Degenerative Conditions of the Spine

Degenerative conditions of the spine include anatomical changes to the back that either affect the healthy functioning of the back or result in pressure and inflammation on the spinal nerves and joints. Some degenerative conditions of the spine may be reversible, though the loss of disc height and joint tissues in the spine may be permanent. But the diagnosis of certain types of degenerative conditions need not be frightening or the harbinger of future disability and chronic pain. For most people, the human body is able to adjust to these types of anatomical changes to the spine without being affected by pain and disability. Let's take a look at what degenerative spine conditions are and what types of treatments are available to treat them.

What are degenerative spine conditions? Degenerative spine conditions involve negative changes to the structures of the spine that affect how we move and how well protected vulnerable tissues such as the spinal nerves are. Due to the long term effects of injury, accident, disease, or simply the natural wear and tear of time, the structures of the spine may change their form, lose their density, or lose their volume. These structural changes in the density, volume, and shape may affect the their functioning, and we may experience these changes in our nerves, joints, and the amount of comfort we experience as we move. The wear and tear effects of time are the most common cause of most degenerative spine conditions. Other medical conditions which may affect one or more units of the spine include arthritis, infections, and tumors.

It is interesting that in the majority of cases, degeneration to many of these spinal units occurs with people none the wiser. Many people have herniated discs and degenerative disc disease without experiencing any pain at all. When do conditions such as herniated discs affect patients in the experience of back pain and when do they not? Doctors interestingly do not have a clear cut reason why some patients are affected by disc disease and others are not. But here's what they think. Patients are most commonly affected by degenerative conditions of the spine when the spinal nerves are compressed or constricted as a result. The nerves may become constricted as a result of spinal stenosis - which is a narrowing of the spinal canal. The nerves may also become constricted when part of the disc becomes herniated and projects directly into one or more of the spinal nerves, causing a disruption of the way the nerve operates.



What are the symptoms of degenerative spine conditions? The effects of these conditions may be apparent in the patient's posture or upon visual inspection of the patient by the doctor upon physical examination. The doctor may also learn a lot about the patient's condition through testing of the patient's reflexes or physical strength tests. Patients with conditions that affect their spinal nerves may have diminished reflexes or a lack of strength on one side of the body. Or doctors may learn a lot about the patient's conditions by the symptoms they report. Degenerative spine conditions include:
  • Neurologic Symptoms (nerve injuries)
    • Sexual dysfunction
    • Incontinence (bowel and bladder function problems)
    • Sensory loss
    • weakness
  • Back Pain or Neck Pain
    • Pain at rest or upon movement
    • Chronic or sharp pain
  • Range of motion deficits (limited motion)
  • Spinal deformity
How are degenerative spine conditions diagnosed? Degenerative spine conditions may be diagnosed based on the patient's signs and symptoms, medical imaging studies, and certain back pain treatments that also provide diagnostic information. Examples of back procedures that offer back pain relief as well as diagnostic value include pain injections. When compression of a particular spinal nerve is suspected, doctors will apply a local anesthetic to the area before a second corticosteroid injections that is designed to provide weeks to months of pain relief. If these injections are successful, it gives doctors strong evidence that that part of the spine is the pain generator. The pain generator is the anatomical part of the spine which is the source of the patient's back pain.

The most common exams that are done to diagnose conditions are medical imaging studies. X-rays provide doctors with good illustration of the spine itself, and the amount of space between the vertebral bones. Magnetic Resonance Imaging (MRI) provides doctors with must more detail of the intervertebral discs. When patient's MRI results is not consistent with the patient symptoms, CT Scans may be ordered to resolve any inconsistencies. When patients are thought to have pain that is directly related to their disc disease, a discogram may be ordered.

In a typical discogram procedure, a contrast dye is injected directly into the intervertebral disc. Because soft tissue structures such as the disc show up so poorly on medical imaging tests such as X-Ray, this procedure involve the injection of a high density dye which will accurately depict the shape and anatomical features of the disc. A diagnosis of discogenic pain is made when the injection procedure elicits a pain response from the patient.