Multiple sclerosis (MS) is an autoimmune disease that damages the central nervous system (CNS). Degenerative disc disease (DDD) is a chronic medical condition that affects the bones and joints of the spine. These two conditions are different but may overlap for some people.
MS and DDD are both chronic, degenerative conditions, which means they are long-term and often get worse with time. In MS, the immune system causes inflammation and scarring (called plaques or lesions) in the CNS, which includes the brain and spinal cord. MS causes problems with nerves and muscle control, along with many other symptoms. DDD, on the other hand, affects the bones of the spine that surround and protect the spinal cord. It is a major cause of back pain.
DDD and MS are sometimes mistaken for one another, even by health care providers, as they share some symptoms and they both develop at a similar age (30s). “They were looking for lesions and found I had DDD as well,” reported one member of MyMSteam.
In this article, we’ll explore DDD and its connection to MS.
The spine is made up of many bones that provide a protective cover for the spinal cord (the bundle of nerves that connects the brain to the different parts of the body). In between each bone of the spine are intervertebral discs. These shock-absorbing pads, sometimes likened to jelly donuts, act as cushioning between the 33 individual bones (vertebrae) of the spine.
DDD occurs when these discs start to wear down. They can bulge out or dry up. The bulges can then rub on nerves and ligaments, causing pain, numbness, tingling, or weakness. The bones of the spine can begin to rub together, creating bony outgrowths (osteophytes) that can harm the nerves of the spine.
Symptoms of DDD include low back pain, neck pain, and stiffness, as well as numbness, weakness, and pain shooting down the arms and legs. Signs of DDD, often seen on X-rays or MRIs, can include shrunken discs, bone-on-bone rubbing, osteophytes, disc herniation, and disc bulging.
DDD can affect the lower back, called lumbar disk disease, as well as the neck, called cervical spondylosis. Disc degeneration can lead to more serious conditions. Among them is radiculopathy (or sciatica), characterized by a pinched nerve root in the spine. It also can lead to spinal cord compression (myelopathy).
“My degenerative disc disease started in my thoracic spine, which is unusual because it’s not an area that gets a lot of wear and tear,” a MyMSTeam member said of their DDD experience. “It rapidly spread to my cervical spine [neck] over the next nine months. Within another two months, bulging discs and spinal stenosis in my lumbar [low back] region knocked me on my ass.”
DDD and MS share some symptoms, which can lead to diagnostic delays, misdiagnoses, and treatment delays. “One of the problems with MS (out of its many problems) is that doctors, friends — even yourself — can get into a pattern of blaming every symptom or illness on MS,” observed one member. “Like, ‘Back pain? Must be my MS.’ when you could have a herniated disc or DDD.”
DDD can also cause back pain, as well as radicular pain — pain that moves along the spinal nerve root, causing discomfort in the hips, legs, and spine. People with MS may also experience pain in their backs, hips, and legs, such as from altering their walk to accommodate muscle weakness or balance issues.
One team member said, “I have several herniated discs and torn discs that appear to be causing some tingling in my feet and significant back pain.”
Pain from DDD tends to get worse with sitting, twisting, and lifting. It often improves with moving around, walking, running, or lying down. DDD-related pain can be recurring (comes and goes), acute (sudden and temporary), or chronic (persistent and long-lasting).
In addition to pain, DDD can cause neurological symptoms similar to those of MS, such as vibrating and paresthesias (numbness and tingling). “My left leg goes numb due to my back, my right leg due to MS. Both have severe burning sensations when I stand or walk too far,” said a MyMSTeam member.
Many people experience DDD as part of the aging process. It can result from a prior injury. MS is caused by a combination of environmental, genetic, infectious, and immune system factors.
Both DDD and MS are linked to low levels of vitamin D, which is crucial for maintaining bone health. Having DDD may increase the risk of spinal cord compression and nerve damage. If a person has MS, they may already be experiencing nerve damage due to demyelination — the process of the immune system attacking the protective fatty myelin sheath around nerves. DDD can further worsen that effect.
More research is needed, but researchers believe MS may be linked to earlier onset and more severe DDD of the neck (cervical spine). “I was diagnosed with DDD when I was 30,” shared one member of MyMSTeam about their surprising double diagnosis.
One study found higher rates of cervical DDD among people with progressive MS. Additionally, having MS and DDD was linked to having more MS lesions in the brain. “I have about 20 lesions in my brain from MS and nine in my spinal cord,” shared one team member. “I had an MRI in 2013 that showed DDD all through my lumbar spine and three bulging discs.”
When a person has two or more chronic conditions at the same time, they are called comorbid conditions. It is not uncommon for a person to have both MS and DDD. In fact, having MS is thought to increase the likelihood of developing DDD. “I have MS, fibro[myalgia], degenerative disc disease, scoliosis, scapula dyskinesis, bone spurs, and bulging discs,” shared a MyMSTeam member.
Living with multiple health conditions can take an even greater toll on one’s quality of life.
When a person has MS and other chronic health conditions — especially when they have symptoms in common — getting an accurate, timely diagnosis can be more challenging. “Back pain and searing leg pain causes stress and stress affects MS! Especially if it’s constant pain (e.g., neuropathy),” shared one member. “Because you never get away from the pain, it also wears on you mentally and emotionally, not just physically!”
There are several options to relieve symptoms of DDD and MS. For pain particularly, specialized pain management may be a good option for both MS and DDD. While several options exist for symptom management and spinal repair options, finding the right one can take time, trial, and error.
Medical treatments for DDD include:
Having comorbid MS and DDD can complicate MS treatment and complicate overall health management. Here is what one MyMSTeam member had to say about their treatments: “I went through physical therapy and two rounds of epidural steroid injections.”
Another noted, “I’ve had injections, physical therapy, fluoroscopy (discogram I believe), but I just don’t get enough relief and it’s getting exhausting being in pain all the time.”
If more conservative medical treatments are ineffective, neurosurgery may be the best remedy for DDD. Surgery might include artificial disc replacement or decompression surgery. “If you can get in to get surgery, I do recommend it,” shared one MyMSTeam member. “Mine was filled with complications but the disc pain I had for 15 long months is gone completely … Had I had surgery sooner, the outcome would have been better.”
In some cases, MS can be a barrier to certain DDD treatments, or DDD can complicate MS treatments. “My discs are crumbling and bulging. Holding off on surgery (many years) because my largest lesion is in the same spot,” said a team member.
In other cases, the damage is beyond surgical repair. Such was the case for a member who reported, “I have DDD and all my lumbar discs are bone on bone without any surgical option.”
Many people seek alternatives to medical and surgical options. With DDD, MS, and in general, there are many other ways to reduce pain and symptoms:
Other treatments that have some evidence to help reduce back pain include:
Prevention is also key. A MyMSTeam member offered this sage advice: “The BEST thing you can do for your spine is to exercise your CORE! Strong core muscles and good posture will prevent many spine issues and/or keep them from becoming worse.”
MyMSTeam is the social network for people living with multiple sclerosis (MS) and their loved ones. MyMSTeam is a virtual community of nearly 186,000 members where people can ask questions, give advice, and share stories about life with MS.
Do you have DDD and MS? Share your experience in the comments below, or start a conversation by posting on your Activities page.