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Introduction
In this free educational guide on degenerative disc disease, we provide you with a general discussion about this severe medical condition, and review what evidence or tests are needed to help prove that you are eligible for Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI).
For your general knowledge about this medical condition, we have included in this guide helpful information about what the disease is, symptoms, diagnosis, common treatment, and where you can find more help and information for this medical condition. This guide may also provide information about current legal issues that may be of value to you. This guide is not intended as legal advice or as a legal opinion.
After reading this guide, if you still have questions or would like to discuss your case with us, please call Chad Brown Law at (336) 962-5373. We are here to help you get the benefits you deserve.
1. What is degenerative disc disease?
Degenerative disc “disease” can be better described as a “disorder” rather than a disease. This term is usually related to normal changes in the spine due to aging, but can be speeded up with an injury to the spine. Degenerative disc disease can occur throughout the spine but most frequently occurs in the lumbar (lower back) and cervical (neck) areas of the spine.
Spinal discs separate the bones (vertebrae) of the spine. The discs help the spine twist and bend, and act as a cushion for the spine. When changes in the discs occur due to aging or injury, pain in the neck or back and loss of nerve function may result.
1a. What causes degenerative disc disease?
Over time or when we suffer an injury to the spine, our spinal discs degenerate or break down. The discs are made up of soft, fibrous material on the outside and fibrous materials in a gel or liquid on the inside. Spinal discs lose fluid over time which thins the disc. This thinning and fluid loss can affect the ability of the disc to cushion the vertebrae, and the spine becomes less flexible (difficulty bending or twisting). Also, cracks or tears in the outer layer of the disc can force out the jelly-like inner part of the disc, which causes the disc to bulge or rupture (herniate).
These disc changes more frequently occur with people who have repeatedly done heavy physical labor. Also, people who smoke cigarettes or who are obese are more likely to have the symptoms of this disorder. A sudden injury can cause a herniated disc which can also lead to the start of the degeneration process.
The spine becomes less stable when the discs get thinner. The body will produce bone growths or bone spurs to help stabilize the spine. When this occurs, the bone spurs (osteophytes) can put pressure on the nerve roots or the spinal cord which results in pain and the loss of nerve function.
2. Common Medical Terms Associated with Degenerative Disc Disease
Bone spurs – Bone spurs represent an enlargement of the bony structure and are a sign of spinal degeneration (aging). Spine bone spurs can cause intense pain.
Herniated nucleus pulposus (Herniated disc) – A herniated disc (also known as slipped disc, bulging disc, herniated nucleus puplosus, or ruptured disc) is a rupture of the outer casing of the disc.
MRI – Magnetic resonance imaging (MRI) is a test that uses a magnetic field and pulses of radio wave energy to make pictures of organs and structures inside the body. MRI is often used to help diagnosis disorders of the spine.
Neck pain – Neck pain can be caused by a variety of factors, including injury, stress or some other health problem.
Neck problems and injuries – Most people will have a minor neck problem at one time or another. Our body movements usually do not cause problems, but it’s not surprising that symptoms develop from everyday wear and tear, overuse, or injury.
Nerve root compression (“pinched nerve”) – A pinched nerve causes pain or impaired function when a nerve is under so much pressure that its ability to carry signals is hindered.
Osteoarthritis – Osteoarthritis (OA or degenerative arthritis) is a joint disease caused by cartilage loss in a joint. Pain and stiffness are symptoms.
Radiculopathy – Radiculopathy refers to a set of conditions in which one or more nerves in the spine is affected and does not work properly (a neuropathy).
Spinal arachnoiditis – Arachnoiditis is a debilitating chronic pain condition characterized by severe stinging, burning pain, and neurologic problems.
Spinal stenosis – Spinal stenosis is a narrowing of the open spaces within your spine, which can put pressure on your spinal cord and the nerves that travel through the spine, causing pain and/or numbness.
3. Degenerative Disc Disease Symptoms
Not everyone is affected the same way when degenerative disc disease is diagnosed. Some people may not experience any pain, while others may have severe pain that affects their activities. A degenerated disc in the neck may result in pain in the neck or arms area. Affected discs in the lower back may result in pain in the back, buttocks, abdomen or legs. When a person with disc disease bends, twists, or reaches above their shoulders, often the pain will get worse.
Other symptoms include numbness or tingling in the legs or arms. The pain may start immediately with an injury or normal motion of the spine. The pain may start gradually and get worse over time.
In addition to pain, patients may experience limited abilities to twist, bend, and lift. Also, difficulty standing, walking, and sitting, and weakness in arms or legs may occur. Severe cases involved bladder and bowel control due to loss of nerve function.
4. How is degenerative disc disease diagnosed?
Generally, the diagnosis of degenerative disc disease is made by a physical exam and medical history. Imaging tests (x-ray, CT scan, or MRI) may be necessary if symptoms occur after an injury, if nerve damage may be suspected, or if other conditions are suspected from your medical history to be causing your symptoms. Doctors sometimes also do an electromyogram (EMG), which is an electrical test that may help determine the exact nerves involved.
5. What is the common treatment for degenerative disc disease?
Pain management: Conservative treatment will usually be started first. Ice or heat and acetaminophen (Tylenol or similar) or non-steroidal anti-inflammatory drugs (naproxen or ibuprofen) will generally be tried first. Stronger medicines may be prescribed.
Physical therapy and exercises for strengthening and stretching the back: If you develop spinal stenosis, a herniated disc, or osteoarthritis, you may need this beginning treatment.
Surgery: If pain or nerve function loss is intolerable, surgery may be considered.
- Laminectomy – a surgery that removes the back part of the lamina (vertebrae) that covers your spinal column. This surgery is designed to relieve pressure on your spinal cord or nerve when you have spinal stenosis or a herniated disc.
Lamina entirely removed
- Laminotomy – a surgery that removes part of the lamina, rather than the full removal of the lamina in a laminectomy surgery.
- Cervical or Lumbar Fusion – Surgery that is designed to stop the motion in a painful vertebrae, thereby stopping the pain coming from the joint.
6. Degenerative Disc Disease – What has to be proven for you to be considered disabled by Social Security?
Social Security maintains a list of medical conditions that are so severe they automatically mean that you are disabled. This list of conditions are ones that are expected to be permanent, or expected to result in death, or have a certain length of time that it must last. Each medical condition on this list has a complete description of what symptoms or conditions have to be present with your medical condition for you to “meet the listing”. The complete medical listing for degenerative disc disease is found in medical listing 1.04 (Disorders of the Spine), on this Social Security Administration website and is printed below for discussion:
https://www.socialsecurity.gov/disability/professionals/bluebook/1.00-Musculoskeletal-Adult.htm#1_04
If you do not “meet” this listing, you may still be considered disabled if you are not able to do your past relevant work, or you are not able to do any other work that you may have the education or
experience to do.)
6a. Social Security’s Rules for Degenerative Disc Disease
“1.04 Disorders of the spine (e.g., herniated nucleus pulposus, spinal arachnoiditis, spinal stenosis, osteoarthritis, degenerative disc disease, facet arthritis, vertebral fracture), resulting in compromise of a nerve root (including the cauda equina) or the spinal cord. With:
A. Evidence of nerve root compression characterized by neuro-anatomic distribution of pain, limitation of motion of the spine, motor loss (atrophy with associated muscle weakness or muscle weakness) accompanied by sensory or reflex loss and, if there is involvement of the lower back, positive straight-leg raising test (sitting and supine);
OR
B. Spinal arachnoiditis, confirmed by an operative note or pathology report of tissue biopsy, or by appropriate medically acceptable imaging, manifested by severe burning or painful dysesthesia, resulting in the need for changes in position or posture more than once every 2 hours;
OR
C. Lumbar spinal stenosis resulting in pseudoclaudication, established by findings on appropriate medically acceptable imaging, manifested by chronic nonradicular pain and weakness, and resulting in inability to ambulate effectively, as defined in 1.00B2b.”
6b. Chad Brown’s Explanation of Social Security’s Rules
For you to “meet the listing” and thereby qualify for Social Security disability benefits, your degenerative disc disease must be causing compression of a nerve root or the spinal cord as the result of wear and tear over time (arthritic changes)or an injury. This nerve or spinal cord compression causes:
A. Serious pain, limitation of movement of the spine, loss of movement and control of extremities with muscle weakness causing muscle loss, along with a loss of feeling or reflexes. If the lower back is involved, a positive result to the straight-leg raising test while sitting and lying down is present.
OR
B. Spinal arachnoiditis (Arachnoiditis is a pain disorder caused by the inflammation of the arachnoid, one of the membranes that surrounds and protects the nerves of the spinal cord), confirmed by operative notes or a pathology report of tissue biopsy, or by imaging, that includes severe burning or painful to light touching, resulting in the need for changes in position or posture more than once every 2 hours;
OR
C. Lumbar spinal stenosis resulting in painful muscle spasms, confirmed by imaging, with chronic radiating pain and weakness, and resulting in an inability to move around effectively, as defined in 1.00B2b.
7. Internet Resources for Degenerative Disc Disease
For other general information about Social Security and Supplemental Security Income disability programs and how the law firm of Chad Brown Law can help you, visit:
For a complete listing of conditions that Social Security considers disabling, go to Social Security’s website at:
https://www.socialsecurity.gov/disability/professionals/bluebook/AdultListings.htm
For more medical information on degenerative disc disease, visit:
https://www.webmd.com/back-pain/tc/degenerative-disc-disease-topic-overview
8. Community Resources for Degenerative Disc Disease
Ask your doctor to refer you to an orthopedic back surgeon or neurosurgeon for more comprehensive options and treatment for degenerative disc disease. In each community or region of North Carolina are usually found such medical experts on this medical condition of the spine.
