Question 1

What is Degenerative Disc Disease?

Accepted Answer

Degenerative Disc Disease (DDD) is caused by the wear and tear of spinal discs in your back or neck. The spinal discs act as cushions between the vertebrae in your spine, helping you to move, bend and twist comfortably.

As you age, the cushioning begins to wear away (degenerate) and the discs lose their flexibility, elasticity and ability to absorb shocks. In some individuals, this process is genetically predisposed. It can also be influenced by physically demanding jobs and sporting activities.

However, it’s important to understand that heavy lifting or prolonged sitting does not cause disc degeneration, but these activities will cause more pain if you already have painful worn discs.

As discs degenerate, they bulge and can even burst, causing pain and a loss of flexibility in the spine. As a result, the associated facet joints (the small joints located between each vertebra) may become worn and painful. The degenerate discs can also press on nerves, causing arm or leg pain.

If the outer wall of the disc does burst or break, the middle part (known as the nucleus pulposus) may leak out. This is called a slipped disc or a herniated disc. If this presses on one of the nerves supplying your arm (known as a neck or cervical prolapse), or your leg (in the case of a lumbar prolapse), you’ll experience pain in the arm (brachialgia) or in the leg (sciatica).

DDD can occur in any of the three regions of the spine: the neck (cervical spine); the chest (thoracic spine); and lower back (lumbar spine).

Question 2

What are the signs of DDD?

Accepted Answer

Disc degeneration can cause inflammation in the surrounding area, leading to a dull, persistent pain in the back. This chronic pain can last anywhere from a few days to a few weeks.

Other symptoms depend on where the worn disc is located and may include:
- Pain in the neck and shoulders, which may radiate down the arms to the wrists or fingers
- Lower back pain, which may extend to the buttocks or thighs

If you’re worried about your symptoms and think you may have DDD, then it’s important to see a spinal specialist. You can phone us to book an appointment or book online.

Question 3

How is DDD diagnosed?

Accepted Answer

You can read more about the ways in which we diagnose DDD below, but typically it falls into three areas:
- Clinical history: Your consultant will ask you how long you’ve had back pain, what causes the pain, where it is in your back and if it radiates to other areas
- Physical examination: Your specialist will examine your spine at your consultation and talk to you about the types of pain you’ve been experiencing
- Imaging tests: With imaging tests such as MRI scans, your consultant can assess the damaged disc in your spine

Question 4

How is DDD treated?

Accepted Answer

Many patients can be treated without the need for surgery. Once you’ve had an examination, your specialist will talk to you about the most useful treatment for you.

Typically, they’ll suggest a non-invasive treatment option first, such as:
- Physiotherapy
- Medication (anti-inflammatory drugs)
- Spinal injections: Injecting medicine near the spinal nerves, discs, or joints to reduce inflammation and pain.

When discs wear down, the bones can start to rub together. This contact can cause pain and other problems, such as a herniated disc, also called a bulged, slipped or ruptured disc.

If non-surgical treatments have not relieved your pain or weakness, you might need spinal disc surgery.

Question 5

What’s the difference between the different types of surgery for DDD?

Accepted Answer

Most patients don’t need surgery for degenerative disc disease. However, if you’ve tried multiple non-surgical treatments and have persistent pain and/or weakness, you may be offered one of the following surgical procedures:
- Lumbar discectomy: This minimally invasive surgery is used to correct problems in the lower (lumbar) spine and involves removing part of a bulging or herniated disc in your lower back.
- Spinal fusion: Used to treat compressed nerves and/or disc problems in your lower (lumbar) spine, this minimally invasive procedure involves fusing two or more of your vertebrae together to make your spine more stable. At HCA UK, we can also carry out more extensive surgical corrections of the spine, if needed.

Question 6

Can DDD cause other back problems?

Accepted Answer

Degenerated discs can increase your risk of developing other spinal conditions. These include:
- Osteoarthritis: Osteoarthritis occurs when the cartilage surfaces of a joint and the underlying bone begin to break down. Sports injuries can sometimes accelerate this process.
- Adult scoliosis: Scoliosis is where the spine twists and curves to the side, and adult scoliosis (also known as ‘de novo’ scoliosis) is caused by the wear and tear of the joints and discs in the spine.
- Spinal stenosis: Spinal stenosis is a condition in which the spinal canal (which houses the spinal cord) becomes narrow, compressing the nerves inside.

Question 7

What are the symptoms of DDD?

Accepted Answer

Symptoms include a dull, persistent pain in the back. This chronic pain can last anywhere from a few days to a few weeks.

Other symptoms depend on where the worn disc is located. You may experience pain in the neck and shoulders, which radiates down the arms to the wrists and fingers. If you have lower back pain, this may extend to the buttocks and thighs.

If you’re worried about your back pain, then you should book a GP appointment first, which we can help with. We have same-day and next-day GP appointments available.

Question 8

What are the four stages of Degenerative Disc Disease?

Accepted Answer

1. Dysfunction: Your spinal discs have started to degenerate and you may be experiencing mild DDD. You may notice mild to moderate pain where the disc is located.
2. Dehydration: Your spinal discs continue to degrade and start to dry out, which results in them losing some of their height and flexibility. You may notice your back and neck pain getting worse at this stage.
3. Stability: Postural stages become more pronounced at this stage, as your spine tries to stabilise itself and bone spurs start to form. This can result in spinal stenosis and severe pain.
4. Collapse: In the final stage of DDD, the discs continue to shrink and are very thin. Bones can fuse together and the damaged discs can press against your nerves, causing severe pain.

Question 9

How fast does degenerative disc disease progress?

Accepted Answer

There is no set timeline, as everyone experiences DDD differently. In some people it can start suddenly and in others it may start gradually, with mild pain that can be managed with stretching exercises and heat therapy.

Like any disease, it’s best if DDD is caught early so a spinal specialist can help you understand the condition and treat the pain.

Question 10

Is degenerative disc disease a disability?

Accepted Answer

Is degenerative disc disease a disability?

In England, Scotland and Wales, you’re disabled under the Equality Act 2010 if you have a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on your ability to do normal daily activities.

You can find out more here.

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