Is Your Spine “Degenerating”? How to Recognize Early Symptoms

Causes and Symptoms of Degenerative Spine Disease

The primary cause of degenerative spine disease is aging, which leads to the natural wear and tear of the spinal joints and discs. Other causes can include overuse, such as lifting heavy objects, infections, or accidents that damage the spinal joints. While degenerative spine disease is most common in older adults, it can also occur in younger people due to excessive strain on the spine.

Degenerative spine disease typically presents in two forms:

• Cervical Spine Degeneration: This affects the neck and may cause neck pain, shoulder blade pain, or headaches. If the condition compresses the nerve roots, it may lead to radiating pain, numbness, or weakness in the arms. In severe cases, compression of the spinal cord may result in muscle weakness, paralysis, difficulty using the hands, or difficulty walking. Patients with severe cervical degeneration may walk slowly, experience frequent falls, or have issues with bladder or bowel control.

• Lumbar Spine Degeneration: This affects the lower back and typically presents as lower back pain that worsens with activity but improves with rest. If the nerve roots are compressed, it can lead to radiating pain, numbness, or weakness in the legs. In more severe cases, narrowing of the spinal canal (spinal stenosis) can result in difficulty walking, where the patient may have to stop and rest before continuing. Severe compression may also affect bladder or bowel function.

Additionally, spinal degeneration can cause a loss of height due to collapsed intervertebral discs, resulting in a hunched posture or forward tilting of the body. This is often seen in older adults with a curved or hunched back. In cases where the left and right spinal joints degenerate unevenly, it may lead to spinal curvature (scoliosis) in older individuals.

In summary, degenerative spine disease not only affects the external appearance of the spine, causing curvature or hunching, but it can also lead to symptoms such as radiating pain, numbness, and weakness in the arms and legs.

Risk Factors: Which Age Groups or Behaviors Increase the Risk of Degenerative Spine Disease?

Both age and lifestyle behaviors play a significant role in the development of degenerative spine disease:

• Age Factor: Intervertebral disc degeneration can begin as early as age 30, while facet joint degeneration typically occurs after age 40. The risk of developing degenerative spine disease increases with age, and this is an uncontrollable factor.
• Behavioral Factors:  These are factors that can be modified. Behaviors that accelerate spine degeneration include heavy lifting, prolonged sitting, repetitive bending or twisting of the neck or back, being overweight, participating in high-impact sports, and smoking. These behaviors can significantly contribute to the early onset of spine degeneration.

How is Degenerative Spine Disease Diagnosed?

Before starting treatment, if you suspect that you have degenerative spine disease, a doctor will follow these steps to make a diagnosis:

• Medical History: The doctor will begin by asking about the nature of your pain, including its location, duration, and whether you experience radiating pain. For example, neck pain may radiate into the arms, while lower back pain may radiate down the legs. These symptoms often indicate nerve compression, and other concerning symptoms like numbness or weakness, particularly affecting bladder or bowel control, may point to more serious nerve or spinal cord compression that requires urgent care.
• Physical Examination: The doctor will perform a physical exam, observing your posture, walking pattern, areas of tenderness, and mobility. They’ll also check for signs of sensory loss (numbness) and muscle strength to assess nerve involvement.
• X-ray Imaging: The doctor may order X-rays to check for abnormalities in the bones, such as bone spurs, misaligned vertebrae, or disc height loss. However, X-rays do not show the details of the intervertebral discs or nerve compression.
• MRI (Magnetic Resonance Imaging): This is the most detailed and safest diagnostic tool, as it does not involve radiation. MRI uses magnetic waves to provide clear images of the discs, facet joints, and nerve compression, allowing the doctor to evaluate the extent of degeneration.

Treatment Options for Degenerative Spine Disease: Can It Be Cured?

Treatment approaches for degenerative spine disease vary depending on the severity of the condition:

• Lifestyle Adjustments: Avoiding activities that worsen symptoms, such as heavy lifting or excessive bending and twisting, can help. Losing weight and quitting smoking are also important for reducing strain on the spine.
• Physical Therapy: This may include heat therapy, ultrasound therapy, shock wave therapy, cervical or lumbar traction, and strengthening exercises to improve muscle strength and reduce pain.
• Pain and Anti-inflammatory Medications: Over-the-counter pain relievers like acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation. However, long-term use should be monitored to avoid potential side effects on the kidneys.
• Epidural Steroid Injections: If pain persists, steroid injections into the epidural space around the spinal cord may reduce inflammation and relieve pain. However, this treatment may not provide permanent relief and is typically effective for 3-6 months.  
• Surgical Intervention: If non-invasive treatments are ineffective and symptoms include significant muscle weakness or dysfunction in the bowel and bladder, surgery may be recommended. The goal of surgery is to relieve nerve compression, stabilize the spine, or correct any misalignments that are causing severe symptoms.

Preventing or Reducing the Risk of Degenerative Spine Disease

There are many ways to prevent or reduce the risk of developing degenerative spine disease, such as:  

• Maintaining Proper Posture: Sit with your back straight, ensuring your posture supports spinal health. Take breaks to stretch periodically.
• Avoid Prolonged Static Positions:  Avoid staying in one position for too long, whether sitting or standing.
• Exercise Regularly: Engage in exercises that strengthen the muscles of the back and core, helping to stabilize the spine.
• Avoid Risky Activities: Steer clear of behaviors such as heavy lifting or excessive bending and twisting.
• Prevent Accidents: Take care to avoid situations that could lead to spinal injury, such as falls or sudden impacts.

Understanding Degenerative Spine Disease

Degenerative spine disease is a condition that affects the components of the spinal joints, including the intervertebral discs and facet joints. It is most common among older adults but can also affect individuals with poor posture or those who frequently lift heavy objects. Symptoms often include localized back pain or radiating pain and numbness in the arms or legs if nerve compression occurs.

If you experience symptoms or notice any abnormalities in your spine, it is crucial to consult a healthcare provider for proper diagnosis and treatment. With the right care, patients can effectively manage the disease and return to their normal, daily activities.

Article by: Assoc. Prof. Koopong Siribumrungwong, M.D., Specialist Spine Surgoen