I have something called Degenerative Disc Disease. Funny thing is, it’s not a disease at all. It actually has nothing to do with a disease, it just has a funny name to it. Degenerative Disc Disease, or DDD, is a degenerative condition resulting in pain produced from a damaged disc. DDD is a condition that is far more common now due to people’s life style that has become more sedentary and people have spent more hours sitting, glued to their computers, laptops, smartphones, and tablets. Due to what most people think, sitting down puts a tremendous amount of stress on the back, causing more of a risk of people hurting their back.
DDD is the process in which the disc gets worse over time, while the person ages. This is a degenerative condition resulting in pain from a damaged disc. Even though the degenerative disc disease should affect any part of the spine. it usually only affects the lower spine and sometimes the neck. Even though the disc degeneration does not produce any symptoms, the degeneration brings “about circumstances in and flammation and movement which manifest as painful symptoms”.
The human spine is composed of thirty-three vertebrae. There are “twenty-four upper vertebrates that are flexible and divided from each other through the intervertebral disc, while the lower nine are fixed”. The lower nine, or intervertebral discs have different materials on the outside then they do on the inside. The outer part is tough and fibrous while the inner is soft and gel-like in nature. The functions of the discs is to help the spine remain flexible and elastic. Because of the discs, we can bend our backs and then return to the upright positions. The discs are also important as it is a shock absorber and they take the pressure from any stress and distributes the weight.
As we begin to age, the intervertebral discs that is the inner core, which is 90% made of water, begins to lose some of the water content and start to shrink in size. Therefore when this starts to take place, the shock absorbing abilities start to become less effective. When this all starts to take place, the height of the vertebrae come in “closer in contact with each other. When a load is lifted, the stress impact that was once cushioned does not happen effectively and the discs hit into each other”. Once this starts to happen, the discs begin to rub each other and this cause something called a bone spur. According to chronicbodypain.net, bone spurs are “abnormal bone growth which can hit the nerves or their roots and aggravate the symptoms experienced by developing conditions such as sciatica”. When this pain becomes chronic and is mostly in the lower back areas, then this is called Degenerative Disc Disease. Once this starts to happen, “the intervertebral disc called the annulus can begin to experience tears”. Then the gel-like material begins to escape through the tears into the wall and reaches the outer nerve. “The material is very rich inflammatory proteins, it will then irritate the nerves and cause pain”.
Degeneration happens in everyone but certain people, like me, who are predisposed to having back problems, begin to have the pain. Even a minor injury to the back, can become worse and worse over time, therefore later becoming chronic. Even though DDD usually affects the lower back and the neck area, pain can radiate to other region such as the hips, buttocks, and thighs. Each person can have the symptoms begin while doing such things as in walking, or affect areas such as knees and fingers. Mine started with lower back and now radiates to hips and feet. I rarely have anything higher than middle stomach area and above. I do have pain from the nerves from the leaking of the gel-like substance and from multiple surgeries, that cause shooting pain down my legs with my feet feeling like they are on fire. Unfortunately, they do not know if there was one single occurrence of trauma to my lower back or multiple factors to cause me to get DDD. I did begin to have back issues during my third trimester of my last pregnancy. And had my first surgery two years following giving birth to my son.
Diagnosing DDD can be quite complicated. There are the typical test; x-rays, CT scans, and MRI. But these test can only give a general idea about what the cause of the pain can be. The hardest test that I had to go through number of times is a Discogram. During this procedure, you lie on your stomach, and a doctor begins to insert needles that have dye in them and injects the dye into the disc. The injections themselves can reproduce the back pain that you have. But you can not receive anything for the pain, till the test is all over with. The doctor needs you to be able to have the pain to get a good test results. Once the dye is injected into the discs in questions, the doctor can look on a x-ray or CT scan to see if there is any cracks in the disc’s exterior. Even if there are cracks in the discs, the doctor will not truly know if this is the problem till there is surgery and he/she can see for themselves. I’ve had 3 back surgeries and every time the surgery was 100% needed.
Treatment for DDD can be different for each person. Surgery is usually the last step if nothing else has worked for the patient. Different treatment can be as simple as changing habits. not sitting as long in one place. Reduce stress so you are less likely to tense your body. Physical therapy has been too known to help along with regular exercise. And also prescription medications like anti inflammatory medicines and steroids. And if anyone is at all like me, you tried all of these methods and they don’t help so the last resort is surgery…….spinal fusion.
Spinal fusion takes place by the surgeon inserting a rod along the spine and putting screws into the vertebra to immobilize the disc with another healthier disc. Bone graft from a cadaver or another part of your body is used to have your body build bone between the two vertebrates. This is the surgery that I have had twice and looking to have a third time. Once they start fusing the spine, there is a good chance that more fusions will be needed later on. Fusions can be stacked on top of each other to strengthen the back. I also have had surgery that is called Artificial Disc Replacement. According to some, ADR is better for the spine and can mimic the motion characteristics of the disc it is replacing. Unfortunately for me, the ADR failed horribly and caused a lot of damage. Hence why I had to go on to having two fusions.
Once the fusion surgery is complete, usually after 6 months to 9 months later, you can opt to have the metal from the rod and the screws removed. Your spine will have fused itself together with the immobilization and the bone graft that was used during the spinal fusion. I have opted to leave all metal in my back as it’s another surgery that I don’t have to have. You can function normally with the titanium and the fusion, it just feels very different. At times, I can feel the rods in my spine and when the weather is cold, the rod becomes cold too.
There are two other surgeries that can be performed for DDD. There is decompression surgery and Intradiscal Electrothermal Therapy. Decompression surgery can be done 6 different ways, depending on what the surgeon believes is happening. Decompression surgery is just that, relieving pressure on the spine.
- Facetomy- Removing the facet joints
- Foraminotomy – Enlarging the foramen area to relieve compression on the nerve
- Laminectomy – Removing all parts of the lamina to relieve pressure on the spine
- Laminotomy – Opens the lamina larger to give the nerve more room
If there is a bulging disc or herniated disc, then the surgery needs to be anterior and those surgeries are:
- Discectomy- Removal of partial or entire spinal disc
- Corpectomy – The vertebral bodies and adjacent discs are removed to help relieve pressure
There are many different ways you can try to prevent DDD but hereditary place a big role in this at least for me. Once DDD started, its extremely hard to prevent it. Start early if you have any back pain, consult your doctor to get a cleat diagnosis. Even if you are diagnosed like me, doesn’t mean its the end of the world. Just maybe a new chapter.0