- Degenerative Disc Disease (DDD)
- Lumbar Stenosis
- Herniated Disc
Degenerative Disc Disease (DDD)
Your spine is made up of 33 vertebrae that are stacked on top of one another. Between each of these vertebrae is a rubbery piece of cartilage called an “intervertebral disk.“
As we age, and sometimes with injury, the volume of the disk decreases, resulting in less space between the vertebrae. Sometimes bone spurs form in response to this degeneration of the disk, which could make the spine stiff.
Often, this flattening and additional stiffness to the spine is not at all painful. However, in some cases, when the rough surfaces of the vertebral joints rub together, pain and inflammation may result.
The nerve root, the point where a spinal nerve exits the spine and extends to other parts of the body, may become irritated or compressed.
Degeneration does not always lead to pain. For some people, however, it can cause a great deal of pain and disability.
Spinal stenosis is a narrowing within the vertebrae of the spinal column that results in too much pressure on the spinal cord (central stenosis) or nerves (lateral stenosis). The most common causes of spinal stenosis are related to the aging process in the spine:
- Osteoarthritis is a deterioration of the cartilage between joints. In response to this damage, the body often forms additional bone (called “bone spurs”) to try to support the area. These bone spurs might cause pressure on the nerves at the point where the nerves exit the spinal canal.
- Normal aging can result in a flattening of the disks that provide space between each set of vertebrae. This narrowed space allows less room for the nerve to exit from the spinal cord.
- Spinal injuries, diseases of the bone (such as Paget disease), spinal tumors, and thickening of certain spinal ligaments also may lead to spinal stenosis.
A herniated disc occurs when the cushion-like cartilage (the disc) between the bones of the spine is torn, and the gelatin-like core of the disc leaks. Often mistakenly called a slipped disc, a herniated disc can be caused by sudden trauma or by long-term pressure on the spine.
This condition most often affects people aged 30 to 50 years; men are twice as likely to be diagnosed as women. Repeated lifting, participating in weight-bearing sports, obesity, smoking, and poor posture are all risk factors for a herniated disc. The majority of herniated discs do not require surgery
In people younger than 30 years of age, the disc is soft, flexible, and absorbs shock extremely well. As individuals age, however, the disc can lose some flexibility. If stress is applied to the spine, the outer part of the disc (AF) can tear, and the gelatin-like core (NP) leaks through the tear. This leaking, or bulging, of the gelatin is called a herniated disc. In more severe cases, the leaked NP can seep outside the spinal column. Injuries that cause herniation can occur rapidly, or develop slowly over time.
Arthritis of the spine (DJD or OA)
As we age, the discs in our spine can wear, begin to bulge, and become narrowed. These changes can put strain on the cartilage, ligaments, and joints at the involved level of the spine and may cause pain.
The narrowing of the disc also results in narrowing of the space between the spinal joints, called the “facet” joints. Weight-bearing forces on the joints increase because of these disc changes. As a result, the cartilage covering the joint surface can begin to fray and wear away over time.
As OA of the spine progresses, your body will try to repair it by growing new bone. This bony growth is called a “bone spur.“
Spur development can result in a condition known as spinal stenosis. Most often this disorder affects men and women over 50 years of age.
If the spurs enlarge, they can create a narrowing of the spaces in the spine. The narrowing can involve small or large areas and can result in pressure on nerves near the involved joints, resulting in symptoms that may include pain, tingling, numbness, or burning.
With early or mild disease, symptoms will be intermittent, or come and go. You might feel stffness or aching after sitting a long time, on waking in the morning, or after vigorous activity