Common Symptoms of Degenerative Disc Disease

Along with MRI scan results that show disc degeneration, there are some common symptoms that are fairly consistent for people with low back pain from degenerative disc disease.

The typical individual with degenerative disc disease is an active and otherwise healthy person who is in their thirties or forties. In general, the patient’s pain should not be continuous and severe. If it is, then other diagnoses must be considered. Degenerative disc disease pain is usually more related to activity and will flare up at times but then return to a low grade pain level or the pain will go away entirely.

Common symptoms of degenerative disc disease include:

• The low back pain is generally made worse with sitting, since in the seated position the lumbosacral discs are loaded three times more than standing.
• Certain types of activity will usually worsen the low back pain, especially bending, lifting and twisting.
• Walking, and even running, may actually feel better than prolonged sitting or standing.
• Patients will generally feel better if they can change positions frequently, and lying down is usually the best position since this relieves stress on the disc space.

Types of pain from degenerative disc disease

Most patients with degenerative disc disease will have some underlying chronic low back pain, with intermittent episodes of severe low back pain. The exact cause of these severe episodes of pain is not known, but it has been theorized that it is due to abnormal micro-motion in the degenerated disc that spurs an inflammatory reaction. In an attempt to stabilize the spine and decrease the micro-motion, the body reacts to the disc pain with muscle spasms. The reactive spasms are what make patients feel like their back has "gone out".

The severe episodes of low back pain from degenerative disc disease will generally last from a few days to a few months before the patient goes back to their baseline level of chronic pain. The amount of chronic pain is quite variable and can range from a nagging level of irritation to severe and disabling pain, although severe, disabling pain is quite rare.

In addition to low back pain from degenerative disc disease, there may be leg pain, numbness and tingling. Even without pressure on the nerve root (a "pinched nerve"), other structures in the back can refer pain down the rear and into the legs. The nerves can become sensitized with inflammation from the proteins within the disc space and produce the sensation of numbness/tingling. Generally, the pain does not go below the knee.

These sensations, although worrisome and annoying, rarely indicate that there is any ongoing nerve root damage. However, any weakness in the leg muscles (such as foot drop) is an indicator of some nerve root damage.

Chronic pain versus acute pain

One very important tenet in chronic pain is that the level and extent of pain does not equal tissue damage. Severely degenerated discs may not produce much pain at all, and discs with little degeneration can produce severe pain.

In this manner, chronic pain is very different from acute pain. With acute pain, the severity of pain directly correlates to the level of tissue damage. This provides us with a protective reflex, such as the reflex to remove your hand immediately if you put it on something hot.

In chronic pain, the pain does not have the same meaning—it is not protective and does not mean there is any ongoing tissue damage.

• Article written By:
• Peter F. Ullrich, Jr, MD

November 29, 2005

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