Degenerative Disk Disease: How Time, Activity and Lifestyle Affect Your Spine
Your spine is a complex array of structures. A key component of your spine are are the cylindrical discs that are tucked between each vertebra.
Your spine is a complex array of structures. A key component of your spine are the cylindrical disks that are tucked between each vertebra. When the disks are injured or go through changes, it can mean a type of back pain called degenerative disk disease.
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The disks, which act as shock-absorbing cushions, are composed of a fibrous outer shell with a jelly-like substance inside.
“When we are young, the jelly is 90 percent water, and there are no nerve endings or blood vessels in the disks,” says Fredrick P. Wilson, DO, Director of Cleveland Clinic Solon Center for Spine Health.
As you get older, the jelly loses fluid and becomes stiffer. The disk’s outer shell can tear and weaken, and the disk can become thinner.
Sometimes, nerve fibers from a nearby ligament spread into cracks in the disks. When this happens, increased pressure in the back of the disk can cause what is called discogenic pain.
“Imagine a blob of jelly between two dinner plates,” Dr. Wilson says. “If you are in a flexed forward or sitting position, the front of the dinner plates will push the jelly backwards, toward the location of the nerve ending. This is why sitting tends to increase discogenic pain.”
The back of the disk also can be the source of a pain-causing condition called herniation, Dr. Wilson says. Herniated disk is more common in younger than older people, with 40 the peak age for the injury.
Herniation happens when some of the jelly inside a disk pushes through a tear in the outer shell and presses on a nearby nerve. This can cause pain or numbness.
“You can herniate a disk if you bend forward and turn your torso while lifting something,” Dr. Wilson says.
The good news is that your body can heal itself, Dr. Wilson says.
“It’s important to understand that 95 percent of the time the jelly that has pushed through will retract enough so that the pain will go away and surgery is not needed,” he says.
Severe pain may last for four to six weeks, but should subside after three to six months, as the jelly retracts toward the disk.
As disks flatten, the facet joints, which are the small stabilizing joints between and behind vertebrae, are under more pressure. Increased pressure on facet joints can wear down the cushioning cartilage, leading to osteoarthritis.
In spinal stenosis, the opening of the vertebrae that carry nerves from the spinal canal begin to close.
“As a disk degenerates, you can lose volume in that space, and the hole starts to close up, which pinches the nerve when you stand,” Dr. Wilson says. “Leaning forward can open the space, which relieves the pain.”
Even though disks undergo changes with age in almost everyone, not everyone has symptoms. Disk problems that are accompanied by symptoms may be inherited.
Smokers tend to have more disk problems, and people in certain occupations are at increased risk. These are jobs that involve vibration , such as a truck or bus driving, or bending, rotating and lifting, such as construction work.
Most disk problems are treated with physical therapy and possibly nonsteroidal anti-inflammatory drugs. If you have disk degeneration, avoid any activity that puts extra pressure on your spine.