About degenerative disc disease and sciatica

What is degenerative disc disease and sciatica?

Degenerative disc disease and sciatica facts

  • The discs of the spine serve as "cushions" between each vertebral segment.
  • The discs are designed somewhat like a jelly donut.
  • Degeneration (deterioration) of the disc makes the disc more susceptible to herniation (rupture), which can lead to localized or radiating pain.
  • Sciatica can result from disc herniation ("ruptured disc") when nerves in the low back are irritated.

How is the spine designed?

The vertebrae are the bony building blocks of the spine. Between each of the largest part of the vertebrae are the discs. Ligaments are situated around the spine and discs. The spine has seven vertebrae in the neck (cervical vertebrae), 12 vertebrae in the mid-back (thoracic vertebrae), and five vertebrae in the low back (lumbar vertebrae). In addition, in the mid-buttock beneath the fifth lumbar vertebra, are five sacral vertebrae - usually fused as the sacrum bone followed by the tailbone (coccyx).

What is the purpose of the spine and its discs?

The bony spine is designed so that vertebrae "stacked" together can provide a movable support structure. The spine also protects the spinal cord (nervous tissue that extends down the spinal column from the brain) from injury. Each vertebra has a a bony arch behind the spinal cord that shields the cord's nerve tissue. The vertebrae also have a strong bony "body" in front of the spinal cord to provide a platform suitable for weight-bearing.

The discs are pads that serve as "cushions" between each vertebral body that serve to minimize the impact of movement on the spinal column. Each disc is designed like a jelly donut with a central softer component (nucleus pulposus). With injury or degeneration, this softer component can sometimes rupture (herniate) through the surrounding outer ring (annulus fibrosus) and irritate adjacent nervous tissue. Ligaments are strong fibrous soft tissues that firmly attach bones to bones. Ligaments attach each of the vertebrae and surround each of the discs. When ligaments are injured as the disc degenerates, localized pain in the area affected can result.

What are the symptoms for degenerative disc disease and sciatica?

Radiculopathy refers to nerve irritation caused by damage to the disc between the vertebrae. This occurs because of degeneration ("wear and tear") of the outer ring of the disc traumatic injury, or both. Weakness of the outer ring leads to disc bulging and disc herniation. As a result, the central softer portion of the disc can rupture through the outer ring of the disc and abut the spinal cord or its nerves as they exit the bony spinal column.

It is important to note that many people have degenerative spines without having any symptoms. When nerves are irritated in the neck from degenerative disc disease, the condition is referred to as cervical radiculopathy. This can lead to painful burning or tingling sensations in the arms. When nerves are irritated in the low back from degenerative disc disease, the condition is called lumbar radiculopathy, and it often causes the commonly recognized "sciatica" Pain that shoots down a lower extremity. This condition can be preceded by a localized low-back aching. Sciatica Pain can follow a "popping" sensation at onset and be accompanied by Numbness and tingling. The Pain commonly increases with movements at the waist and can increase with coughing or sneezing. In more severe instances, lumbar radiculopathy can be accompanied by incontinence of the bladder and/or bowels.

What are the causes for degenerative disc disease and sciatica?

As we age, the water and protein content of the cartilage of the body changes. This change results in weaker, more fragile, and thin cartilage. Because both the discs and the joints that stack the vertebrae (facet joints) are partly composed of cartilage, these areas are subject to wear and tear over time (degenerative changes). The gradual deterioration of the disc between the vertebrae is referred to as degenerative disc disease, sometimes abbreviated DDD. Wear of the facet cartilage and the bony changes of the adjacent joint is referred to as degenerative facet joint disease or osteoarthritis of the spine. Trauma injury to the spine can also lead to degenerative disc disease.

Degeneration of the disc space and its contents is medically referred to as spondylosis. Spondylosis can be noted on X-ray tests or MRI scanning of the spine as a narrowing of the normal "disc space" between the adjacent vertebrae.

What are the treatments for degenerative disc disease and sciatica?

The treatment of degenerative disc disease, radiculopathy, and sciatica ranges from nonsurgical (medical) management to surgery. Medical management of radiculopathy includes patient education of the condition, medications to relieve pain and muscles spasm, cortisone injection around the spinal cord (epidural injection), physical therapy (heat, exercises, massage, ultrasound, electrical stimulation), chiropractic manipulation and rest (not strict bed rest, but avoiding reinjury). With unrelenting pain, severe impairment of function, or incontinence (which can indicate spinal cord irritation), surgery may be necessary. The operation performed depends on the overall status of the spine and the age and health of the patient. Procedures include removal of the herniated disc with laminotomy (producing a small hole in the bone of the spine surrounding the spinal cord), laminectomy (removal of the bony wall adjacent to the nerve tissues), by needle technique through the skin (percutaneous discectomy), disc-dissolving procedures (chemonucleolysis), and others.

What are the risk factors for degenerative disc disease and sciatica?

Degenerative disc disease is a condition caused by the wearing down of the discs in your spine. The discs are cushions between each vertebrae that help absorb shock and keep bones separated, but as they get older, they become less effective at doing this.

Sciatica is a painful condition caused by compression of the nerve root at the lower end of your spine. This can cause pain or tingling in one or both legs, which is often worse when you sit or stand up.

Degenerative disc disease and sciatica are complicated conditions, so it's important to understand all the risk factors that could make you more susceptible to developing them.

The most common risk factors for degenerative disc disease are:

1. Age - as we get older, our bodies can't handle the same amount of stress as they used to. This means that our discs may not be able to support themselves as well as they used to, which causes them to start degenerating.

2. Smoking - smoking weakens your bones and connective tissue over time, making it harder for them to support your spine. This can lead to degenerative disc disease or sciatica if you have any sort of predisposition toward these conditions.

3. Poor posture - this is a factor in many conditions because it puts pressure on your spine, which can cause discs in your back and neck area to bulge out or shrink in size over time. This can lead to degenerative disc disease or sciatica if you have any predispositions toward these conditions already in place.

4. Having had a previous episode of sciatica

5. Being overweight or obese

6. Having had a previous back surgery or spinal procedure

7. Having an injury or trauma to your back, such as falling on it or lifting something heavy improperly

Symptoms
Pain that travels down the back of your leg, behind your knee, or into the calf,Numbness and tingling in the leg or foot,Loss of muscle strength in your legs and feet,A difference between one leg and the other when you walk (called a limp)
Conditions
Spondylolisthesis,Spinal stenosis,Herniated disc,Fractured vertebrae,Scoliosis
Drugs
Painkillers,Antidepressants,Steroids,Muscle relaxants

Is there a cure/medications for degenerative disc disease and sciatica?

There is no cure for degenerative disc disease, but there are many treatments that can help relieve the pain associated with this condition.

The first step in treating degenerative disc disease and sciatica is to find out what's causing your sciatica. Your doctor will likely recommend some sort of physical therapy to help stretch and strengthen your muscles, which can help relieve tension on the spine. If that doesn't work, they may recommend prescription medications such as antidepressants or anti-inflammatories.

If these treatments don't work or if you want to avoid taking medication, you might want to consider surgery. However, this is usually only recommended after all other options have been exhausted and if there are other conditions like spinal stenosis or arthritis along with your degenerative disc disease.

Some of the medications used in treating degenerative disc disease include:

1. NSAIDs (non-steroidal anti-inflammatory drugs): These reduce pain and inflammation by inhibiting the production of prostaglandins, which are substances that cause inflammation in the body. Examples include ibuprofen, naproxen sodium and diclofenac sodium.

2. Tramadol: Tramadol is a synthetic opioid that works by altering how your brain perceives pain signals coming into it from the spinal cord. This means that even though it doesn't have any direct effect on nerve cells themselves (that's what opioids do), it can still be quite effective at reducing the sensation of pain.

3. Opioids: Opioids are drugs derived from opium poppies and have been used as analgesics since ancient times because they work well at knocking out pain signals in your brain and spinal cord (which is why they're often prescribed as part of treatment for terminal cancer). They're also highly addictive though so they need to be taken under strict medical supervision if you're going to use them long-term or regularly.

Symptoms
Pain that travels down the back of your leg, behind your knee, or into the calf,Numbness and tingling in the leg or foot,Loss of muscle strength in your legs and feet,A difference between one leg and the other when you walk (called a limp)
Conditions
Spondylolisthesis,Spinal stenosis,Herniated disc,Fractured vertebrae,Scoliosis
Drugs
Painkillers,Antidepressants,Steroids,Muscle relaxants

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