Best treatment for degenerative disc disease in lower back

 Degenerative Disc Disease

Degenerative disc disease causes the soft discs between vertebrae (which act like cushions) to begin to dry out and shrink.  This leads to wear and tear on the vertebrae and the discs themselves. It can lead to other problems that can put pressure on the spinal cord and nerves.  At Southwest Scoliosis and Spine Institute, our orthopedic specialists, Drs. Hostin, Kishan, and Wiesman, treat patients of all ages.  These experts see this disc disease in many of our older patients.

Degenerative Disc Disease Treatment  

Degenerative disc disease treatment focuses primarily on reducing pain.   At our practice, we always exhaust all avenues of nonsurgical treatment before considering surgery.

Non-surgical Treatment

Non-surgical degenerative disc disease treatment methods your doctor may recommend include:

Pain Medications

Your doctor will most likely recommend over-the-counter pain relievers. These medications are typically recommended for mild pain, and they also help with swelling and inflammation. For severe pain, the doctor may prescribe narcotics.  Prescription pain medicine is usually prescribed for short-term pain. Patients must take pain medicine as directed by their doctor.

Heat/cold treatment

Applying ice or a cold pack to a painful area of the spine can relieve pain by reducing inflammation.  Using heat from a heating pad, a warm bath or another heat source can relax the muscles around the spine.  The heat can also soothe muscle tension and stop spasms that can lead to pain.

Epidural Steroid Injections

Certain injections around the protective outer layer of the spine can provide temporary pain relief.  In addition, this helps to improve mobility. The doctor may recommend Injection treatments prior to a physical therapy program so that it can take place with minimal pain.

Physical Therapy

Physical therapy is often quite successful at reducing the pain and other symptoms of degenerative disc disease.  Also, physical therapy can help prevent or reduce further injury to the spine.

Exercise programs

Exercises for painful degenerated discs typically include:

• Stretches are often useful for decreasing tension and improving spinal muscles. For cervical disc pain, stretching muscles in the neck, shoulders, and upper back can relieve pain.  Stretching the muscles of the lower back, hips, pelvis, and hamstring muscles can help reduce lower back pain.
• Strengthening exercises. Conditioning the muscles – especially those of the core – can help support the  spine.

In many cases, trial and error are needed to figure out which treatment(s) works best, and in what order. Because degenerative disc disease appears as a long-term condition, pain management methods may also need adjustment over time.

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Degenerative Disc Disease Surgery

Surgery for disc disease occurs when the pain gets severe and other treatments do not work after 4-6 months. It is estimated that only 10-20% of cases involving lumbar discs and up to 30% of cases involving cervical discs will require surgery for degeneration.  Surgery occurs to address the cause of pain.  For instance, a herniated disc or micromotion in the spine due to instability.  Therefore, surgical treatment options include:

Spinal Fusion Surgery

This is one of the most common surgeries for stabilizing the spine and involves fusing two vertebrae together.  Spinal fusion uses a bone graft and screws and rods to hold the bones in place. Thus, fusing the vertebrae helps to remove micromotions and instability, and it can also help to reduce pinched nerves.

Artificial Disc Replacement

This involves removing the damaged disc and replacing it with a surgical implant designed to mimic the natural height, motion, and support of the spinal disc.

Microdiscectomy

This is a minimally invasive surgical procedure that involves making a tiny (3  to 5 mm) incision and removing a portion of a herniated disc. Minimally invasive techniques involve using highly specialized instruments and magnification to perform the surgery.  This procedure offers a number of benefits such as reduced scarring and quicker recovery times.  Also, the surgery occurs on an outpatient basis where patients go home the same day as the procedure.

Southwest Scoliosis and Spine Institute offers minimally invasive options for many spinal procedures.  The doctor will discuss these with you when suggesting the best course of action for you.  

Symptoms of Disc Degeneration

This disc disease affects nearly 30 million people each year.  Over time most people will exhibit some changes in their discs due to age. However, these conditions do not always cause pain, and when they do, they vary in nature and severity.

The most common symptom of degenerative disc disease is chronic pain that periodically intensifies into more severe disabling pain.  In some cases, this disc problem can also cause weakness, numbness, and shooting pains down the arms or legs.  This pain results from the affected disc(s) putting pressure on the nerves or spinal cord.

Other common symptoms of degenerative disc disease include:

• Pain that increases during lifting, twisting, and bending motions
• A sense that the back or neck is locking up or giving out
• Muscle spasms and tension
• Sharp pains radiating to the shoulder, arm, or hand 
• Sharp pains radiating to the hips, buttocks, or down the back of the leg
• Pain that gets worse from holding certain positions, including sitting, standing, or looking down for too long

Often, the pain from a disc can get better by changing positions rather than remaining seated or standing. In addition, regular stretching and short, frequent walks may help reduce pain in the neck and lower back.

Diagnosing Degenerative Disc Disease

At Southwest Scoliosis and Spine Institute, our doctors start by carefully reviewing the patient’s medical history and discussing any symptoms they experience. For example, current and past pain symptoms, how the pain started, how often it occurs, and where the pain is felt can help the doctor to diagnose the condition and determine which discs cause the biggest concerns.

Then, the doctor will perform a physical exam, looking for any spinal problems and testing things like range of motion and reflexes.

Finally, imaging tests, including X-rays and an MRI scan, are used to confirm a diagnosis and determine the best treatment for each patient. While an X-ray can show any problems in the bones themselves, an MRI is typically used to show any damage to the soft tissues, such as torn, herniated, or dehydrated discs.

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