In order to understand why degenerative disc disease diagnosis can be complicated, you need to understand the ways in which it manifests and the process of diagnosis. This will give you a better insight into what makes such a common condition so tricky to recognize.
Symptoms of Degenerative Disc Disease
There are many common symptoms of degenerative disc disease, and that’s part of what can make it difficult to diagnose. This is because some symptoms of this condition, such as sporadic pain, sciatica, and headaches, aren’t usually connected to degenerative disc disease until symptoms more clearly related to back pain are felt.
One prevalent symptom of degenerative disc disease is pain that worsens when sitting, coughing, or sneezing but may be relieved by running, walking, lying down, or constantly shifting positions. The load placed on spinal discs when sitting is three times greater than when standing, which is why sitting with degenerated discs can be so painful. Pain that is felt when you bend down, twist, or lift things is another symptom, and this pain is also a result of the stress placed on spinal discs when in these positions.
Pain caused by degenerative disc disease may also come and go, making it difficult to determine whether the pain is chronic or acute. This is because these periods of pain may last only a few days before stopping for some time, or may last as long as a few months at a time. This pain may also be nothing more than mild, nagging pain or can be seriously debilitating.
Sciatica is also a common symptom of degenerative disc disease, but it often is considered its own issue. When spinal discs develop tears, this reduces the ability of the annulus pulposus, or the outer part of the spinal disc, to contain the nucleus pulposus, the center, jelly-like part of the spinal disc. When the nucleus pulposus is no longer contained within the spinal disc, it can come into contact with surrounding nerves, causing irritation and inflammation. If this happens near the sciatic nerve, this contact can cause symptoms of sciatica, such as numbness or a sensation of burning or tingling felt in the hips and lower extremities, weakness of the leg muscles, or foot drop.
Similar sensations of burning, tingling, or numbness may be felt in the back of the head, neck, arms, and hands if the degenerated discs are located in the cervical spine.
You may also experience muscle spasms in the lower back or neck as a result of degenerative discs as well. These spasms are caused by instability of the spine and are your body’s way of attempting to stabilize the vertebrae.
Degenerated discs located in the neck, or cervical spine, may also lead to headaches. Unfortunately, headaches are a symptom of a number of different conditions and can even be caused for no larger underlying reason, making this symptom particularly difficult to connect to degenerative disc disease.
Other symptoms that may be difficult to connect to degenerative disc disease include reflex issues in the knee or ankle and issues with bladder or bowel function. It should be noted that problems with bladder or bowel function is an advanced symptom of degenerative disc disease requiring emergency care.
Once you have a broad understanding of the symptoms of this condition, there are still degenerative disc disease diagnosis issues that can make it difficult to determine with certainty.
Getting a Degenerative Disc Disease Diagnosis
If you suspect that you have back pain due to degenerative disc disease, after making an appointment with your doctor, the first thing they will want to do is learn more about your medical history and current symptoms. You will likely be asked questions such as
- What part of your spine hurts?
- Have you had any injuries to your spine in the past?
- Has the pain spread to any other part of your body?
After getting a better understanding of your history and your current pain, your doctor will examine your spine and ask you to perform certain movements such as walking or bending down in order to determine which specific movements cause you pain. This is important in diagnosing degenerative disc disease because movements such as bending or twisting usually cause pain for people with this condition while walking generally provides relief.
If your doctor believes that you may be experiencing pain caused by degenerative disc disease, more tests will be ordered in order to check for any abnormalities in your spine or to pinpoint the source of your pain. These tests may include X-rays, MRI, or a CT scan.
Once these tests have been completed, if abnormalities are found your doctor will most likely recommend additional testing in the form of a discography. The purpose of discography is to evaluate spinal discs for tearing. They are also commonly used to determine which spinal discs need to be removed in order to plan spinal fusion surgery. Annulograms are also used for the purpose of disc evaluation and function similarly to discography. A key difference between the two is that in evaluation by an annulogram, less pressure is placed on the disc.
Issues With Diagnosis
X-rays, MRI, and CT scans are commonly used imaging techniques to determine whether patients have spine issues. However, while these techniques can efficiently find spine abnormalities, they cannot pinpoint the exact source or cause of pain, making diagnosis problematic.
Even discography has been proven to lack accuracy in showing which discs are the cause of back pain, or if discs even are the cause of pain.
It can also be difficult to determine when pain should be taken seriously enough to consider that degenerative disc disease may be the cause. Because symptoms include pain that can be mild only for a few days, giving the impression that it has solved itself, people may not realize that their actual problem is the result of degenerated discs. Other symptoms have a similar issue as well, such as muscle spasms. Muscle spasms can be caused by torn muscles or simply strain from overuse, which also makes determining the cause of degenerative disc disease difficult.
Finally, a lack of understanding and awareness of annular tears adds to the difficulty of getting a degenerative disc disease diagnosis. For example, sciatica caused by degenerative disc disease is a result of annular tears that allow the nucleus pulposus to come into contact with the sciatic nerve. Without understanding that these tears may be causing this issue, the connection between a patient’s sciatica symptoms and degenerated discs may not be made, and treatment may only be focused on solving sciatica.
When it comes to degenerative disc disease, there are many seemingly small symptoms that can become the focus and may cause you to miss the bigger picture. The best way to avoid this is by having a good understanding of this condition and knowing all the ways in which it tends to show itself. Education is always your best tool in taking control of your health and well being.
