes in their discs. However, a degenerating disc does not always cause symptoms to develop. In fact, degenera-tive disc disease is quite variable in its nature and severity.

  • Symptoms

    The most indicative symptom of degenerative disc disease is a low-grade, continuous pain around the degenerating disc that occasionally flares up into more severe, potentially disabling pain. Pain flare-ups can be related to recent activity and abnormal stress on the spine, or they

    may arise suddenly with no obvious cause. Episodes can last between a few days to several weeks before returning to low levels of pain or temporarily going away entirely.

    • Increased pain with activities that involve bending or twisting the spine, as well as lifting something heavy.
    • A “giving out” sensation, caused by spinal instability, in which the neck or back feels as if it is unable to provide basic support, and may lock up and make movement feel difficult.
    • Muscle tension or muscle spasms, which are common effects of spinal instability. In some cases, a degenerated disc may cause no pain but muscle spasms are severely painful and temporarily debilitating.
    • Possible radiating pain that feels sharp, stabbing, or hot. In cases of cervical disc degeneration, this pain is felt in the shoulder, arm, or hand in cases of lumbar disc degeneration, pain is felt in the hips, buttocks, or down the back of the leg.
    • Increased pain when holding certain positions, such as sitting or standing for extended periods (exacerbating low back pain), or looking down too long at a cell phone or book (worsening neck pain).
    • Reduced pain when changing positions frequently, rather than remaining seated or standing for prolonged periods. Likewise, regularly stretching the neck can decrease cervical disc pain, and taking short, frequent walks during the day can decrease lumbar disc pain.
    • Decreased pain with certain positions, such as sitting in a reclining position or lying down with a pillow under the knees, or using a pillow that maintains the neck’s natural curvature during sleep.
  • Treatment

    The goals of degenerative disc disease treatment are primarily to reduce baseline pain and prevent pain flare-ups as much as possible. Most cases of degenerative disc pain are manageable through a combination of pain management methods, exercise/physical therapy, and lifestyle modifications. A key focus of pain management is to improve mobility and reduce pain so daily activities and rehabilitative exercise are more tolerable. Pain from a degenerated disc is usually attributed to instability, muscle tension, and inflammation, so these causes should be addressed.

    • Heat therapy. Using heat from a heating pad, adhesive wrap, warm bath or other heat sources can relax the surrounding muscles and reduce tension and spasms, a significant contributor to degenerative disc pain.
    • Pain medications. Over-the-counter pain medications fall into two main categories— pain relievers, such as acetaminophen (Tylenol), and anti-inflammatory medicines such as ibuprofen (Advil), aspirin (Bayer), and naproxen (Aleve). These medications are typically recommended for low-level chronic pain and mild pain episodes. For severe pain episodes, prescription painkillers such as muscle relaxants and narcotic painkillers may be recommended. Prescription pain medications are usually prescribed for short-term pain, as they can be highly addictive.
    • Epidural Steroid Injections. Asteroid injected around the spine’s protective outer layer can provide temporary pain relief, which helps to improve mobility. Injection treatments may be recommended prior to a physical therapy program, so exercises can be effectively completed with minimal pain.

    Due to the long-term nature of degenerative disc disease, preferred pain management methods may change over time.