Spinal stenosis from degenerative disc disease, as a sole cause, is an almost nonexistent diagnostic theory. It must be understood that what is known as degenerative disc disease is actually a completely normal, expected and universal condition in the cervical and/or lumbar spinal regions. DDD is scapegoated as the source of many spinal stenosis back pain syndromes, even though there is truly no clinical evidence to support such theories. In fact, ongoing and extensive clinical studies have shown no correlation at all between the evidence of advanced disc degeneration and the incidence of back pain or neck pain. However, all that being said, it is clear that disc degeneration is certainly a possible contributor to many central canal and foraminal stenosis conditions, although it is almost impossible to be the exclusive causation of symptomatic canal or foraminal space narrowing.
This dialog details how intervertebral desiccation can contribute to the formation of normal degrees of spinal stenosis in particular regions of the backbone.
Spinal Stenosis from Degenerated Discs
In patients with central stenosis conditions, the chances of coincidental disc desiccation and degeneration being present are almost 100%. We all have disc deterioration in the mid to low cervical levels and low lumbar levels by age 30 and many of us show these signs much, much younger. I was diagnosed with DDD at age 16 as a perfectly healthy teenager.
When discs degenerate, the incidence of spinal osteoarthritis increases due to bone-on-bone contact, arthritic debris and bone spur formation. Degenerated discs are also more prone to herniation.
Both of these factors make DDD a possible contributor to central canal stenosis, although the actual herniated disc or the arthritis is the true culprit and the DDD is just a facilitator of the process.
Foraminal Stenosis from Degenerative Disc Disease
Neuroforaminal stenosis works in much the same way as central stenosis when it comes to the potential contribution of degenerative disc disease. As discs degenerate, the bones move closer together, decreasing the neuroforaminal spaces and possibly contributing to alignment issues which further narrow the openings.
Once arthritis and possible herniations exist, the DDD once again may be responsible for helping some of the causes of foraminal stenosis to occur. However, the DDD itself is certainly not the direct cause of foraminal stenosis in virtually every case.
Diagnosis of Spinal Stenosis from Degenerative Disc Disease
We really hate the using words spinal stenosis from degenerative disc disease. It is such a frightening sounding condition which amounts to nothing at all, except a huge nocebo effect cast over the patient like an evil curse. So many patients, myself included, were frightened into believing that DDD is something really wrong with them, rather than a perfectly normal occurrence. If your doctor tells you that you have DDD, tell them: “Yes, I know already. I have it. You have it. We all have it. So what? Now earn you money and tell me something I don’t know doc”.
So, in essence, DDD is not completely innocent, but is not a culprit unto itself. It is merely a universality of aging and will be there if you go looking for it. Being that there is no truly effective cure or treatment for disc desiccation, the best idea is to focus on conditions which are truly responsible and seek proper diagnostic evaluation and treatment for these actual causes of spinal stenosis.