Nearly everyone shows some signs of wear and tear on the spinal discs as they age. Not everyone, however, will have symptoms as a result of degenerative discs. Not actually a disease, degenerative disc disease refers to a condition in which pain is caused from a damaged disc. A wide range of symptoms and severity is associated with this condition.
The discs are like shock absorbers between the bones of the spine and are designed to help the back stay flexible while resisting terrific forces in many different planes of motion. Each disc has two parts:
A firm, tough outer layer (anulus fibrosus). The outer portion of this layer contains nerves. If the disc tears in this area, it can become quite painful.
A soft, jelly-like core (nucleus pulposus). This part of the disc contains proteins that can cause the tissues they touch to become swollen and tender. If these proteins leak out to the nerves of the outer layer of disc they can cause a great deal of pain.
Unlike other tissues of the body, there is very little blood supply to the disc. Once a disc is injured, it cannot repair itself, and a downward spiral of degeneration ensues.
The typical person with degenerative disc disease is in his or her 30s or 40s.
A diagnosis is based on a medical history and a physical examination, as well as the symptoms and the circumstances where the pain started. MRI can show damage to discs, but it alone cannot confirm symptoms due to degenerative disc disease.
A diagnostic study commonly performed is discography. A discogram is a diagnostic procedure to determine if your vertebral disc(s) is/are your source of back pain.
A discogram is an invasive test that generally isn’t used for an initial evaluation of back pain. But your doctor may suggest a discogram if your back pain persists despite conservative treatments, such as medication and physical therapy.
Some doctors use a discogram before spinal fusion surgery to help identify which disks need to be removed. However, discograms are not always accurate in pinpointing which disks, if any, are causing back pain. Many doctors instead rely on other tests, such as MRI and CT scanning, to diagnose disk problems and guide treatment.
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