Degenerative Disc Disease (DDD)

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Diagnosis

To diagnose degenerative disc disease, the physician or physical therapist takes a medical history, and performs a physical examination and diagnostic tests. During a medical history, the physician may ask the following questions:

• Are you experiencing any numbness or tingling?
• When did the pain start?
• What activities seem to lead to pain?
• What treatments have been tried so far?
• Does the pain radiate or travel beyond the neck or back?
• What makes the pain worse? Better?

During physical examination, the health care provider evaluates the patient's posture, flexibility, range of motion, and overall physical condition, and examines the alignment and curvature of the spine. In some cases, a neurological exam is performed to evaluate reflexes, muscle strength, and nerve involvement elsewhere in the body, and to determine where pain has spread.

Diagnostic Tests There are a number of tests that can be done to confirm a diagnosis of degenerative disc disease. These tests include the following:

• Imaging tests (e.g., x-rays, CT scan, MRI scan)
• Electromyography (EMG)
• Discography
• Bone scan

X-rays of the spine can be used to pinpoint narrowed disc space, fractures, bone spurs, and arthritis. CT scan can be used to evaluate bone structures and determine how much space is available for the nerve roots. MRI scan can be used to detect bulging discs, herniation, and nerve root compression.

Electromyography (EMG, myogram, or nerve conduction test) is a neurodiagnostic test used to assess the health and function of the muscles and the nerves that control the muscles. This test can be used to detect nerve damage.

Discography (discogram) involves injecting a contrast dye into the invertebral discs and then viewing the discs using a special type of x-ray. Discography can be used to determine which disc is causing pain.

A bone scan involves injecting a small amount of radioactive material into the blood stream that travels through the body and collects in the bones. In this test, a computer scanner is used to detect signs of arthritis, fracture, or infection.

In some cases, laboratory tests (e.g., blood tests) are used to rule out other conditions, such as rheumatoid arthritis.

Degenerative Disc Disease (DDD), Diagnosis reprinted with permission from painchannel.com
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