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DDD begins with disc loss of proteoglycans and water content, tear formation of the annulus, and progressive fraying of the nucleus. Eventually, there is a loss of disc height, and with degeneration, the weight is shifted on the posterior spine elements, which causes facet joint arthritis.

In addition, osteophytes form around the disc spaces, and bone spurs grow into the spinal canal, pressing on the spinal cord and associated nerves (spinal stenosis). Degeneration disc disease progresses through three states: temporary dysfunction, unstable, and stabilization.

. Age
. Family history
. Chronic vibration
. Smoking
. Diabetes
. Heavy, repetitive work

The most common symptom of degenerative disc disease is back pain, which can spread to the buttocks, upper thighs, and legs. Discogenic pain is a common symptom of DDD, which can be mechanical in nature.

Movement places stress on one or more discs will result in pain, which is aching, throbbing, stabbing, and severe. When this pain spreads out to other regions of the body, it is referred to as radiation.

Treatment of degenerative disc disease can be either passive (done to the patient) or active (done by the patient). Most often, the pain specialist will use a combination of active and passive treatments for DDD. Options include:

. MedicationsTo alleviate inflammation and swelling, the doctor may prescribe steroids or NSAIDs. In addition, muscle relaxants are used when spasms occur. For severe pain, narcotic drugs are prescribed short-term.
. Chiropractic careManual manipulation by a qualified health professional can take pressure off sensitive tissue and increase spinal range of motion. The chiropractor may use adjustments to reduce muscle tension and restore blood flow to the degenerative disc.
. Epidural steroid injection (ESI)The doctor will insert a small needle into the epidural space just outside the spinal cord using x-ray guidance. The steroid is instilled near the nerves, with or without an anesthetic agent. The success rate of ESI was reported at 85% in one clinical study, and another study found cervical ESI to offer short-term relief of back pain.
. Physical therapyThe therapist can use ultrasound to warm the back region and increase blood flow to the spinal discs. In addition, massage reduces muscle stiffness, raises endorphin levels, and increases spine range of motion.
. Intradiscal injectionsinjections into the disc may consist of either steroid or regenerative medicine materials. This may include PRP Therapy or stem cell therapy with either bone marrow derived or amniotic derived medicine.
. IDETThis treatment, known as intradiscal electrothermal treatment, used to be fairly popular years ago. It was covered by insurance until studies began to show questionable effectiveness. At this point it is a self-pay option.