Degenerative Disc Disease in the Neck

Degenerative Disc Disease in the Neck

Degenerative disc disease in the neck is not technically a disease, but, rather, is a term used to describe the gradual deterioration of the intervertebral discs. Degenerative disc disease typically affects individuals who have reached or exceeded middle age, though the pain and discomfort of the condition can be experienced in younger individuals. Regardless of how young or old a patient is when they receive their diagnosis, most are focused on the same thing: relieving their pain.

About the Spinal AnatomyTo understand exactly what degenerative disc disease in the neck is, it can be helpful to first learn about the spinal anatomy and the role the intervertebral discs play. Discs are positioned between adjacent, articulating vertebrae (the bones that shield the spinal cord) and absorb the impact that is placed on the spine when it bears weight or facilitates movement. In fact, these saucer-shaped structures are sometimes likened to mechanical shock absorbers due to the fact that they share similar responsibilities.

The discs have a tough yet pliable outer shell, called the annulus fibrosus, which is made primarily of fibrocartilage and other fibrous materials. This gives the disc its ability to conform to the strain that is placed on it. On the inside of each disc is a gelatinous material called the nucleus pulposus. This substance is responsible for evenly dispersing the impact that is placed on the discs and is mostly made of collagen and a water-retaining material.

An Overview of the ConditionThe strain and pressure that are continually placed on the intervertebral discs can eventually cause them to deteriorate. Specifically, the annuli fibrosi can become weak, brittle, and less able to adapt to the strain that is placed upon them, and the nuclei pulposi can dehydrate and become less able to evenly distribute pressure in all directions. These consequences of continued wear and tear are collectively known as degenerative disc disease. Patients whose discs have undergone deterioration are at risk for developing herniated and bulging discs. Many individuals use these terms interchangeably, when in fact they are two unique conditions:

• Herniated discs – This condition occurs with a disc’s annulus fibrosus

develops a crack or tear. In turn, this enables the nucleus pulposus to escape and seep into the spinal canal.

• Bulging discs – In the case of this condition, the annulus fibrosus remains intact but weakens to the point that it can no longer contain the nucleus pulposus within its normal boundary. As a result, the nucleus shifts out of place, causing the disc to balloon outward.

An Overview of the Condition

It’s interesting to note that herniated and bulging discs are not always symptomatic in and of themselves. Most patients only become aware of these conditions when a spinal nerve, a nerve root, or the spinal cord is compressed by either a misshapen disc or extruded disc material. Neural compression caused by degenerative disc disease in the neck can lead to symptoms of pain, numbness, tingling, and muscle weakness, which may be experienced in the neck, upper back, shoulders, arms, and/or hands.

Receiving a Degenerative Disc Disease Diagnosis

Many spinal conditions can cause similar symptoms, making it prudent for an individual who is experiencing pain or any neurological symptoms to receive an official diagnosis from a medical professional. A family doctor, neurologist, orthopedist, or other type of physician will generally use the following techniques to either reach or rule out a degenerative disc disease diagnosis:

• Question and answer session (to assess the patient’s symptoms, overall medical history, and the history of his or her family)

• Physical examination (to feel for tender or inflamed spots)• Neurological examination (to test reflexes and muscle

strength)• Diagnostic imaging (i.e. X-rays, MRI, or CT scans)

Nonsurgical TreatmentsOnce a physician has determined that a patient’s pain and discomfort can be attributed to degenerative disc disease in the neck, he or she will recommend a regimen of conservative, nonsurgical treatment. This will usually include the use of over-the-counter, nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen or ibuprofen. Depending on the patient’s medical history and degree of discomfort, the physician may instead recommend over-the-counter analgesics like acetaminophen, or prescription medications such as muscle relaxants or narcotic pain relievers. Many physicians will also advise their patients to work with a physical therapist to increase muscle strength in the neck and upper back. This can provide the cervical spine (in the neck) with greater support, which may help to relieve some of the burden that is being placed on the intervertebral discs and the affected spinal nerves. Physical therapy may also entail the use of other techniques, including transcutaneous electrical nerve stimulation (TENS), therapeutic ultrasound, massage therapy, cryotherapy, thermotherapy, and posture modification exercises, among others. Making certain lifestyle changes and/or reversing unhealthy habits can also prove beneficial to patients who suffer from degenerative spinal conditions. Losing weight, for instance, can greatly affect the spinal health of an obese individual. Supporting excess body weight places undue strain on the neck and back, which can exacerbate the deterioration of the intervertebral discs. Shedding excess pounds can not only slow the gradual weakening of the discs, but it may also help to relieve some of the pressure that is being placed on the affected spinal nerve.

Nonsurgical TreatmentsOther lifestyle changes that may help those who suffer from chronic back or neck pain include:

• Quitting smoking• Reducing alcohol consumption• Becoming more active• Participating in sports and activities that place

less strain on the neck and back Before undergoing any of these lifestyle changes, an individual should first consult a physician.

Surgery for Degenerative Disc Disease in the Neck

If the symptoms of degenerative disc disease in the neck persist after following a conservative treatment plan for several weeks or months, the patient may be advised to consider surgical treatment. During traditional, open spine surgery, the affected disc is removed in its entirety and is replaced with a bone graft and supporting hardware. This prohibits further mobility in that area of the spine and oftentimes requires a lengthy – and demanding – rehabilitation. Some patients with degenerative disc disease in the neck may be candidates for a minimally invasive procedure. This type of operation is performed on an outpatient basis and utilizes an endoscope to gain access to the affected intervertebral disc. The portion of the disc that is causing neural compression is them removed and the disc is sometimes “shrunk” with the use of a laser. Since no portion of the spinal anatomy is being removed in its entirety, spinal fusion and the use of a bone graft are unnecessary. This allows most patients to return to daily activities within a matter of weeks and some even experience relief immediately following their procedure. Before consenting to either type of surgery for degenerative disc disease in the neck, patients should thoroughly research all of their options and the risks and benefits associated with each one. It may also be advisable for patients to receive a second or third opinion to ensure surgical treatment is necessary.