What are the Causes and Symptoms of Cervical Degenerative Disc Disease and How is it Diagnosed and Treated?

What are the Causes and Symptoms of Cervical Degenerative Disc Disease and How is it Diagnosed and Treated?
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What is CDDD?

Degenerative disc disease is an often painful spinal condition that arises when discs of the backbone, or vertebrae, wear down or degenerate such that they no longer effectively cushion the spine. This condition is specifically referred to as cervical degenerative disc disease (CDDD) when one or more discs of the neck are affected in this manner.

What are the causes and symptoms of CDDD?

It is not exactly known what causes CDDD, but certainly advanced age and injury to the spine are factors that can contribute to this condition. It is also believed that, in some individuals, CDDD may have a genetic cause. Further, smokers and those who lead active lifestyles and/or who have very physical jobs, such as construction workers, farmers, fishermen and athletes, for example, are particularly susceptible to developing CDDD.

Those who suffer from CDDD experience a variety of symptoms. While many have excruciating neck and arm pain, some are free of pain or have only minor discomfort. Interestingly, pain due to CDDD can arise differently among individuals. In some cases, pain immediately follows a major injury (e.g., one caused by a fall down a flight of stairs or a car accident), and in other cases, the pain is sudden but is due to a very minor injury (e.g., one caused by bending over awkwardly). For some others, pain starts slowly and is almost unnoticeable, but then gets progressively worse.

How is CDDD diagnosed and what treatments are available?

When a person with CDDD visits his or her family doctor for diagnosis, the doctor likely will first obtain and review the patient’s complete medical history and discuss with the patient his or her prior injuries, if any, and typical lifestyle activities. This information can help the doctor gain a preliminary assessment of what factor or factors may be the root cause of the condition. As a next step, the doctor is likely to take images of the affected region of the neck, such as by x-ray, CT scan or MRI, for example, for evidence of any problem that may be causing abnormal stress upon one or more discs and nearby nerves. At this time, the family doctor may refer the patient to a specialist who routinely treats bone and/or nerve disorders.

Once the patient is definitely diagnosed as having CDDD and the root of the problem in that particular patient is determined, the specialist will prescribe one or more courses of treatment. Treatment options include nonsurgical options such as physical therapy, periodic manipulation by a chiropractor, long periods of rest, and medication such as anti-inflammatory drugs, pain inhibitors and steriods, for example (usually nonsurgical options are the first ones tried).

One or more surgical options also may be pursued. Available surgical options include spinal fusion, in which multiple discs of the vertebrae in the affected region are fused together to alleviate disc stress, and intradiscal eletrical therapy, in which a catheter is inserted into the neck and near the affected disc(s) and nearby nerves to deliver therapeutic heat to the disc(s) and nerves.

Additionally, some patients elect to try herbal supplements and/or acupuncture as means for alleviating the pain associated with cervical degenerative disc disease.

References

D.S. Rishi et al., Long-term outcome after anterior cervical discectomy without fusion, European Spine Journal 16:1411-1416 (2007): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2200758/pdf/586_2007_Article_309.pdf

Mayfield Clinic, Degenerative disc disease: https://www.mayfieldclinic.com/PE-DDD.HTM

Mayo Clinic, Mayo Clinic offers cervical spine surgery with newly approved artificial disc: https://www.mayoclinic.org/news2007-jax/4291.html