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Spine Conditions

Degenerative Disc Disease

Degenerative disc disease is a weakening of one or more vertebral discs, which normally act as a cushion between the vertebrae. It typically begins when small tears appear in the disc wall, called the annulus. These tears can cause pain. When the tears heal, they create scar tissue that is not as strong as the original disc wall. If the back is repeatedly injured, the process of tearing and scarring may continue, weakening the disc wall. Over time, the nucleus (or center) of the disc becomes damaged and loses some of its water content. This center is called the pulposus, and its water content is needed to keep the disc functioning as a shock absorber for the spine. When the disc is unable to act as a cushion, the nucleus collapses. As a result, the vertebrae above and below this damaged disc collapse or slide closer together. This improper alignment causes the facet joints (the areas where the vertebral bones touch) to twist into an unnatural position. In time, this awkward positioning of the vertebrae may create bone spurs. If these spurs grow into the spinal canal, they may pinch the spinal cord and nerves (a condition called spinal stenosis). Consequently, the spine may be painful, and the entrapment of the nerves may result in shooting pain and/or weakness of the extremities.

This condition can develop as a natural part of the aging process. With aging and repetitive injury to the back, the disc may lose fluid and become dehydrated, causing a loss of the normal shock absorber function of the disc. These age-related changes can lead to disc herniation, spinal stenosis, scoliosis, instability (spondylolisthesis), and bone spurs, which can put pressure on the spinal cord and nerve roots.

Degenerative disc disease can occur in the neck (cervical spine) and back (lumbar spine).

Symptoms of cervical degenerative disc disease include numbness, tingling, and weakness to the shoulders, arms, forearms, and/or the hands.

Symptoms of lumbar degenerative disc disease include numbness, tingling, and weakness to the low back, buttocks, groin, thighs, legs, and/or feet.

Sitting upright puts the most pressure on the disc and may worsen symptoms, while lying down tends to relieve the pain.

During your consultation, Dr. Ball will ask you questions about your medical history and your symptoms. He will ask you where the pain started, which part of your spine hurts, if the pain has spread to other parts of your body, if you have had past spine injuries, and if you have a family history of similar problems.

Dr. Ball will also conduct a physical examination, looking for signs of pain in your lower back or neck, and asking you to walk or bend to see which movements cause pain. He will test your strength, sensation, and reflexes to focus his precise diagnosis of your condition. Imaging studies may be ordered to confirm your diagnosis, which will then allow for the correct treatment recommendations.

At what age can degenerative disc disease begin?

On average, degenerative disc disease can begin in one’s thirties, depending on the history of activity and trauma during one’s lifetime. A single traumatic event, or repetitive trauma, may cause this condition to occur at younger ages.

Can degenerative disc disease spread to other parts of the spine?

Degenerative disc disease can spread to other parts of the spine as they develop arthritis. Fortunately, most of the time, the symptoms are short-lived and could get better either on their own or with physical therapy and over-the-counter anti-inflammatory medications or other types of pain medications. Occasionally, the condition may require more advanced treatment.

What kind of exercise is good for degenerative disc disease (DDD)?

Aerobic exercises, including walking, swimming, or taking low-impact aerobics classes are all good exercises for managing degenerative disc disease. Yoga, Pilates, and core strengthening exercises are excellent for conditioning and preventing the development of DDD. These exercises help relieve pain, promote a healthy body weight, and improve overall strength and mobility.

Can degenerative disc disease cause sciatica?

When a degenerated disc collapses or directly impinges on a nerve root in the low back or neck, it can cause a form of sciatica or shooting pain into the arm/forearm/hand.

What is the difference between a discectomy and a laminectomy?

A discectomy is done to treat problems related to the vertebral discs, and a laminectomy is done to treat problems associated with the back of the vertebrae, causing stenosis. While both surgeries relieve pressure on the nerves and the spinal cord, they differ in that they address different structures of the spine. Dr. Ball often performs these procedures in an outpatient setting.

At a Glance

Dr. Hieu Ball

  • Double fellowship-trained orthopedic
  • Orthopedic surgery residency at Harvard Medical School
  • Over 20 years of spine surgery experience
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