Painful Degenerative Disease

There are various ways that degenerative changes can cause lower back pain or pain spreading down one of the legs.

Discogenic Pain and Annular Tears

Discogenic pain arises from the disc itself. Areas of high stress within the disc can be uncomfortable, particularly with standing or sitting for long periods. The disc will also be vulnerable to jarring, for example causing pain when a step is missed. Inflammatory substances build up in the disc and can leak out through tears in the disc wall (annular tears) causing back pain and sometimes nerve pain as well. This is occasionally referred to as 'chemical spill'. Annular tears can be seen on MRI scans and are by no means always symptomatic. However, it has been shown that very sensitive new nerve fibres can grow into these tears and cause pain.

Instability

The instability from softening of the disc may cause sudden painful episodes which may last days, weeks or longer. There will often be a sense of vulnerability with certain movements which, of course, will lead to functional limitations and a gradual stiffening of the back.

Facet Joint Disease

As with any other joint, arthritic changes affecting the facet joints can be painful. This may be helped by injections of anti-inflammatory steroid into the joint or by radiofrequency denervation of the affected joints. When joints are affected by arthritis they may enlarge. This enlargement is not really a problem in other joints, although it can be a little unsightly. In the spine this enlargement can encroach on the space available for the spinal nerves, a condition called spinal stenosis.

About Degenerative Disc Disease

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