Vertebrae and discs degenerative disease.Degenerative Disc Disease

Degenerative disc disease is a condition in which the soft discs between vertebrae (which act like cushions) begin to dry out and shrink, leading to increased wear and tear on the vertebrae and the discs themselves. It can lead to arthritis, herniated discs, spinal stenosis, and other problems that can put pressure on the spinal cord and nerves.  At Southwest Scoliosis Institute, our orthopedic specialists, Drs. Hostin, Kishan, and Wiesman, treat patients of all ages, and degenerative disc disease is one we see in many of our older patients.

Degenerative Disc Disease Treatment  

Degenerative disc disease treatment is primarily designed to minimize pain and inflammation and reduce the number of episodes of intense pain as much as possible.  At Southwest Scoliosis Institute, it’s our philosophy to always exhaust all avenues of conservative treatment before considering surgical options.

Conservative (Non-surgical) Treatment

Conservative degenerative disc disease treatment methods your physician may recommend include:

Pain Medications

Your physician will most likely recommend over-the-counter pain relievers, such as acetaminophen, ibuprofen, or naproxen. These medications are typically recommended for mild pain, and they also help with swelling and inflammation. For severe pain, narcotic painkillers may be recommended. Prescription pain medications are usually prescribed for short-term pain, and care must be shown to take them only as directed by your doctor.

Heat/cold treatment

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

Epidural Steroid Injections

Corticosteroid injections around the protective outer layer of the spine can provide temporary pain relief, which helps to improve mobility. Injection treatments may be recommended prior to a physical therapy program so that exercises can be done with minimal pain.

Physical Therapy

Physical therapy is often quite successful at reducing the pain and other symptoms of the degenerative disc disease and 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 the flexibility of spinal muscles. For cervical disc pain, stretching muscles in the neck, shoulders, and upper back can relieve pain, and stretching the muscles of the lower back, hips, pelvis, and hamstring muscles can help alleviate lower back pain.
  • Strengthening exercises. Conditioning the muscles – especially those of the core – can help support the cervical and lumbar spine by providing better support to reduce pain and instability.

In many cases, trial and error are necessary to figure out which treatment(s) works best, and in what combination. Because degenerative disc disease is a long-term condition, pain management methods may also need to be adjusted over time.

Degenerative Disc Disease Surgery

Surgery for degenerative disc disease is typically recommended only if the pain is severe and non-surgical treatments have proven ineffective after at least 4-6 months. It is estimated that only about 10-20% of cases involving lumbar disc degeneration and up to 30% of cases involving cervical disc degeneration will require surgical intervention.  The primary goal of surgery in these cases is to address the underlying problems that are causing the pain and inflammation, such as a herniated disc or micromotion in the spine due to instability.

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 with the help of a bone graft and specialized instrumentation (such as screws and rods) that holds the bones in place until they become one. Fusing the joint between the vertebrae helps by eliminating micromotions and instability, and it can also help by decompressing pinched nerves.

Artificial Disc Replacement

This procedure involves removing the damaged disc entirely 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 with specialized surgical instruments and an operating microscope. Surgeries using minimally invasive techniques are often done as an outpatient procedure, meaning the patient can return home the same day as the operation.

Southwest Scoliosis Institute offers minimally invasive options for many of these procedures, and the doctor will discuss these with you before suggesting the best course of action for you.  Minimally invasive techniques involve using highly specialized instruments and magnification to perform the surgery, and they offer a number of benefits such as reduced scarring, quicker recovery times, and the ability to get the surgery on an outpatient basis – meaning patients can often return home the same day as the procedure.

Symptoms of Degenerative Degeneration

Degenerative disc disease affects nearly 30 million people each year and over time most people will exhibit some changes in their discs due to degenerative changes. However, a degenerated disc does not always cause painful symptoms to develop, and when they do, they can vary quite a bit in nature and severity.

The most common symptom of degenerative disc disease is minor but chronic pain that periodically intensifies into more severe and potentially disabling pain.  In some cases, degenerative disc disease can also cause weakness, numbness, and shooting pains down the arms or legs –- a result of 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
  • Sensations that the back or neck is locking up or giving out
  • Muscle spasms and tension
  • Sharp pains radiating to the shoulder, arm, or hand (cervical radiculopathy)
  • Sharp pains radiating to the hips, buttocks, or down the back of the leg (lumbar radiculopathy)
  • Pain that gets worse from holding certain positions, including sitting, standing, or looking down for too long

Often, the pain from a degenerated disc can get better by frequently changing positions rather than remaining seated or standing for long periods of time. In addition, regular stretching and short, frequent walks during the day may help reduce pain in the neck and lower back.

Diagnosing Degenerative Disc Disease

At Southwest Scoliosis Institute, our doctors start by carefully reviewing the patient’s medical history and discussing any symptoms they may be experiencing. Details such as current and past pain symptoms, how the pain started, how often it occurs, and where the pain is felt can be critical indicators when it comes to diagnosing the condition and determining which discs are causing the biggest problems.

Next, the physician will perform a physical exam, feeling for any abnormalities in the spine (known as palpitation) and testing things like range of motion and reflexes.

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

If you or your loved one is suffering from degenerative disc disease, a herniated disc, or another complex spine condition, there is hope. We can help. Call Southwest Scoliosis Institute at 214-556-0555 to make an appointment today.