Degenerative Disk Disease? There Will be Pain…Maybe

Degenerative Disk Disease? There Will be Pain…Maybe

0

Hi my name is Dr. John Shim and I want to talk about a topic that's very familiar to all of you and that's back pain. Well the truth is if you live long enough you're supposed to have back pain. When you're in your teens sometimes you have back pain is usually sports related or maybe growth spurt related but it usually resolves. By your early 20s to 30s a few percentage of you will have back pain maybe twenty to twenty-five percent of you will have some back pain again it might be activity-dependent or positional based on how you slept or how you sat but it's not an uncommon thing but by the time you're 50 and beyond eighty percent of us will have some episode of back pain that will interfere with our ability to work to take care of our family to do recreation and to enjoy life and when you have that episode of back pain it never happens when you can have time for it usually your in the midst of something very very important very frustrated a lot of anxiety sometimes depression sometimes fear because it doesn't seem to be going away this is the good news it affects eighty percent of us but most of us can and will resolve this back pain over time. You have to do the things that make common sense. Number one keep your weight down, number two exercise, number three stop smoking and number four understand that when you have back pain it's a common occurrence and usually you'll give better with a little bit of time a little bit of encouragement and a little bit of help at times from one of your doctors. This is Dr. Shim talking about back pain please understand it's a part of life and I hope it gets better soon take care

Have you been told you have Degenerative Disk Disease? If so, welcome to the club. If you live long enough, you will get it. If you think about it, degenerative disk disease really should not be called a disease, as it is the normal process of disk degradation. It is like saying aging is a disease, which we all know it not true.

So, how does the degenerative disk disease process begin? It really starts almost from childhood. As you develop and grow, the intervertebal disk, does get subject to increasing forces. As we have discussed before, the disk is made of two components, the annulus, which is a tough woven outer structure that contains the softer, initially more jelly-like, full of water, shock absorbing center. With a full of water center, there is enough water pressure to maintain the side walls of the disk. The walls are nice and straight. The disk is also firm. With the height of the disk, and  strength of the well hydrated disk, it acts as a spacer between the vertebrae. Secondary to the space, nerves can easily exit out of the spinal canal in the holes called the foramen. In the normal disk, there is plenty of room for the nerve to exit out the center of the spinal canal but, with a degenerated disk, the space narrows, potentially pinching a nerve in the process.

As we stated above, when the disk is full of water, the pressure in the disk is such that the disk is of a normal height. But, the side walls are also flat. The often used analogy is that of the car tire. When properly inflated, the tire side walls are flat, and the tire is firm, giving a better, more controlled ride. When the disk starts to lose its water content, which is a necessary component of the degenerative disk disease process, the side walls begin to bulge, and the strength and firmness of the disk reduces. In the side wall bulging process, it can also cause further narrowing of the space for the nerve sacs. By losing some of its firmness, it can allow extra motion of the vertebral bones upon one another.

This extra motion causes the facet joints, located in the back of the spine to rub excessively on one another causing development of facet joint arthritis. Also, the extra motion of the vertebra on one another can lead to instability or slippage of the vertebra, potentially causing further irritation of the nerves. This process can lead to what is called degenerative spondylolithesis.

Luckily, the process is usually very gradual. In fact, there are plenty of people who live their whole life without any significant episodes of back, neck or extremity pain, even though their backs and necks may look horrible to a spine surgeon like me.

In general, by age 20 about 15-20% of the population will have some evidence of degenerative disk disease. By age 40, it will be a majority that will have these changes.

And,  unfortunately for most,  degenerative disk disease can cause pain.  The source of the pain can be secondary to the pinching of the nerves,  or the arthritis of the facet joints,  or the related pain associated with the muscles attaching to these joints.  Also,  secondary to the potential development of the spinal instabilities,  the muscles often will need to work extra hard to keep the bones properly aligned and not rubbing against each other,  or pinching the nerves.  This extra work may explain the increasing muscle aches to the neck and back.

Also,  with further collapse of these disks, and reduced heights,  the overall normal body curvatures,  Lordosis, and kyphosis,  can be reduced.  And,  because of the reduction of curvature, and the arthritis to the facet joints,  we experience increased stiffness as we age.    For the more mature reading audience,  I think all these points do sound familiar.

Fortunately,  we usually learn to accomodate these changes,  and we have medical treatments such as anti-inflammatory medications,  muscle relaxers and narcotics to treat the severe episodes.  If necessary,  we can also use corticosteroid injections to accelerate the reduction of the inflammation.  In certain relatively rare situations,  surgery may be necessary to help with the pinched nerves or instability.

Help yourself by doing  the proper things.  Stay disciplined by not smoking,  not gaining weight, and eating properly.  Get exercise, and stretch.

But,  in the end,  we need to accept some of this is secondary to the aging process.   As I discussed with my patients,  it is better than the alternative.

Citations

  • Cho IY, Park SY, Park JH, Suh SW, Lee SH. MRI findings of lumbar spine instability in degenerative spondylolisthesis. J Orthop Surg (Hong Kong). 2017 May-Aug;25(2):2309499017718907. PubMed PMID: 28685666

No comments

Leave a Reply

Your email address will not be published. Required fields are marked *

*
*

Disclosure Statement

The information provided on this website does not provide or should be considered medical advice. It is not a substitute for diagnosis or treatment of any condition. The information provided is for informational purposes only. You should not rely solely on the information provided on this website in making a decision to pursue a specific treatment or advice. You should consult directly with a professional healthcare provider.

As a condition of using the information on this website, ShimSpine and its physicians are not responsible for any advice, diagnosis, treatment or outcome you may obtain.

ShimSpine.com is completely self-funded. No outside funds are accepted or used. This website does not utilize paid advertising as a source of revenue.

This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information:
verify here.

Author and Contributor to www.Spine-Health.com – July, 2015

www.Spine-Health.com/author/john-h-shim-md-facs

Chief of Surgery, Mease Countryside and Mease Dunedin Hospitals, Safety Harbor and Dunedin, Florida. 2014-2016.

Orthopaedic Section Chief Mease Countryside Hospital; Safety Harbor, Florida Mease Dunedin Hospital; Dunedin, Florida.2008-2013

Board Member Morton Plant Mease Research Council

Co-Director of Mease Neuro-Ortho Spine Center Mease Dunedin Hospital; Dunedin, Florida.

One of “6 Spine Physicians Ranked #1 on Google” – December 2016

Top Ten Most Liked Spine Surgeons on the Internet – July 2016

2016 Spine Surgeons to Know list – January 2016

2014 Spine Specialists to know list – September 2014

One of Ten Leaders of Certified Spine Programs – December 2011

 

The Best Orthopedics in Tampa

The information provided on this website does not provide or should be considered medical advice. It is not a substitute for diagnosis or treatment of any condition. The information provided is for informational purposes only. You should not rely solely on the information provided on this website in making a decision to pursue a specific treatment or advice. You should consult directly with a professional healthcare provider.

As a condition of using the information on this website, ShimSpine and its physicians are not responsible for any advice, diagnosis, treatment or outcome you may obtain.

ShimSpine.com is completely self-funded. No outside funds are accepted or used. This website does not utilize paid advertising as a source of revenue.
Outpatient Spine Surgery Considerations. www.Spine-Health.com. January 2016.

What is Spinal Stenosis? www.Spine-Health.com. October 2015.

Surgeon insights on the Changing Landscape of Orthopedic Care. OrthopedicToday. June 2014

Chapter 33: Interspinous Spacers. Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

Chapter 35: Minimally Invasive Percutaneous Lumbar Fusion Technique.Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

March 2010 Minimally Invasive Transforaminal Lumbar Interbody Fusion American Academy of Orthopaedic Surgeons Annual Meeting New Orleans, Louisiana February 2010

February 2010 A Review of Dynamic Stabilization in the Lumbar Spine Selby Spine Symposium; Park City, Utah

November 2009 Lumbar Spinal Stenosis Community Based Lecture; Tampa, Florida

September 2009 Instructor/Proctor Minimally Invasive Lumbar Cadaver Lab; Tampa, Florida

February 2009 New Spinal Technology: Cervical Disc Replacement and Interspinous Spacers. Selby Spine Symposium; Park City, Utah

February 2008 The Degenerative Spine: The Role of Dynamic Lumbar Stablization and Interspinous Spacers Selby Spine Symposium; Park City, Utah

October 2008 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

September 2007 Emerging Technology in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

October 2006 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

May 2005 The Role of Kyphoplasty in the Treatment of Vertebral Compression Fractures Mease Neurosciences Symposium; Clearwater, Florida
Please note all articles, blogs and Q&A’s on this site are general information and are not to be used as medical advice for individuals. No specific diagnosis or treatment should be made based on this information. Only a physician can provide you with advice specific to your situation. Please followup with your physician if you would like to discuss your individual condition.

If you are having a medical emergency,  contact your Doctor immediately,  or go to the Emergency Room.
ShimSpine and ShimSpine.com is committed to honoring and respecting the privacy and anonymity of the individuals using its website(s) and/or services. The purpose of this Privacy Policy is to inform the individuals about the collection, processing and protection of information done by ShimSpine what information we collect, why we collect this information and how we use this information.

This Privacy Policy will be reviewed regularly to reflect the up-to-date practices of ShimSpine.