Degenerative Disc Disease in the Low Back
Degenerative disc disease is one of the most common causes of back pain and leg pain. Spinal discs have a soft jelly-like center and a tough outer layer. Spinal discs act like shock absorbers between the vertebrae, or bones, of your spine. As you get older, discs can show signs of wear and tear, and may break down.
Also referred to as a disc herniation, degenerative disc disease occurs when the softer part of a spinal disc pushes through a crack of the exterior into the spinal canal. This causes irritation to passing nerves, sometimes resulting in pain. The pain can be chronic or can include intermittent episodes of intense pain. It can cause pain in the neck, back, or legs. Pain in the neck region, called the cervical spine, is addressed differently than pain occurring in the lower back and/or legs. This page deals with degenerative disc disease in the lumbar spine, or lower back. You can read more about neck pain and neck pain surgery in other sections of our website.
Risk Factors for Degenerative Disc Disease
Degenerative disc disease is most often caused by normal wear and tear we experience as we age. In fact, age is the greatest risk factor for degenerative disc disease or herniated discs. The chances of developing degenerative disc disease increase significantly after age 40. Some studies suggest that almost everyone experiences some level of degenerative disc disease eventually, though the condition does not always cause pain.
Women are slightly more likely to develop degenerative disc disease.
Other risk factors for degenerative disc disease include:
- Regularly sitting or standing for long periods
- Engaging in physical labor
Common Symptoms of Degenerative Disc Disease
Many people who have degenerating discs experience no symptoms at all. Among those who do experience a herniated disc, the symptoms can vary greatly but almost always involve pain in either the lower back or the legs, or both. Common symptoms that may require treatment include:
- Low-grade, chronic pain around the degenerating disc that occasionally erupts into more severe pain
- Pain with bending or twisting the spine, or when lifting heavy objects
- A feeling that the back is unable to provide support, or that it may “give out” or lock up, making movement difficult
- Muscle tension or muscle spasms
- Radiating pain that feels sharp, stabbing, or hot
- Pain that radiates down the leg
- Pain when sitting or standing for long periods
- Pain that lessens with movement such as walking, or with changing positions
Non-surgical Treatments for Degenerative Disc Disease
Degenerative disc disease typically is first treated with non-invasive therapies including:
- Ice. Cold packs or ice applied to the area may reduce inflammation and relieve pain.
- Steroid injections. A steroid injection can provide temporary pain relief.
- Physical therapy. Your physician may suggest physical therapy, possibly along with pain-relieving steroid injections so that exercises can be done with minimal discomfort.
- Pain medications. Over-the-counter pain relievers, such as acetaminophen (Tylenol), and non-steroidal anti-inflammatory medicines such as ibuprofen or aspirin may be useful for chronic pain. Prescription pain relievers may be necessary during episodes of extreme pain but are not recommended for long-term relief.
Learn more about non-surgical treatments.
Surgery to Relieve Pain from Degenerative Disc Disease or Herniated Discs
At Neurosurgery ONE, formerly South Denver Neurosurgery, our Denver spine surgeons are very conservative and will recommend surgery for degenerative disc disease only in patients experiencing severe pain that is not relieved by non-surgical treatments. Patients with degenerative disc disease should try conservative treatments for six months. However, if the herniated disc is causing leg pain, you shouldn’t wait that long and should instead talk with your spine surgeon about surgery if your pain isn’t better after six to 12 weeks.
Depending on your symptoms and the specific nature of your herniated disc, your spine surgeon may recommend surgery. However, our Denver spine surgeons recommend surgery for degenerative disc disease in the low back (lumbar spine) only if you are experiencing leg pain, either alone or in conjunction with low back pain. NeurosurgeryONE spine surgeons do not recommend surgery for a degenerated disc if you are experiencing low back pain only, without leg pain, as it has not been shown to be effective. If you have leg pain only or back and leg pain, we may recommend one of the following types of surgery:
- Spinal fusion for degenerative disc disease permanently connects two or more vertebrae to eliminate motion, relieving the irritation on the nerve. Between 60 and 90 percent of spine fusion patients have significantly reduced back and/or leg pain or their spine pain has been eliminated completely after receiving a spine fusion, according to numerous studies. Learn more about spinal fusion surgery.
- Discectomy surgery for degenerative disc disease removes the damaged disc to relieve pressure on the nerves that are causing pain.
- Microdiscectomy uses small incisions and instruments to perform discectomy. Patients who receive microdiscectomy typically have less pain and quicker recovery times. NeurosurgeryONE spine surgeons offer three types of microdiscectomy:
- Open microdiscectomy is sometimes called “mini open” discectomy. It is similar to a traditional discectomy, but the spine surgeon performs the procedure through a very small incision.
- Tube, or tubular, microdiscectomy uses a series of small expanding tubes to open or dilate the surgical area so the surgeon can get the proper view. The spine surgeon then uses special surgical instruments to remove part of the affected disc.
- Endoscopic microdiscectomy, also called microendoscopic discectomy, involves inserting an endoscope with a tiny video camera through a tube into a small incision. The spine surgeon then uses small instruments to remove the disc.