Degenerative Spine Disease Treatment , Causes & Symptoms

Overview

Degenerative spine disorders involve the degeneration or deterioration of your spine's ligaments, discs, and joints. These changes are often seen in the neck (cervical spine) and the lower back (lumbar spine). The degenerative disorders commonly occur due to aging, which causes immense pain, numbness, or weakness in your arms or legs. Obesity (being overweight), injury, family history, lack of exercise, osteoporosis, and smoking are risk factors that increase your probability of developing degenerative spine disorders. Medications and physical therapy are the first lines of treatment to manage pain; however, surgery would be recommended if these fail to provide relief. 

What Are Degenerative Spinal Disorders?

Degenerative spine disorders are medical conditions that involve the gradual loss of normal structure and function of the spine over a period of time. 

There are many conditions related to degenerative spine disorders, namely:

• Overgrowth of bone and thickening of the spinal joints (that is caused by repeated irritation and inflammation of the joint)
• Spinal stenosis (narrowing of the spinal canal)
• Spinal Osteoarthritis (inflammation inside the joints)
• Myelopathy (abnormal compression of the spinal cord)
• Spinal tumors (abnormal growth of tissues within or surrounding the spinal cord)
• Spinal infections (caused by either a bacterial or viral infection in another part of the body that is carried into the spine through the bloodstream)
• Scoliosis and spinal deformities (occur due to birth defects, aging, or trauma)
• Vertebral fractures ( when the bony components of the spine collapse)
• Degenerative disc disease (occurs when your spinal disc wears down)
• A herniated disc is also called a slipped or ruptured disc (a part of the spinal disc that is pushed into the spinal canal through a tear)

There are three stages of spinal degeneration, namely:

• Stage 1: Dysfunction
  • The curvature begins to change and shows signs of misalignment
  • There is a weakness in spinal muscles and ligaments
• Stage 2: Dehydration of the spinal disc
  • The discs begin to dehydrate and shrink in size
  • There is roughening of the joints with reduced mobility
• Stage 3: Stabilization
  • This is a late stage with severe bone remodeling, decreased joint space, and limited mobility.

What Are The Causes of Degenerative Spinal Disorders?

Your spine comprises individual bones (vertebrae) that stack up one on top of another, forming a vertebral column. It is divided into four segments, - the cervical spine (neck), thoracic spine (mid-back), lumbar spine (low back), and sacral spine (lower end of your spine). The intervertebral discs are structures that connect the vertebrae and act as cushions and shock absorbers. 

Causes:

The degenerative disorders of the spine are a consequence of aging and are most commonly seen in the third decade of life. Some common causes include:

• Congenital (present by birth)
• Poor blood supply to the intervertebral discs
• Multiple injuries to the discs
• Repeated cartilage wear and tear in the joints (inflammation)
• Herniation or bulging of the disc
• Reduction in the number of chondrocytes (the type of cells found in healthy cartilage)
• Biomechanical overload on the spine

Risk factors:

• Age is the most common risk factor, as degenerative changes occur with aging.
• Your family history may also play an important role in how quickly your joints degenerate.
• Lifestyle factors like obesity and smoking may increase your risk.
• Increased physical stress or strain on your neck and back, as seen in high-impact activities and sports.

What Are The Symptoms of Degenerative Spinal Disorders?

The primary symptom of degenerative spine disorders is neck or back pain, which can be sharp and stabbing, dull or aching. The severity of pain depends on the area of the spine affected, which may radiate or migrate to other parts of the body. This usually occurs because the nerves that branch from the spine travel throughout your body. 

Other symptoms of degenerative spinal disorders include:

• Increased pain in your neck or back while sitting for a long period of time, bending, twisting, or lifting
• Pain decreases while walking or running
• Reduced pain while lying down
• Weakness, numbness, or tingling sensation in your arms or legs
• Neck or back pain that worsens at night
• Neck or back pain accompanied by weight loss
• Neck pain accompanied by difficulty breathing or swallowing
• Abnormally rounded shoulder or back
• Bladder or bowel incontinence and/or numbness in the areas (known as saddle anesthesia)
• Nausea and/or vomiting
• Stiffness or tightness in your neck
• Uneven appearance, such as one shoulder being higher than the other

How Are Degenerative Spinal Disorders Diagnosed?

Degenerative spinal disorders present with varying symptoms, with neck and back pain being the classical sign. Consult a neurologist (a doctor specializing in the diseases of the brain, spinal cord, and nerves) or an orthopedic surgeon (a doctor specializing in the diseases of bone and joints) for further evaluation. 

Medical history

• Your neurologist will evaluate your symptoms and record your medical history to rule out other conditions like diabetes (increased blood sugar levels), hypertension (high blood pressure), asthma, bleeding disorders, and other disorders related to the heart, lungs, and kidneys.
• Your history of allergies, injuries, and previous surgeries will be assessed, which may increase your risk of degenerative spinal disorders.

Physical examination

• Your doctor will examine you clinically based on your signs and symptoms.
• He/she will check for swelling and tenderness in your neck, shoulder, or lumber region (lower back). 

Your doctor will recommend a few medical tests to confirm the diagnosis, which will help determine a treatment plan for your situation. 

Diagnostic tests

• X-ray: It provides an overall assessment of the bone anatomy, the curvature, and the alignment of the vertebral column. Dynamic or flexion/extension X-rays (types of X-rays that show the spine in motion) may be used to check any abnormal movement or instability in the spine.
• MRI (Magnetic Resonance Imaging) scan: This provides a detailed picture of the soft tissues like discs, nerves, and the spinal cord.
• CT (Computed Tomography) scan: It provides a detailed image of the bony structures in the spine. 
• Electromyography (EMG): This test checks the electrical activity of the nerve root to determine the cause of pain.
• Discogram: This evaluates the intervertebral disc by injecting a contrast dye into the disc and capturing the X-ray images. 
• Myelography: It is performed by injecting a contrast dye into the spinal column and studying the CT scan images to check for spinal cord compression or nerve roots.

How Are Degenerative Spinal Disorders Treated?

Degenerative spinal disorders are usually treated according to the severity of the condition. They can be non-surgical or surgical methods that help manage pain and prevent further degeneration of the spine's structures. 

Non-surgical treatment

Hot and cold therapy

• This can help reduce inflammation and soreness of the spine. 
• Alternate ice packs and heating pads are used for 10 to 15 minutes up to 3 to 4 times per day. 

Physical therapy

• Strengthening and stretching exercises of the affected area (neck or back) can help relieve pain.
• Gentle yoga or light exercises like walking or swimming can strengthen back muscles and reduce pain. 

Medications

• These include anti-inflammatory drugs that reduce inflammation of the joints or ligaments of the spine.
• Muscle relaxers can also help reduce pain and swelling.

Steroid injections

• Injecting steroids like cortisone near your spinal nerves, joints or disk can reduce swelling and pain.

Radiofrequency ablation (RFA)

• It is a minimally invasive procedure using heat generated from medium frequency current, especially to treat chronic (long-lasting) back and neck pain.

Surgical treatment

Your surgeon may recommend any one of the following spinal decompression surgery depending on the type of degenerative spinal disorder:

Discectomy 

• It is a surgery to remove a part of your spinal disk to relieve pressure on your nerves.

Foraminotomy

• This procedure involves the removal of tissue and bone to expand the opening of your nerve roots.

Laminectomy

• It is a surgical procedure to remove tiny fragments of bone from your lower spine (lamina).

Osteophyte removal

• This procedure involves the removal of bone spurs that are known as osteophytes.

Spinal fusion

• In this surgery, your surgeon connects two or more vertebrae.
• This helps to improve your overall stability.

How to Prevent Degenerative Spinal Disorders?

Degenerative spinal disorders occur mostly due to age-related wear and tear of the structures of your spine, but there are a few preventive measures that can help delay the onset of the condition. 

• Live an active life - Regular exercise with an active life improves your range of motion. Walking is an excellent workout that helps increase circulation and muscle endurance. Avoid or minimize over-twisting and be doing actions during your workouts.
• Maintain muscle balance and body mechanics- Proper body mechanics will help establish an excellent balance between the muscles designed to move the joints. A lack of muscle balance can cause increased joint wear and tear, the main precursor to degenerative changes.
• Quit smoking- Excess smoking causes constriction of the blood vessels that deliver nutrients to the spine's structures. Smoking also increases your pain perception. 
• Maintain an ideal weight- Carrying more weight on your body will increase the pressure or strain exerted, worsening your symptoms. 
• Balance manual labor and avoid being sedentary (inactive)- Being sedentary will negatively affect your muscle strength, which is important to keep the pressure off your spine. Heavy labor is also detrimental since you will be more prone to joint inflammation.
• Change your diet-Foods and supplements can support your musculoskeletal system that helps preserve your disc. Consume foods rich in Vitamin D, such as fish, salmon, and eggs. 

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