A Simple Guide to Living with Degenerative Disc Disease by an Esteemed Neurosurgeon in Singapore

What is Degenerative Disc Disease?

Are you aware that Degenerative Disc Disease (DDD) is not a disease but is considered a natural part of the ageing process? It is a common condition that affects the small joints and spinal discs, leading to pain, stiffness, and reduced mobility, compromising the quality of life of many people in Singapore especially those who are 60 years or older.

While DDD can present challenges, it is possible to live well with this spinal condition by adopting healthy lifestyle practices, seeking appropriate medical care from a Neurosurgeon in Singapore, and making necessary adaptations to daily life.

What Causes Degenerative Disc Disease?

Simply put, due to the strain of daily activities, parts of the spine can progressively lose their normal alignment, structure and, eventually, function, resulting in Degenerative Disc Disease (DDD). Specifically, DDD is caused by changes to the structure of the intervertebral discs. Spinal discs cushion each vertebral bone when functioning normally, resulting in its flexible and durable nature. As we age, due to constant pressure and strain, the outer layer of the disc becomes weaker, and the disc becomes thinner, reducing its ability to compress and absorb pressure. Flat, dry spinal discs can rupture and press on sensitive nerves in your spinal cord, which may cause back pain. Severe degeneration may leave your vertebrae vulnerable to fractures.

In general, several risk factors contribute to the development of DDD, including:

Ageing as the risk of developing DDD increases with age, particularly after 40 years old
Familial history of back pain or DDD
Excessive strain on the lower back because of constant heavy lifting or sports injuries
Lifestyle factors, including obesity and smoking, may affect the blood supply to the discs and accelerate the degenerative process

Other conditions that can affect the spine include inflammation (arthritis), scoliosis (abnormal spine alignment), infection, tumours (primary or secondary), physical inactivity (being bed-bound or wheelchair-bound due to stroke or trauma), congenital or acquired neuromuscular disorders (like multiple sclerosis), endocrine disorders affecting bone, and congenital or genetic disorders affecting the axial spine (such as ankylosing spondylitis).

Can Young People Suffer from Degenerative Disc Disease?

Despite its association with old people, degenerative disc disease (DDD) does not just affect the elderly. DDD can impact individuals of any age — even young people —due to the occurrence of annular tears in the spinal discs, which are a fundamental cause of the condition. These tears can develop at any stage of life, leading to the progression of DDD regardless of age. Hence, some adolescents and young adults may suffer from juvenile DDD, often leading to lower back pain and other symptoms similar to those seen in older patients.

Besides factors such as genetic predisposition, repetitive stress and trauma can also contribute to the early onset of disc degeneration in younger individuals. In particular, young people with sports injuries are more prone to DDD than their counterparts who have not incurred such injuries. This is because repetitive stress and trauma from sports activities, such as athletics, boxing, swimming, and tennis, can accelerate the degeneration of spinal discs. These activities often involve chronic application of stress or pressure on the spine and torso, which can damage the discs and lead to early degenerative changes. Therefore, while exercising is generally beneficial for the spine, everyone should prioritise safety when playing sports to reduce the risk of sports injuries that take a toll on spinal health.

What Are the Symptoms of Degenerative Disc Disease? When Do I Need to See a Neurosurgeon?

You may need to see a Neurosurgeon for Degenerative Disc Disease if conservative treatments like medication, physiotherapy, and lifestyle changes have not provided sufficient relief, and you experience persistent and severe symptoms such as:

Unrelenting Back Pain: Chronic and severe back pain that lasts more than two to three months.
Nerve Compression Symptoms: Symptoms of nerve compression, including radiating pain, numbness, tingling, weakness, or loss of sensation in the arms or legs.
Functional Impairment: A reduced quality of life due to DDD-related symptoms, which make it challenging for you to perform daily activities like walking and standing.
Progressive Neurological Deficits: Worsening neurological deficits such as muscle weakness, coordination problems, or bowel/bladder dysfunction.

What Are Some Tips for Living with Degenerative Disc Disease?

Here are some tips to follow for a higher quality of life:

Attend regular follow-up appointments with a Neurosurgeon

While degenerative disc disease is not reversible, getting the specialised care you deserve from a Neurosurgeon can be beneficial for certain patients. In some cases, regular monitoring with periodic check-ups may be recommended to track the progression of DDD, assess functional status, and address any emerging issues. A Neurosurgeon can provide tailored medical advice on the following points:

Adjusting of Recommended Medication Dosage: When consumed at the right dosage, pain relievers, anti-inflammatory drugs, and muscle relaxants, may effectively relieve pain and inflammation. Therefore, doctors need to closely monitor how patients respond to medication, including improvements in symptoms and any adverse reactions, to make necessary dosage adjustments.

Determining When Surgery is Necessary: Surgical treatment is an option in cases of severe, debilitating DDD. It is recommended when nonsurgical treatment options are unsuccessful in managing DDD’s symptoms.

Maintain proper posture to alleviate back pain

Regularly sitting with the wrong posture is a major factor in causing frequent back pain. This is because incorrect posture (i.e. leaning the head forward and hunching the shoulders) can add strain to the spinal cord, resulting in discomfort, particularly for those already dealing with DDD.

Therefore, it’s crucial to adopt a healthy posture by sitting with a straight back and legs aligned parallel to the ground.

Engage in good exercises for degenerative disc disease

Apart from the treatments mentioned above, specific exercises can be crucial in managing the discomfort associated with DDD. It is important to note that the suitability of these exercises may vary depending on the root cause of their condition, and patients should consult with their Neurosurgeon before starting any exercise routine.

Here are some exercises for DDD that may improve your condition:

Core Exercises: They help to build up your core muscle strength, allowing it to provide better support for your upper body weight and alleviate tension from your back. Some examples include bridges or pelvic tilts.
Stretching Exercises: These exercises help restore your mobility and flexibility.
Low-impact Aerobic Exercises: This type of physical activity elevates the heart rate gradually without placing excessive stress on the joints. You can, for example, typically engage in walking, cycling, swimming, and dancing, while minimising concerns about aggravating your Degenerative Disc Disease (DDD) condition.

Lead a healthy lifestyle

The usual healthy living advice that you are familiar with is also relevant to the management of DDD:

Eat in Moderation: Maintaining a healthy weight (i.e.ensuring your Body Mass Index falls within the healthy range of 18.5 and 22.9 kg/m²) is important to reduce strain on your spine and discs.
Avoid Smoking: Smoking can worsen disc degeneration and hinder healing. Nicotine and other harmful chemicals in cigarettes can damage the blood vessels supplying nutrients to the spinal discs, leading to faster degeneration.
Manage Stress: Utilise relaxation techniques like yoga or meditation to reduce muscle tension and spinal pain.

Summary

Degenerative Disc Disease (DDD) is related to spinal misalignment which induces further damage to the nerve roots and spinal cords during activities of daily living. Although DDD is an age-related spinal condition, it can affect anyone regardless of their age even young people.

While DDD can’t be prevented, it doesn’t necessarily need to be debilitating. Becoming aware of the symptoms, exploring the treatment options, and following certain healthy lifestyle practices can help patients manage the pain and discomfort often associated with DDD. , Leading a healthy lifestyle, such as maintaining a proper posture, engaging in suitable exercises and eating in moderation, can enable patients with DDD to control their condition.

Visit Advanced Brain and Spine Surgical Centre

In order to boost your quality of life, seek specialised care to manage your DDD effectively. Book a consultation with our experienced Senior Consultant Neurosurgeon, Dr Sein Lwin, today for disease monitoring, tailored treatment advice, and personalised lifestyle tips. Dr Sein is well-versed in treating DDD in adults of all ages including young adults, helping them to take charge of their spinal condition and enjoy a higher quality of life.

References

Australia H. Spinal disc problems. www.healthdirect.gov.au. Published July 24, 2021. https://www.healthdirect.gov.au/spinal-disc-problems
Braverman J. What Core Exercises Can I Do With Degenerative Disc Disease and Herniated Discs? LIVESTRONG.COM. Published February 1, 2020. Accessed November16,2023. https://www.livestrong.com/article/546962-what-core-exercises-can-i-do-with-degenerative-disc-disease-herniated-discs/
Donnally III CJ, Hanna A, Varacallo M. Lumbar Degenerative Disk Disease. PubMed. Published 2020. https://www.ncbi.nlm.nih.gov/books/NBK448134/

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