Discopathy: definition, symptoms, diagnosis and treatment

By Cristiano Antonino On Apr 18, 2023

When we talk about discopathy we refer to the degeneration of one or more rings or intervertebral discs, located between the vertebrae in the spinal column

These discs have the function of cushioning the loads to which the spine is subjected during normal movement, as well as harmonizing its movement.

The deterioration of this function of the discs, mainly due to wear and tear and aging, generates disc disease which is classified into 4 levels of impairment and progressive severity: mild, moderate, severe and severe.

Usually, the segments of the spine most subject to alteration are the cervical spine and the lumbosacral area.

This is because they are the points of the column most subject to movement stress, and, in the case of the lumbo-sacral area, most stressed by the weight of the body itself.

Although it can also be found in young people, discopathy is a condition that mainly affects the elderly population

In 75% of cases it resolves spontaneously within four weeks and in 95% of cases within six months. However, the relapse rate climbs to 60% over the next two years.

What are the symptoms of a discopathy?

The main symptom of discopathy is more or less intense pain in the neck or back, depending on whether it is cervical or lumbar discopathy respectively.

Sometimes, along with neck pain, pain in the arm (cervicobrachialgia) can appear, while pain in the back can be associated with pain in the leg (lumbosciatica).

In addition to pain, functional problems such as tingling or numbness of the lower limbs with difficulty walking (in the case of lumbar disc disease), or of the upper limbs with impaired dexterity of the hands (in the case of cervical disc disease) may overlap.

In the most serious cases, real deformities of the spine can occur, with evident damage and compression of the nerve roots and spinal cord which can therefore cause serious neurological consequences, such as loss of strength and sensitivity in the upper and lower limbs.

Causes of discopathy

Disc disease is caused by disc wear, which can occur with age and therefore in a certain way is considered part of a normal physiological aging process.

Each intervertebral disc has a flattened and oval shape, and is formed by two concentric structures: a nucleus pulposus in the center, surrounded by an annulus fibrosus externally.

Composed of 88% water, the nucleus pulposus must remain hydrated to maintain its thickness and elasticity.

However, with age or even with particular repeated efforts and prolonged static positions, the disc can dehydrate and degenerate.

This determines an approach of the vertebrae which, by rubbing, transmit painful stimuli to the nervous structures.

Incorrect postures and incorrect or sudden movements with the body can also weaken the disc, causing its degeneration.

Less frequently, the cause of the weakening can also be an infectious process.

Given that it is a typical process of the elderly population, in some subjects it can occur at a young age and in a rather serious way.

The reasons are often linked to excessive body weight, too strenuous work activities, too sedentary life, an unbalanced diet low in fruit and vegetables, excessive use of alcohol, smoking or prolonged competitive sports activities that require excessive loads and twists on the column.

In some cases, it can also be the result of a back injury.

The causes of discopathy can therefore be summarized in:

traumatic (as a result of excessive and repeated exertion)
degenerative (due to age)
infectious (for infections such as staph, strep, and tuberculosis)
inflammatory (as a result of the presence of irritants)

Risk factors

Some predisposing factors, such as the presence of a disc with intrinsic fragility or rheumatic diseases such as rheumatoid arthritis, increase the likelihood of incurring disc disease.

In the event of progression, discopathy can generate very annoying and dangerous pain, which can affect lifestyle and limit the patient’s work activity, sometimes making even the common activities of daily life difficult and painful.

Due to these limitations, the subject could be led to excessive and prolonged use of analgesic and anti-inflammatory drugs, which can cause damage and even serious side effects to the kidneys, liver, gastrointestinal tract, increase blood pressure and promote diabetes , as well as worsening other pathologies that the patient may be affected by.

How to diagnose discopathy

To diagnose discopathy, a medical examination is advisable with a particularly careful objective examination in search of signs and symptoms in the neck, back and limbs, which can guide the doctor, who can then request specific diagnostic tests to confirm the suspicion.

During the first visit, the doctor evaluates the flexibility and range of motion of the back and the presence of certain marks on the spine.

It may be necessary to evaluate muscle endurance and reflexes in order to examine function.

The first examination usually prescribed by the doctor is then an x-ray of the spine followed, if the specific case requires it, by a CT scan and an MRI of the affected column section.

Magnetic resonance is the exam that best of all manages to “photograph” the state of the spine and to provide the most precise information for a correct diagnosis: it highlights the herniated disc, the nervous structures and their relationship with the bone structures.

Cervical discopathies

Cervical disc disease manifests as neck pain and numbness and/or weakness radiating to the shoulders, arms, and hands.

It is caused by an alteration of one or more intervertebral discs located between the cervical vertebrae.

These discopathies are characterized by other typical symptoms, such as pain and stiffness in the neck muscles, headache, dizziness with a sense of heel, nausea or vomiting, and stiffness or difficulty in turning the head.

The most common causes of cervical disc disease include:

“whiplash”;
jaw problems or malocclusion;
sedentary lifestyle (for example office jobs that require you to maintain the same position for a long time, with your arms resting on the desk to type on the computer keyboard, causing overload of the cervical muscles);
anxiety (anxious people usually tend to have “short”, thoracic and superficial breathing, which engages the cervical muscles).

If the nucleus pulposus creates radicular symptoms, the problem can be tackled with targeted physiokinesitherapy treatments, acupuncture for analgesic and/or decontracting purposes, postural exercises to counteract the incorrect attitude of the spine which may have caused the problem, possible infiltrations for analgesic purposes, intradiscal ozone therapy or decompressive laminectomy surgery or vertebral stabilization, depending on the damage to the disc.

To keep your neck healthy and avoid the onset of cervical disc disease, it is advisable to exercise regularly (according to your abilities) and pay attention to your posture, always keeping your neck straight and your back well supported.

Treatments and cures

In the initial stage of diagnosis of discopathy, it is necessary to proceed with a conservative treatment that involves the use of:

analgesic and anti-inflammatory drugs (cortisone and non-cortisone);
muscle relaxants administered topically, orally, intramuscularly, or intradermally;
local infiltrative therapy (such as ozone therapy);
deep infiltrations with cortisone;
Physiotherapy;
physical therapies such as Tecar, Laser, US, Iontophoresis.

Along with physical rest, treatments of this type are almost always effective.

When conservative therapies fail, doctors may consider surgery.

The surgical interventions possible today involve minimally invasive techniques which however allow the surgeon to repair, reconstruct and reinforce entire sections of the spinal column damaged by discopathy.

There are three possible surgeries:

Dynamic stabilization: Minimally invasive surgery with an interspinous spacer that can remain permanently or can also be removed later. No structurally important bone is exported, the interspinous spacer offers the patient and the surgeon the possibility of subsequently evaluating any further treatments should the patient experience a worsening of the vertebral condition.
Discoplasty: artificial discs are prostheses that replace the diseased disc, which is removed from the column, while ensuring movement and flexibility.
Spinal fusion surgery: Surgery that involves the use of bone grafts and tools, such as metal plates and screws, to fuse two or more adjacent vertebrae.

In the context of homeopathic remedies, Hypericum Perforatum is reported for its beneficial action in all traumas of the nerve fibers, including those affecting the spine.

Natrum muriaticum, on the other hand, is indicated when the pain extends to the entire spine, with a sensation of hypersensitivity to touch and pressure, a sensation of extreme weakness, muscle twitches and a widespread sensation of tremor.

The importance of prevention

The spine must be kept healthy and since discopathy becomes very common with age, it is important to take precautions to avoid its appearance or at least postpone it as much as possible.

First of all, practicing regular physical activity allows you to strengthen the muscles of the whole body, in particular the muscles defined as “postural”.

A person with a sedentary lifestyle might go for a walk twice during the week and once on the weekend: the important thing is to make a commitment and keep it.

Furthermore, limiting stress and adopting a correct diet contribute to correct prevention. In fact, it is essential to keep your weight at bay so as not to overload the intervertebral discs.

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