As one ages, the spinal intervertebral disc undergoes significant changes. Normally the intervertebral disk is comprised of 80% water. With age, that percentage begins to decrease and the spinal disc begins to lose hydration and undergo degeneration.
Some discs undergo rapid degeneration and that can lead to degenerative disc disease. This may or may not lead to pain. The disc can lose height from lack of water, and it can also start to bulge similar to a tire that is getting flat and bulging. Disc degeneration is diagnosed from either x-rays or an MRI, which can be ordered by a Pain Management Doctor.
Just because a person has degeneration present of spinal discs does not mean pain is inevitable as there are many individuals walking around with discs that are dehydrating, degenerating, and bulging but not causing any pain at all.
As the spinal disc continues to degenerate, it can lead to a cascade of degenerative spinal arthritis that occurs as follows. As the disc loses water and degenerates, it loses disc height. The joints behind the disc space, called facet joints, begin to experience abnormal stresses as the disc becomes defective in its ability to absorb stresses. These stresses go to the rest of the spinal elements at the affected level, in this case the facet joints.
The facet joints begin to degenerate and become arthritic, this involves overgrowth of bone around the joint and further pain. Because the degenerative disc is not always affected symmetrically, the patient may end up with scoliosis due to the degeneration that continues to build on itself.
Treatments for degenerative disc disease are multiple. They are all quality of life treatments, as degenerative disc disease and spinal arthritis are not life threatening. Pain management doctors offer facet injections, nucleoplasty, physical therapy, spinal decompression therapy, bracing, radiofrequency ablation, among other treatments. Surgery should be considered as an absolute last resort.
