Spine-health.com peer reviewed patient education brought to you by
A. Jay Khanna, MD

Johns Hopkins Orthopaedics at Good Samaritan Hospital

(410)532-4538

Lumbar degenerative disc disease can be the source of chronic lower back pain. This occurs when a disc weakens, often due to a torsional (twisting) injury to the disc space. The result of the injury is excessive micro-motion at the corresponding vertebral level because the disc cannot hold the vertebral segment together as well as it used to. The resulting micro-motion, combined with the inflammatory proteins inside the disc that become exposed and irritate the local area, can create lower back pain. There is some confusion over the term degenerative, which makes some people think the condition will worsen with age. Although the disc degeneration will likely progress, the pain that results from it typically does not worsen, but in fact usually gets better over time. The degree of pain will fluctuate however, sometimes being quite painful. Discs do not have a blood supply, so can’t heal themselves the way muscles can. Therefore the pain of degenerative disc disease can become chronic. A fully degenerated disc no longer has any inflammatory proteins and usually collapses into a stable position. While many people over the age of 60 have degenerated discs, it is highly uncommon for them to suffer from pain caused by this condition.

Symptoms
The typical individual with degenerative disc disease is an active and otherwise healthy person who is in their thirties or forties. Common symptoms:

· The pain is generally made worse with sitting, since in the seated position the lumbosacral discs are loaded three times more than standing

· Certain types of activity will usually worsen the pain, especially bending, lifting and twisting

· Walking, and even running, may actually feel better than prolonged sitting or standing

· Patients will generally feel better if they can change positions frequently, and lying down is usually the best position since this relieves stress on the disc space

•	What is degenerative disc disease?
•	Lumbar degenerative disc disease
•	Multi-specialty case review of degenerative disc disease

In addition to low back pain, there may be leg pain, numbness and tingling. Even without pressure on the nerve root (a “pinched nerve”), other structures in the back can refer pain down the buttocks and into the legs. The nerves can become sensitized with inflammation from the proteins within the disc space and produce the sensation of numbness/tingling. Generally, the pain does not go below the knee. These sensations, although worrisome and annoying, rarely indicate that there is any ongoing nerve root damage. However, any weakness in the leg muscles is an indicator of some nerve root damage.

Diagnosis
A Magnetic Resonance Imaging (MRI) scan can be used to determine whether or not there is disc degeneration. However, not all degenerated discs cause pain, so simply seeing the condition on the scan does not necessarily indicate presence of this condition. Experiencing the above symptoms, in conjunction with findings from a clinical exam and MRI scan, is a good indication that this condition exists in a patient.

Next: Treatment of Lumbar Degenerative Disc Disease

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This information is not intended as a substitute for medical professional help
or advice but is to be used only as an aid in understanding back pain and neckpain.
A physician should always be consulted for back pain or any health problem.