Degenerative Disc Disease (also referred to as DDD) is a commonly used medical term to describe what are mostly natural changes in the spine. To some degree, degenerative disc disease happens in most people once they hit 40 years old. It describes a host of changes in and around the spine joints as a result of lost disc height between the vertebrae.
Spinal Discs — Small but Essential
The spine is made up of a group of bones called vertebrae that are stacked on top of each other with shock-absorbing discs between each bone. The discs are made of a fibrous outer layer and jelly-like inner layer. The jelly-like inner layer of the disc, called the nucleus pulposus, has no direct blood supply and needs alternating compressing (think: sitting) and decompressing (think: physical activity such as walking) forces to receive nutrients from the body and stay healthy.
The Degenerative Disc Process
As people age, the compressing forces tend to greatly outnumber the decompressing forces placed on the discs. The forces of gravity and muscle contractions press the vertebrae together and compress the discs. Years and years of pressure dehydrate the discs and they shrink and wear down. In this degenerative condition the discs’ ability to absorb shock is compromised. As one part of the spine deteriorates, it directly affects nearby regions. Hence, as you lose disc height and function, the vertebral facet joints take on more of your body weight. Because these joints are constantly involved with spine motion, they wear down and lose cartilage, a process that is quickened as the joints take on additional weight loads—work that was intended for your discs. This process can result in osteophytes, commonly referred to as bone spurs, to form in and around the joints. When this degeneration causes pain, it’s referred to as degenerative disc disease or osteoarthritis.
Degenerative Disc Disease — Disease or Natural Consequence of Aging?
Degenerative disc disease is not a disease in its truest sense—that is, a disorder of the body, such as heart disease, diabetes and Alzheimer’s. Rather, it is a natural process that happens to most people. Factors that can affect the severity of this condition and the degree of pain include genetic predisposition, body weight, job, lifestyle, and physical activity.
What Causes Degenerative Disc Pain?
Pain can result from ongoing irritation caused by putting pressure on structures that have worn down. One common area for irritation, and therefore pain, is the facet joints. It’s important to note that just because you may have findings of “degenerative disc disease” on an MRI or X-ray, it doesn’t mean that the condition will cause pain or be the cause of the pain that you’re experiencing. Many people with findings of degenerative disc disease on their imaging studies have pain that’s caused by the muscles that surround the joints, not the joints themselves. When muscles are weak or out of balance they can tighten up, causing significant pain.
Treatment for Degenerative Disc Disease
The good news: pain from degenerative disc disease can be treated very effectively at home with exercise and behavior modification. It is very rare for someone to need surgery or drugs for the pain caused by degenerative disc disease if they follow the right exercise plan.
Written by Dr. Jeremy James. Dr. James founded and was director of the Aspen Club Back Institute in Aspen, Colorado, is the coauthor of the bestselling The Younger Next Year Back Book and earned his Doctor of Chiropractic from the University of Western States. Learn more about Dr. James here.