They didn't and new symptoms continue to evolve sending me to new specialists yearly. But this back syndrome was one that stayed with me until it continually worsened and my neurologist sent me for an MRI and EMG two years after my initial diagnosis with fibromyalgia.
When the results were in, I had degenerative discs and nephropathy in the the upper spine. He mentioned an interesting point, "I'm not sure if the fibromyalgia caused this or this caused the fibromyalgia." That is because there is not a lot of concreted evidence out there linking the two. But he also added, "Most of my fibromyalgia patients have nephropathy and degenerative discs."
Cervical degenerative disc disease is a common cause of neck pain and radiating arm pain. It develops when one or more of the cushioning discs in the cervical spine starts to break down due to wear and tear. There may be a genetic component that predisposes some people to more rapid wear. Injury may also accelerate and sometimes cause the development of the degenerative changes.
How Cervical Discs Can Degenerate
Normally, there are six gel-like cervical discs (one between each of the cervical spine’s vertebrae) that absorb shock and prevent vertebral bones from rubbing against each other while the neck moves.
Each disc is comprised of a tough but flexible outer layer of woven cartilage strands, called the annulus fibrosus. Sealed inside the annulus fibrosus is a soft interior filled with a mucoprotein gel called the nucleus pulposus. The nucleus gives the disc its shock absorption property.
In children, the discs are about 85% water. The discs begin to naturally lose hydration during the aging process. Some estimates have the disc’s water content typically falling to 70% by age 70,1 but in some people the disc can lose hydration much more quickly.
As the disc loses hydration, it offers less cushioning and becomes more prone to cracks and tears. The disc is not able to truly repair itself because it does not have a direct blood supply (instead getting nutrients and metabolites via diffusion with adjacent vertebrae through the cartilaginous endplates). As such, a tear in the disc either will not heal or will develop weaker scar tissue that has potential to break again.
The Course of Cervical Degenerative Disc Disease
Cervical degenerative disc disease is not technically a disease, but rather a description of the degenerative process that discs located in the cervical spine go through. Essentially all people who live long enough will develop degenerated discs.
Studies show that a plurality of adults have no symptoms related to degenerative disc disease, even though a high percentage of these adults still shows signs of disc degeneration on an MRI somewhere on the spine. One study found that about half of people start showing some signs of disc degeneration on an MRI by their early 20s. Another study found that about 75% of people under age 50 have disc degeneration while more than 90% of people over age 50 have it.
When degenerative disc disease develops in the cervical spine, it can occur in any of the cervical discs but is slightly more likely to occur at the C5-C6 level.
In cases where cervical degenerative disc disease does cause pain, it can happen in various ways. In some instances, the disc itself can become painful. People are more likely to experience this type of discogenic pain in their 30s, 40s, or 50s.
When symptoms from cervical degenerative disc disease become chronic, the pain and/or symptoms are likely related to conditions associated with disc degeneration, such as a herniated disc, osteoarthritis, or spinal stenosis. Depending on the cause, the pain may be temporary, or may become chronic. To give an example, pain from a herniated disc is likely to eventually go away on its own, but pain from osteoarthritis may require treatment on a chronic basis.
Risk Factors for Cervical Degenerative Disc Disease
While nearly everyone eventually gets cervical degenerative disc disease with age, there are some factors that can make it more likely to develop sooner and/or become symptomatic. These risk factors could include:
- Genetics. Some studies of twins indicate genetics play a bigger role than lifestyle in determining when cervical degenerative disc disease develops and if it becomes painful.
- Obesity. Weight has been linked to risk for developing degenerative disc disease.
- Smoking. This habit can hinder nutrients from reaching the discs and cause them to lose hydration more quickly.
I can tell you I fall under none of the above categories. So I must be an anomaly or my predisposition may be linked with fibromyalgia. Despite several recent studies out there confirming there is no link to fibromyalgia. There was an interesting addition added to The Journal of Physical Science:
Fibromyalgia syndrome (FMS) is a clinical presentation commonly seen in the middle age women, which is accompanied by psychosomatic complaints such as widespread pain and chronic fatigue along with sleep disorder or non-relaxing sleep, paresthesia and subjective swelling of the hands, migraine-type headache, irritable bowel syndrome and dysmenorrhea. Although musculoskeletal pains are generally localized in the neck, interscapular region and low back, they may also spread to the arm and to the chest. During the examination, objective findings other than sensitive points cannot be detected and laboratory analyses have normal results.
Most common reasons of the pain spreading to the neck and to the arm include cervical spondylosis and cervical root compression. Pains that result from the disc herniations located in the cervical region are generally radicular and they may be accompanied by neurologic deficits, such as loss of strength, paresthesia, reflex defect and atrophy. Moreover, in some cases, Raynaud-like swelling and vasomotor changes may be integrated in the clinical presentation.
Patients with fibromyalgia continuously present for a visit and for the periodic controls with the complaints of neck, shoulder, arm, low back and knee pains. The patients resist to the therapy and they ask why they cannot be healed.
It may be very difficult to convince the patients to be treated. Some patients are not so happy despite all therapeutic methods and the doctors may hesitate about the diagnosis with some patients. A cervical MRI may be necessary to elucidate the patients and to eliminate our doubts in the patients that raised a hesitation. In both diseases, cervical and arm-shoulder pains are similar and the laboratory values are normal.
Interestingly enough, they found a VERY HIGH rate of those suffering with fibromyalgia were diagnosed with disc degeneration MORE SO than the average population thought before to have the disease present normally.
Yet, many patients suffering from fibromyalgia are not sent to the usual MRI and EMG testing to note if such issues are present. Be certain to ask for such testing if you feel you may suffer from such problems. Therapy is available for relief.