Orthopaedic Care of Degenerative Disc Disease. – Robert T. Vraney, M.D.

Many patients diagnosed with degenerative disc disease are left wondering exactly what this diagnosis means for them. Common questions that patients have include:

  • If I have degenerative disc disease as a young person, will it get worse with age?
  • Will the degenerative disease become a crippling condition?
  • Will the degenerative disease spread to other parts of the spine?
  • Will the pain from the degenerative disease cause permanent damage?

Part of the confusion probably comes from the term “degenerative.” This term implies that it will worsen with age. While the disc degeneration is likely to progressive over time, the associated pain usually does not get worse; and in fact, often times gets better over time.

Another source of confusion is probably created by the term “disease.” Degenerative disc disease is not actually a disease but is more accurately described as a degenerative condition that at times can produce pain from a damaged disc. It is quite variable in nature and severity. As we age, all people exhibit changes in their discs consistent with degeneration. It is a natural process; however, not all people will develop symptoms.

Finally, some of the confusion likely comes from the medical community, as medical professionals have yet to agree on what the terms describes. Often times the “disease” is nothing more than a radiographic description. Because few practitioners agree on what does and does not constitute a diagnosis of degenerative disc disease, very few medical textbooks even attempt to give an accurate description. Therefore, while many practitioners believe that degenerative disc disease is a common cause of low back pain in young adults, very few agree on the implications.

For these reasons and others, I personally prefer to use the term “discogenic low back pain” or “disc incompetence.” The first term implies that it is the disc that is “generating” the patient’s pain. I often describe to patients that discs inability to handle forces and loads presented to it (“disc incompetence”) is the reason why a damaged disc can become a source of pain. I explain to patients that this damage can occur either through a natural degenerative process or can be accelerated through micro or macro trauma to the spine. Re-enforcing the issue of competence of the disc also illustrates to patients the potential for physical therapy to improve the symptoms. This is not by reversing an irreversible process, but rather by attempting to protect the disc via strengthening of the core extensor muscles.

I believe that providing good medical care and counseling are only part of my job here at Orthopaedic Associates. Patients have much to gain by becoming better educated about the conditions impacting their lives. This education is a vital part of the healing process and certainly one of the biggest services that we as physicians can provide.