Lumbar degenerative disc disease is a condition characterised by low back pain. It’s a common condition, but requires a definitive diagnosis. If you have pain in your lower pack, and you think it may be caused by disc problems, you might be considering a scan. An MRI, or Magnetic Resonance Imaging, scan is considered the gold standard in detecting and diagnosing lumbar disc degeneration and your MRI findings can then be used to formulate a personalised treatment and pain management plan.
This detailed article will help you understand what this condition is, the symptoms, what might be causing it, and how a degenerative disc disease MRI scan can help.
What is Lumbar Degenerative Disc Disease?
The backbone, or spine, has 33 vertebrae (back bones) in total, and doctors refer to the five vertebrae in the lower back as the lumbar region, or the lumbar spine. The five lumbar vertebrae are named L1, L2, L3, L4, and L5.
Along the length of the spine, each vertebrae is connected to the next via joints called facet joints, to form the spinal canal - each facet joint allows us to flex and bend, and the spinal canal contains and protects the spinal cord and nerves of the back. Between each vertebrae sits an intervertebral disc - a flat, circular piece of tissue made mostly of cartilage. Cartilage is predominantly water (along with collagen and other proteins) and as such, the centre of the intervertebral discs are relatively soft, compared to the bony vertebrae. Their spongy nature provides shock absorbing properties, or a cushioning, allowing us to move, stretch, jump, bend, lift, and twist freely.
However, the intervertebral discs are under constant pressure, and as we’ll discuss shortly, these discs can fall foul to general wear and tear and injury, leading to conditions such as disc extrusion (when the gel-like contents of the discs push through the wall of the disc into the spinal canal) and degenerative disc disease. Lumbar degenerative disc disease affects the intervertebral discs of the lower spine.
Lumbar Degenerative Disc Disease Symptoms
If you have low back pain caused by degenerative changes in the discs in your lumbar spine, then you may experience the following symptoms:
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Constant or intermittent low back pain
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Weakness in the lower back
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Pain and weakness that extends away from the affected area such as in the thighs and buttocks
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Muscle spasms
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Tingling and/or numbness in the legs and feet
Your pain may come and go, or it may be constant. Certain actions, such as bending, sitting, lifting, and twisting may make your pain worse, while certain positions such as laying down, gentle walking, or standing upright may ease it.
Diagnosing Lumbar Degenerative Disc Disease
There are a number of steps that your specialist will take in order to diagnose lumbar degenerative disc disease.
Medical History
Your doctor will ask you some questions to ascertain what and where your symptoms are, when they started (were they triggered by a particular event or did they come on gradually), how they affect your life, what makes them worse or better, and what you may have tried to relieve them. They will also ask questions regarding your general wellbeing and lifestyle.
Physical Exam
They will then likely perform a palpation - using their hands to feel along the length of your spine (paying particular attention to each lumbar disc) to get an idea of where your pain is and how it affects you. This will also give them a good indication of where your pain stems from by assessing your freedom of movement, muscle strength, issues with nerve roots, and the actions, movements, and positions that cause or relieve your symptoms.
Degenerative disc disease MRI
Your doctor will arrange a degenerative disc disease MRI scan as it’s one of the most effective ways of determining if low back pain is being caused by disc degeneration. Our Guide to an MRI Scan of the Spine provides more helpful information.
X Rays and CT Scans
It may also be necessary to undergo other tests and scans such as X rays and CT scans so that your doctor has a fuller picture of what’s causing your pain.
Electromyography (EMG)
Electromyography, or EMG, is a test that assesses the skeletal muscles that surround the affected area, and the nerves that control their movement. Your doctor will decide if this test is necessary depending on your own personal circumstances.
Common Causes of Lumbar Degenerative Disc Disease
There are two main factors that can lead to lumbar degenerative disc disease - age-related wear and tear, and injury.
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Age-related wear and tear causes the intervertebral discs to dry up - as we age, the water contained within each vertebral disc gradually dries up and the disc height reduces, causing the discs to become dryer, flatter, and thinner. This means that they’re less able to absorb shocks and become less effective at cushioning the intervertebral discs. Over time, walking, exercising, bending, twisting, lifting, and carrying can lead to long-term disc changes and the problematic low back pain associated with lumbar intervertebral disc degeneration.
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Accidents can affect the structure and function of the disc - injury to the back caused by slips, falls, and incorrect heavy lifting techniques can cause small tears or cracks to an intervertebral disc. This can cause the cartilaginous fluid to slowly leak out of the vertebral body meaning that we’re more likely to develop degenerative disc disease later in life. (Such leakage into the disc space can also cause the lumbar disc to bulge and this is known as a disc herniation. It can also cause a condition called spinal stenosis, where the spinal canal becomes narrower.)
Unfortunately, lumbar degenerative disc disease is part of the natural ageing process for many people. Whether by wear and tear or injury, less cushioning between the discs causes instability in the spine, and in an attempt to restabilise things, the body produces small bony growths (called bone spurs or osteophytes) on the outer edges of the affected vertebrae. With little space in the spinal canal, these extra pieces of bone can press on the nerves and spinal cord, causing pain and weakness.
There are some other factors that can also increase our risk of developing lumbar disc degeneration:
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Constant heavy lifting (such as for our job or during exercise)
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A family history of degenerative disc disease
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Being obese
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Smoking
Treatment Options
Once a degenerative disc disease MRI has confirmed that you have lumbar degenerative disc disease, your medical team will discuss a range of treatment options with you. You may be recommended some or all of the following:
Physical Therapy
Exercise therapy helps to strengthen the muscles of the lower back, stomach, and core to help support the spine and increase mobility and freedom of movement.
Medications
Pain relieving medications such as non-steroidal anti-inflammatory drugs (NSAIDs) including ibuprofen may be suggested to help relieve pain. Your medical history, allergies, and other medications will be taken into account.
Pain Management Strategies
Your medical team may also suggest other strategies such as weight loss if necessary, or a change in lifestyle habits such as the way you exercise to help manage your pain. They may also suggest a discussion with your employer or HR department regarding a change in duties if possible.
Surgery
Sometimes, if other strategies haven’t helped or your lumbar degenerative disc disease is significantly affecting your day to day life, surgery is a consideration. There are various surgical options, including spinal fusion to fuse two vertebrae together to stabilise the area, and decompression surgery to remove part of the affected disc. Your surgeon will talk you through your options.
Differential Diagnosis
In some cases, a spine MRI may confirm a different condition, or even rule out lumbar degenerative disc disease. Other conditions with similar symptoms to lumbar degenerative disc disease include disc herniation, spinal stenosis, a compressed nerve root, and hip problems. Your consultant will discuss your MR imaging results with you, and how best to formulate a treatment plan.
How an MRI Scan Detects Lumbar Degenerative Disc Disease
An MRI scan will be carried out in the department of radiology of your chosen clinic. MRI machines contain strong magnets to create a magnetic field and they also produce radio waves - together the magnetic fields and radio waves create detailed images of the inside of the body.
Around 70% of the body is water, which chemically-speaking, is made up of atoms of hydrogen and oxygen. These atoms contain tiny particles called protons, and it’s these protons that are key in allowing these detailed images to be captured.
An MRI scan involves laying still inside a tube-shaped machine. When the magnets are switched on, the protons, that have magnetic properties, form an orderly queue within their atoms as they’re pulled into place by the magnetic field (much like the hands of a compass, and you won’t feel a thing). The MRI machine then uses a transmitter and receiver to send radio waves towards the lower back (or other affected area) that scatters the protons in this area.
When the radio waves are then turned off, the protons return to their orderly line, and the receiver picks up the resulting radio signals. Different tissue types (such as bone vs muscle vs cartilage) scatter and realign protons at a different speed and signal intensity. Magnetic Resonance Imaging findings and images then highlight the contrast between the bones, soft tissues and potential disc degeneration caused by the intervertebral discs drying out or leaking their protective fluid.
Why an MRI Scan is a Good Option
An MRI scan allows your medical team to get a clear look at the bones and soft tissues as well as highlighting if any infection or inflammation is present. Unlike CT scans and X rays, an MRI scan doesn’t use radiation, and can therefore be used for frequent scanning and monitoring of lumbar degenerative disc disease if necessary. During an MRI scan, you will feel no pain or physical discomfort.
Find an MRI Scan for Lumbar Degenerative Disc Disease
A degenerative disc disease MRI is a good option if you have low back pain and you want to get a definite diagnosis and a treatment plan. Take the first step and book a private MRI scan with us today.
References
Degenerative disk Disease. (2024, May 1). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/16912-degenerative-disk-disease
Khan, H., MD. (n.d.). Lumbar degenerative Disc Disease (DDD). Spine-health. https://www.spine-health.com/conditions/degenerative-disc-disease/lumbar-degenerative-disc-disease-ddd
What is degenerative disk disease? (2023, October 25). WebMD. https://www.webmd.com/back-pain/degenerative-disk-disease-overview
Felman, A. (2023, October 25). All about degenerative disc disease. https://www.medicalnewstoday.com/articles/266630
Suthar, P., Patel, R., Mehta, C., & Patel, N. (2015). MRI evaluation of lumbar disc degenerative Disease. JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH. https://doi.org/10.7860/jcdr/2015/11927.5761
