Degenerative Spine Diseases

• Intermittent or persistent pain in the neck and back, which may radiate to one or both lower limbs. The pain can be localised to a particular region (front or back of thigh/legs).
• Stiffness in the back.
• Occasionally, weakness of the legs or bowel and bladder involvement may occur if the compression is severe.

Degenerative spine disease can take several forms, including:

• Degenerative disc disease, which happens when the cushioning discs between the vertebrae wear down.
• Spinal stenosis, which occurs when spaces within the spine narrow and press on the nerves.
• Spondylosis, which refers to general age-related wear and tear of the spine.
• Spondylolisthesis, which occurs when one vertebra slips forward over another.

People with degenerative spine disease may experience:

• Intermittent or constant pain in the neck and back, which may spread to one or both lower legs.
• Pain that feels localised to a specific area, such as the front or back of thigh or legs.
• Stiffness in the back that makes movement difficult.
• Weakness in the legs, and in severe cases, problems with bowel or bladder control.
   

Several factors can increase the risk of degenerative spine disease, including:

• Natural ageing, which weakens the discs and joints in the spine.
• Previous spine injury, which may accelerate wear and tear.
• Repetitive strain or heavy physical work that stresses the spine.
• Poor posture or prolonged sitting.
• Being overweight, which adds extra pressure on the spine.

Doctors may use different methods to diagnose degenerative spine disease, such as:

• Physical examination of the spine to check for deformity, stiffness, reflex changes, and muscle strength.
• Radiography (X-ray) to assess the vertebral bodies, disc space, bone spurs, and spinal alignment.
• Magnetic resonance imaging (MRI) to detect soft tissue changes, such as nerve and spinal cord compression.

Treatment usually begins with non-surgical approaches, and surgery is considered only if these approaches do not provide relief.

• Non-surgical treatments: Conservative non-surgical treatment methods include:
  • Physiotherapy with exercises to strengthen muscles, stretch the spine, and improve posture.
  • Medication to relieve pain and muscle spasms.
  • Activity changes to avoid movements that worsen the pain.
  • Epidural steroid, facet joint, or nerve root injections for pain relief and reducing inflammation.
• Surgical treatments: Based on the extent of pain and the patient’s overall condition, one of the following surgical treatments is recommended:
  • Laminectomy, where a small portion of bone is removed to relieve nerve pressure.
  • Discectomy, where part of the damaged disc is removed, sometimes combined with spinal fusion to stabilise the spine.

Patients are advised to see a doctor if they notice:

• Neck or back pain lasting more than a few weeks.
• Numbness, tingling, or weakness in the limbs.
• Pain that radiates to the arms or legs and affects daily activities.
• Loss of bladder/bowel control, which represents a medical emergency.

While degenerative spine disease cannot be completely avoided, you can reduce the risk by:

• Staying physically active and keeping back and core muscles strong.
• Maintaining good posture while standing, sitting, and working.
• Avoiding prolonged sitting or screen time without breaks.
• Using safe techniques for lifting heavy objects.
• Maintaining a healthy body weight.

For diagnosis and treatment of degenerative spine disease, you may need to see:

• An orthopaedic spine specialist or a neurosurgeon for evaluation and treatment options.
• A physiotherapist for rehabilitation and exercises.
• A pain specialist if injections or pain management strategies are required.