What is Degenerative Joint Disease?
Written by Neil Badlani, M.D., Chief Medical Officer, North American Spine

Degenerative joint disease is a form of arthritis that is one of the most common joint conditions. When you have the disease, you experience discomfort and pain around the knees, hips, neck, and smaller joints such as those of the toes and fingers, as well as back pain. 

A healthy joint is typically surrounded by rubbery, firm material and cartilage which prevents its bones from rubbing against one another. The cartilage assists in ensuring that the joint receives sufficient lubrication, which prevents the bones from wearing thus avoiding pain. However, as we age, the cartilage is prone to breaking down and wearing out. This leaves your bones susceptible to rubbing against each other.

0 +

Happy former NAS patients

0

Board – Certified Physicians

$ 0

Average out-of-pocket cost per patient

More About Degenerative Joint Disease

lumbar foraminotomy

The constant friction eventually causes the inflammation of the joints. The result is pain which makes it difficult to move your joints. As you get older, the condition worsens and growths might eventually develop around the joints. In extreme cases, the bones may chip, and their fragments might start floating around your body.  Ultimately, the cartilage will get completely worn out and the resulting pain will make it hard for the individual to move. 

 

Most people who get the degenerative arthritis are usually 65 years and older. Statistics show that around 50 percent of all adults eventually develop this condition in their knee joints at some point in their lives, with around 25 percent getting the disease by the time they are 85. As such, this disorder does not discriminate and can occur to anyone. However, those with previous weaknesses or injuries are more likely to develop osteoarthritis.

What are the symptoms?

The symptoms of this condition vary depending on the type of joint affected and how severely it has been affected. Nevertheless, pain and stiffness, especially after waking up or resting are the most common symptoms. 

The joints will often get swollen after a period of activity. These symptoms usually build over time instead of suddenly showing up. This is why the condition is referred to as ‘degenerative.’

The most common symptoms of Degenerative Joint Disease are:

  • Stiffness or limited range of motion that goes away after some movement. 
  • Cracking or clicking sound whenever you bend a joint. 
  • Some swelling around the joint. 
  • Pain around the joint that gets worse after performing an activity.

Here is how the condition affects different areas in your body:

  • Knees. A scraping or grating sensation whenever you move the knees. 
  • Feet. Tenderness and pain at the base of the large toe in addition to some swelling around your toes and ankles. 
  • Hips. Pain around the buttocks and groin area and at times in the inside of the thigh. 
  • Fingers. Red, swollen, and tender tigers that may have some growths at the edge of their joints.

How is a Degenerative Joint Disease Diagnosed?

•  Physical Examination:

Your physician will then examine where you are experiencing pain and stiffness while assessing how these symptoms are affecting your life. The doctor will assess you for any signs of joint damage, spurs, or swollen and tender areas. This will involve examining you for hands, hips, neck, or back pain.

•  Symptom Assessment:

If you begin experiencing symptoms associated with degenerative joint disease pain, it is imperative that you speak to a doctor immediately. This also helps in preventing the condition from getting complicated. As such, your doctor might ask you when the symptoms began.

•  Medical History:

Your doctor will inquire about any other medical issues you might have. They will then examine any medications that you take while running through your family history as well as other activities that you might be involved in.

•  Diagnostic Imaging:

MRI scans and X-rays might be utilized to indicate the severity of damage in your joints or for abnormalities in those areas. Nonetheless, they are not always necessary.

What are the causes of Degenerative Joint Disease?

low back pain

Even though this condition has, and still is, being considered as resulting from the wearing out of joints over time, doctors today are viewing it more as a joint disease. The following are some of the factors that may contribute to developing this disorder:

  • Genes: Genetic traits can leave an individual susceptible to developing degenerative joint disease. Genes:
  • Weight: Carrying extra pounds will put additional pressure on your knees and hips. This might cause the cartilages in these joints to wear out faster. 
  • Overuse or injury: Injuries or repetitive movements might cause one to develop this condition. For instance, athletes who repeatedly damage their joints, ligaments, and tendons might speed up their cartilage breakdown.

How are Degenerative Joint Disease treated?

Conservative Options

Conservative treatment options include nerve root blocks and steroid injections. These are designed to provide temporary relief (up to one year), and you may elect to have the procedure done multiple times. Other conservative strategies may include the placement of a spinal cord stimulator–or STIM–which is designed not to correct the underlying degeneration, but to lessen the pain the condition causes.

Decompression

Minimally invasive decompression surgery aims to relieve pressure on the nerves of the spine. This pressure is often caused by stenosis, bulging or herniated discs, and more. Relieving this pressure can be achieved by reducing or removing soft tissue (disc material or scar tissue) or bone (bone spurs, a section of the lamina or foramina) to decompress the affected nerve. When the compression is caused by soft tissue material, a surgical laser may be used to shrink the impinging material.

Fusion/Stabilization

Fusion surgeries are similar in goal–to remove damaged disc tissue and fuse the bones together–but differ in approach, including the use of specialized hardware to reinforce stability, and the location used to gain access to the spine. A related procedure is an artificial disc replacement, in which a damaged cervical disc is replaced with a synthetic disc, and the vertebrae are not fused.

How Much Does Treatment Cost?

Treatment cost depends on several factors, especially what insurance you have and how much of your deductible has been met. IN the last two years, 90% of our patients have paid less than $2000 out-of-pocket. Some have paid literally nothing, and other have paid much more than that. It depends. The good news is: our Patient Care Managers will handle as much as they can directly with your insurance company, and all your costs will be known up-front.

Important note: spine surgery often pays for itself within a year or two. Many people actually spend more money trying to live with the pain than they do getting the pain fixed. The following calculator is intended to give you a sense of what you spend on managing—rather than eradicating—your pain.

 

Calculate how much you've spent on back pain this year.
(only numbers, no special characters or symbols)

Calculate

This past year you have spent on your pain treatment:

Get surgery now. Getting surgery now is the smartest financial move. Over the last two years, the average North American Spine patient spent around $2,000 out-of-pocket for treatment. You’ve spent that much or more this year to manage your back pain than you could to fix it.

Get surgery soon. Over the last two years, the average North American Spine patient spent around $2,000 out-of-pocket for treatment. At your current rate, you will spend that much or more within the next two years. The sooner you get treatment, the sooner it will pay for itself.

Keep an eye on your spending. Currently, you are managing your pain efficiently from a financial perspective but over time, your expenses could add up. Surgery should be strongly considered if you start missing more work or spending more on treatment medication.

Great job! You are spending very little on your back pain. Keep it up!

Equipment Used in Diagnosis and Treatment of Degenerative Joint Disease

When diagnosing for this disease, the most commonly used equipment are X-rays and MRI scans. 

X-rays. Even though these do not show cartilage loss directly, an x-ray can show the spacing between bones, which can be used to tell whether one has the condition. If one has osteoarthritis, their cartilages are eaten away thus causing the bones to move closer together. 

MRI Scans. This allows the doctor to see soft tissue damage such as cartilages and ligaments. 

Equipment used in treating this condition involves assistive devices that help with mobility and function. Thus, they include items such as canes, splints, walkers, scooters, and shoe orthotics. 

 

How Does the Degenerative Arthritis Compare to Similar Conditions? 

Diseases that are compared with osteoarthritis are often other forms of arthritis. These include:

  • Rheumatoid arthritis. This is an autoimmune disease which causes pain in the patient’s joints. It occurs when the immune system attacks joints, causing pain and stiffness.

  • Lupus. This is also an autoimmune disease which causes inflammation in the joints, tendons, skins, and connective tissues.

  • Gout. This results from the buildup of uric acid crystals in joints, which causes tenderness, inflammation, and pain.

  • Bursitis. This results from the irritation of a fluid-filled sac in the joints, which is known as bursa, thereby resulting in pain.

  • Tendinitis. This results from overuse of certain tendons which can cause swelling and pain in the nearby joints. 

While some of these terms are interchangeable, some are not. In general, all of these terms refer to stages in the process of disc herniation. A disc is a kind of shock absorber located between vertebral segments. It is encased by a protective sac. When the disc loses its shape, herniation results. When this herniation stays within its sac, it is often called a “Bulging” or “Collapsed Disc.” When the disc actually breaks through its sac, it is called a “slipped,” “torn,” or “extruded” disc.

So, a bulging disc is a less severe form of herniation than a torn—or extruded—disc, but all forms of herniation have the potential to cause significant pain. This is because the herniated disc material may “impinge upon,” “compress,” or “pinch” a nerve.

Finally, most disc herniations are the result of an underlying process of deterioration called “Degenerative Disc Disease,” “Degenerative Spine Disease,” or “Arthritis of the Spine.”

So recap: Degenerative Disc Disease is usually an underlying cause of bulging discs (which are sometimes called by another name), which in turn cause the painful phenomenon of a pinched (or compressed, or impinged) nerve.

Analogy: An Old Ladder

A good ladder must support your body weight at every step. The same is true of the spine. Degenerative joint disease can strip, rot, and ruin your vertebral discs, just as weather, age, and misuse can ruin a good ladder.

Surgery will focus on restoring the ladder to its previous glory.

Good Ladder

Bad Ladder

Related Articles