Disc desiccation is degenerative, but it can be treated non-surgically.
What is Disc Desiccation?
The disc desiccation definition is that it is “an extremely common degenerative change of intervertebral discs.” As people age, it is normal, to a degree, that there will be a desiccated disk, but this is not what causes height loss. Disc height loss is due to “annular bulging and vertebral endplate bowing”.1 It is possible to have only mild disc desiccation, and disc desiccation can happen on any of the discs in the
spine. Discs act as shock absorbers, cushioning between vertebrae, but the aging process leads discs to become more dry or flattened, narrowing the disc space and allowing the vertebrae to touch. This entire disorder is called degenerative disc disease. A narrower space between vertebrae gives nerves less room, irritating them and possibly leading to numbness, weakness, tingling, or pain.2
Diagnosis of Degenerative Disc Disease
Medical doctors may order an MRI to confirm degenerative disc disease before planning surgery, if needed. The disc might have pain if the “disc space collapse (is) greater than 50%” or if there is “cartilaginous endplate erosion”. In the latter situation, the disc has live cells, which do not get their nutrition from blood supply; their nutrition comes from “diffusion through the endplate”. Any disruption to the process, from degeneration, compromises the nutrition of the cells. Sometimes the MRI will find disc desiccation, which is considered a type of “early disc space degeneration”. Other findings for back pain include an annular tear or disc bulging. Sometimes the annular tear, disc bulging, or disc desiccation are not the source of the pain and are just “more consistent with the natural aging of the…back”. There may be no symptoms at all in some patients with disc degeneration.3
When patients do have pain with DDD, it is typically as a result of inflammation or “abnormal micromotion instability”. The disc space proteins cause inflammation, which is usually painful. Lower back (lumbar) pain can also radiate out to the hips or down the leg, as is true with “sciatica, or radiculopathy”. The pain can extend to the toes. If the pain is in the neck (cervical) region, the neck pain could radiate to the shoulder or hand (cervical radiculopathy). Abnormal micromotion instability refers to a situation in which the outer ring of the disc (annulus) degenerates and is “not as effective in resisting motion in the spine”. It is referred to as micromotion because the movement is not a “gross instability (such as a slipped vertebral body or spondylolisthesis)”. These two situations cause spasms, which are the body’s way of trying to stabilize the spinal area, and spasms might be painful. Disc dehydration, or desiccation, may or may not be the cause of the pain.4 Disc desiccation symptoms could appear at once, post-injury, or over time. They might include tenderness, pain when moving, weakness, numbness, tingling, or “changes in reflexes”.5
Treatment of Disc Desiccation and DDD
There are several treatment options for disc desiccation, including massage therapy, physiotherapy, medication, weight loss, chiropractic care, or surgery. Medications only provide temporary relief, and they have side effects. Surgery carries its own risks. The general surgery for this situation, once all other treatment options have been exhausted, is called spinal fusion. In spinal fusion, the surgeon removes the disc, possibly replacing it with an artificial one, while “the adjacent vertebrae are joined with screws and rods”.6 There are many non-surgical options to consider for DDD, such as avoiding painful behaviors. For those with lumbar issues, patients can kneel or recline instead of sit. They should consider a corset brace when lifting, and they should not lift while in a bent position. For patients with cervical problems, a cervical spine collar may be helpful. Exercise could also prove beneficial in that the stomach and back muscles could be strengthened with yoga, Pilates, and swimming. In terms of medications, doctors might employ facet joint injections (steroids with a local anesthetic). Another non-surgical treatment option is “intradiscal electrothermal annuloplasty (IDET)” which uses a copper coil to heat the discs and harden them. This technique “allows the disc to resist weight-bearing motion better than the degenerated disc”.7 Chiropractic treatment is useful for avoiding medications and surgery and it can improve motion and reduce inflammation from DDD. Spinal manipulation, flexion distraction, and instrument-assisted chiropractic adjustments may all help a patient with back and neck pain. It is important to note there is not a cure for DDD, but with proper nutrition and treatment, “regeneration of the affected discs can begin”, reducing pain and helping patients resume their daily activities.8 Massage therapy is another non-surgical option for back and neck pain because it helps circulation, bringing nutrients to the muscles, and it decreases tension and increases endorphins to enhance the mood and reduce depression and anxiety.9