Degenerative disc disorder is one of the most common causes of low back pain and neck pain. Degeneration of one or more intervertebral disc(s) of the spine, often called degenerative disc disease, is a pathological process of uncertain causes that may cause acute or chronic back pain. Disc degeneration is a disease of aging, for most people is not a problem, in certain individuals a degenerated disc can cause severe chronic pain if left untreated.
Degenerative disc disorder describes the symptoms of pain and possibly radiating weakness or numbness stemming from a degenerated disc in the spine. While the definition sounds simple, many patients diagnosed with degenerative disc disease wonder exactly what this diagnosis means for them.
A diagnosis of “degenerative disc disorder” is alarming to many patients because it sounds like a progressive, threatening disease. However, it is not really a disease, and it is not strictly degenerative.
For most people the term degenerative implies the symptoms will get worse with age. However, the term does not apply to the symptoms, but rather describes the process of the disc degenerating over time.
While it is true the disc degeneration is likely to progress over time, the pain from degenerative disc disorder usually does not get worse and in fact usually gets better given enough time. The degenerative cascade theory explains how this process works.
Another source of confusion is probably created by the term disease, which is actually a misnomer. Degenerative disc disorder is not really a disease at all, but rather a degenerative condition that at times can produce pain from a damaged disc.
Disc degeneration is actually a natural part of aging, and over time all people will exhibit changes in their discs consistent with a greater or lesser degree of degeneration. However, not all people will develop symptoms. In fact, degenerative disc disease is quite variable in its nature and severity.
Generally, the pain associated with degenerative disc disorder is thought to stem from two main factors:
The proteins contained within the disc space can cause a lot of inflammation, and as a general rule inflammation will cause pain.
- In the lumbar disc space, the low back pain can radiate into the hips. The associated pain can also travel down the back of the leg (also called sciatica, or radiculopathy), and possibly into the foot and toes.
- In the cervical disc space, the neck pain may be local or may radiate into the arm, shoulder and possibly into the hand (a cervical radiculopathy).
- Abnormal micromotion instability
If the outer rings of the intervertebral disc degenerates and wears down, it is not as effective in resisting motion in the spine. This condition has been termed micromotion instability because it is usually not associated with gross instability, such as a slipped vertebral body or spondylolisthesis.
Both the inflammation and micromotion instability can cause lower back or neck muscle spasms. The muscle spasm is the body’s attempt to stabilize the spine. It is a reflex, and although the body’s response of muscle spasm is not necessary for the safety of the nerve roots, it can be quite painful.
The muscle spasms associated with the instability are thought to cause the flare-ups of intense pain often associated with degenerative disc disorder.