Ask the Doctor

Answered by Dr. Sushil K. Basra, M.D.

Q: What can I do to control degenerative disc disease?

A: The degenerative process of the spine is an inevitable one.  For many people this degeneration does not compromise quality of life, yet for some, it is painful and incapacitating.  The real issue from a healthcare perspective is pain associated with the “aging spine” and the neurologic symptoms such as weakness, numbness, and tingling that require evaluation and treatment. The goal is to develop effective solutions to maintain quality of life. In a healthy back, the bones in the spine are cushioned and separated by full, spongy discs.  Aging discs dehydrate with wear and tear over time, causing the space between the bones to narrow. The most common spine issues associated with aging include degenerative disc disease, osteoporosis, vertebral compression fractures, spinal stenosis, lumbar spondylolisthesis and scoliosis. Symptoms associated with these conditions are pain, weakness, numbness and tingling in the buttocks and legs, change in posture, and reduced mobility.

Osteoporotic Fractures:

Osteoporotic compression fractures are one of the most common problems of the aging spine. Osteoporosis and osteopenia affects both men and woman and is caused by a loss of bone density. A weakened vertebra is more prone to fracture. Risk factors include: female gender, early menopause, kidney or thyroid disease, malabsorption problems, inactivity, steroid use, high alcohol intake, history of smoking, fair complexion, underweight, and family history.  These fractures can cause back pain, neurologic issues, and loss of physical function.  Initial treatment options can include bracing of the spine and medication. The treatment plan may include supplements such as calcium and vitamin D3, hormones, and various medications to prevent future fracture. Fractures that do not respond to this treatment may be considered for minimally invasive surgery. Kyphoplasty/Vertebroplasty is usually the surgery of choice to stabilize the spine.

Lumbar Stenosis:

Stenosis of the spine is a condition that results from narrowing of the spinal canal, which may lead to compression of the spinal cord and nerves. Patients usually have pain, weakness and tingling, and numbness in their buttocks and legs especially with walking. These symptoms are decreased with sitting, bending slightly forward, or with use of a walking aid such as a shopping cart.  Initial treatment options include physical therapy, anti-inflammatory medication, and possibly epidural steroid injections.  If symptoms persist, surgery may be necessary.

Lumbar Spondylolisthesis:

Spondylolisthesis literally means a “slip of the vertebrae”.  Spondylolisthesis occurs when normal ligaments, discs, and facet joints weaken and the upper vertebrae moves forward in relation to the lower vertebrae. Patients complain of back pain and symptoms such as leg pain, fatigue, or neurologic symptoms. Treatment options are similar to those used to treat stenosis; rest, physical therapy, anti-inflammatory medication, steroids, epidural injections, and possible surgery.

Degenerative Scoliosis:

Scoliosis is an abnormal curvature of the spinal column. Adult scoliosis is a common and sometimes disabling degenerative condition of the spine that can lead to loss of normal standing posture and impaired function.  Nonoperative treatment may include bracing for comfort, physical therapy, medication, activity modification, and possible epidural steroid injections. Traditional surgical options include techniques to restore normal alignment of the spine and decompression of the nerve roots.  Innovative techniques have drastically changed the way we treat this condition surgically. The less invasive methods available today make recovery easier.

What Can I do to Control Degenerative Disc Disease?

Spinal degeneration is a part of aging.  Although aging and degeneration cannot be avoided, there is increasing evidence that maintaining an active lifestyle is the key.  Exercise, diet and some healthy habits are necessary to maintain overall health. 

  • Physical exercise with strength training and low impact cardio exercise such as swimming or walking and maintain flexibility through practice of Yoga and Tai Chi.
  • Nutrition and weight control is an essential component.  Being overweight contributes to added stress on the spine.  It is important to reduce saturated fats, trans fats, limit sugar, salt, and red meat. Maintain low carb diet.   Fruits and Vegetables should be least 60 percent of your diet.  Consume fish rich in omega –3 oils (salmon).  Since our diet is low in basic nutrients, supplements of Vit D3 and calcium are favored.
  • Hydration is vital. You should drink water throughout the day.
  • Eliminating or reducing use of caffeinated drinks such as coffee, tea, and soda.
  • Alcohol use should be minimized. Alcohol not only decreases hydration, it is a depressant. Red wine does contain a powerful antioxidant, Resveratrol.   While the benefits cannot be denied, drinking red wine should also be limited.
  • Smoking should be curtailed because it accelerates the degenerative process four times faster than normal.

Although the term degenerative disc disease sounds scary, for most people back pain and other symptoms from degenerative disc disease can be managed nonoperatively.  If the degree of pain and symptoms prevent you from enjoying your everyday activities, surgery may be an option.

The surgeons at Long Island Spine Specialists, P.C., perform the most advanced and minimally invasive surgical techniques available today.  The benefit is less time in the hospital, a shorter recovery, and most importantly, a return to normal activities. 

Living to 100, which was once considered nearly impossible, is possible today, and with the advancements in medicine and a commitment of living a healthy lifestyle, aging, though inevitable, does not need to be synonymous with pain and debilitation.