In the spine, there is a “cushion” that sits between the individual bones that make up the spinal column. These “cushions” are called intervertebral discs because they sit in between the vertebral bones. Often the discs are compared to a “jelly donut” with a tough outer casing and a softer inner “gel” referred to as the nucleus pulposus.
As we age, the gel content inside these discs will become dehydrated and ultimately shrink. As the disc loses its integrity, it will eventually degenerate. This degenerative process can sometimes cause pain due to irritation of the outer tougher casing (annulus) or from inflammation of adjacent spinal nerves.
With cervical degenerative disc disease, the most common presenting symptom is neck pain. Typically the pain is described as a constant ache rather than sharp pain, but both can occur. Movement tends to aggravate the pain, specifically looking down, up or to the sides. Lying down provides relief from the symptoms, usually because less stress is placed on the discs in this position. Sometimes pain from discs can radiate into the back of the head. Often these degenerated discs cause bone spurs to form in the adjacent vertebral bones. If these bone spurs are in close proximity to a cervical spinal nerve, pain can radiate into the neck/shoulder/arm.
Degenerated discs in the thoracic spine cause mid-back pain. If it doesn’t involve the nerve root, the pain is usually described as a constant ache. If there is irritation of the nerve root, patients may have pain or numbness that travels across the chest or upper abdomen. Particular movement tends to aggravate the pain, specifically hunching the back or twisting the spine. Lying down provides relief from the symptoms, usually because less stress is placed on the discs in this position.
Degenerated discs in the lumbar spine can cause lower back pain. If the disc is not irritating an adjacent spinal nerve, the pain is primarily localized to the center of the lower back. The pain is described as a constant ache. If there is irritation of the nerve root, patients may have pain or numbness that travels down into the groin, thigh, calf, or foot. Pain is especially notable with prolonged sitting, bending forward at the waist, and prolonged standing. Lying down can provide relief from the symptoms, usually because less stress is placed on the discs in this position.
It is important to note that not all discs that appear degenerated cause pain as degeneration of the discs is a normal aging process.
Intervertebral discs within the spine will degenerate as part of a normal aging process in everyone. This process, however, can also be caused by repetitive stress, trauma or injury. Genetics and scoliosis may also play a role in patients with early signs of disc degeneration.
Your Center for Pain Management physician will work with you to determine the best treatment plan for your individual case. Possible treatments range from non-invasive therapy such as physical therapy and medication to minimally invasive options such as an epidural steroid injection.