Understanding Degenerative Spine Conditions

About one-third of Americans 45 and older experience lower back pain in a given year, according to the Centers for Disease Control (CDC). The National Institutes of Health estimate that eight out of 10 people will be affected by back pain at some point in their lives. Degenerative spine conditions contribute significantly to this preponderance of back and neck pain. For something that has such a widespread and profound effect on the daily lives of so many people, the nature of these conditions remains a relative mystery to most.
A degenerative spine condition develops as a result of age-related deterioration affecting the anatomical components of the spine. These components – primarily the vertebrae, the vertebral facet joints, the intervertebral discs, and spinal ligaments – are subjected to a great deal of wear and tear over the years. As these components deteriorate, the back and neck can begin to feel stiff and achy. In addition, the spinal cord and adjacent nerve roots become vulnerable to nerve compression, which can give rise to pain, tingling, numbness, or muscle weakness in the extremities.
Categories of Degenerative Spine Conditions
Degenerative spine conditions develop gradually. Stress-inducing spinal movement and the burden of supporting the body’s weight combine to wear down the vertebral joints, as well as the cushioning structures, known as the intervertebral discs, that are sandwiched in between individual vertebrae. The cartilage on the end of the joints begins to break down over time, while the discs lose water content and height. At the same time, spinal ligaments begin to stiffen and lose elasticity. Any one of these cases of deterioration can lead to a degenerative spine condition, but most people experience them in combination as a natural result of aging.
Some of the most common degenerative spine conditions are osteoarthritis, which is the wearing down of cartilage on the ends of joints; and degenerative disc disease, which is the drying out and thinning of one or more intervertebral discs. These two age-related conditions can, in turn, lead to additional anatomical abnormalities that include:
• Spinal stenosis – the narrowing of one of the channels within the spinal column, including the spinal canal and intervertebral foramina (passages where the spinal nerve roots are located)
• Spondylolisthesis – the displacement, or slippage, of one vertebra over another
• Osteophytes – excess growths of bone, also known as bone spurs, that develop near an unstable joint
• Bulging disc – protrusion of the layered, cartilaginous outer wall of an intervertebral disc
• Herniated disc – extrusion of a portion of the gel-like nucleus material of a disc through a rupture or split in the outer wall
These conditions can develop anywhere along the spine, but are most common in the lumbar (lower back) region, where the spinal anatomy is subjected to the greatest amount of movement and body weight. While traumatic injury can contribute to the development of one or more of these conditions, the aging process is usually to blame.
Treating Degenerative Spine Conditions
Many of the aforementioned degenerative spine conditions never produce symptoms. Or, if they do, the symptoms are limited to mild swelling, stiffness, and occasional spasms at or near the location of the anatomical deterioration. However, if a bone spur or extruded nucleus material makes contact with an adjacent nerve root, this compression can produce radiating pain, tingling, numbness, and/or muscle weakness in the upper body (in cases of cervical compression) or the lower extremities (lumbar compression).
Surgery is almost always considered the last resort for managing symptoms related to a degenerative spine condition. In most cases, a doctor will develop a regimen of conservative treatment that might include non-steroidal anti-inflammatory drugs (NSAIDs), exercises to build core strength, stretching to improve core flexibility, or inflammation-reducing injections of corticosteroid compounds. If no combination of conservative treatment proves sufficient after several weeks or months, a doctor may suggest surgery as an option.