What is degenerative disc disease?
The intervertebral discs are tough, fibrous structures that act as ligaments between the spinal vertebrae. These discs are responsible for providing cushion and absorbing the pressure from the spinal column. They allow you to flex and extend your back and allow you to move from side to side.
Discs naturally dry out and stiffen with age. Everyone will experience some form of degeneration of their discs over time. Degenerative disc disease refers to the condition where painful, degenerated, and worn out discs cause pain.
What are the causes of degenerative disc disease?
The spinal discs are shock absorbers between the bones or vertebrae of your spine. They are made up mostly of water. These discs help you stay flexible, so you can bend and twist. As you get older, these discs tend to dry out and become less flexible. They begin to break down and may not work as well. Nearly everyone’s disc will break down and not work as well over time. But, this does not cause everyone to have pain. If your worn out discs are causing you pain, then you have degenerative disc disease.
What are the symptoms of degenerative disc disease?
You may have degenerative disc disease if you have:
- low-level continuous low back pain. The pain may spread to the butt, groin, and upper thighs.
- If you have occasional flare-ups. This means the back pain worsens for a few days or weeks before it goes back to its normal moderate level. The flare ups may be so severe that you lose mobility.
- Tenderness around the area of the degenerative disc. This pain is from the inflammation and muscle tension surrounding the degenerated disc.
- Pain in your legs: you may have numbness, weakness, or sharp, shooting pain in the butt, hips, or behind the leg. This may happen if the disc has collapsed enough to pinch the nerve.
- Feelings that your back gives out
- Pain with sitting, though you generally feel better if you lay down
- Twisting or bending movements cause pain
- Feeling better when you change positions.
How is Lumbar Degenerative Disc Disease treated?
Most patients with lumbar DDD or degenerative disc disease can be treated successfully with conservative levels I and II treatment modalities. Weight loss and smoking cessation are really important in the treatment process as well.
Level I – Non-operative/Conservative treatment
- Oral pain medications
- Oral steroid medications
- Oral muscle relaxant medications
- Physical and/or chiropractic therapy
- Activity modification
Level II – Spinal Injections
Spinal steroid injections
- Outpatient procedures
- Done with x-ray guidance
- 1-3 injections may be needed
Level III: Surgery
If you are unable to live with your pain and have failed levels 1 and 2, then Dr. Webb may recommend surgery. This may be a lumbar spinal fusion or an artificial disc replacement (if you are a candidate). Fusion procedures for low back pain due to degenerative disc disease have less favorable outcomes. Dr. Webb prefers not to fuse unless absolutely necessary.
- Lumbar Spinal Fusion
Involves removing the affected intervertebral disc, also called a discectomy, and fusing the degenerated segment of your spine with the help of a plastic or metal cage along with screws and rods. The fusion does not immediately happen after surgery, but usually takes weeks to months to happen. Read more about lumbar spinal fusion surgery
- Lumbar Artificial Disc Replacement
A lumbar artificial disc replacement is an alternative to spinal fusion which allows you to maintain your motion after surgery. Performing an artificial disc replacement also decreases your risk of the need for additional surgery in the future. There are strict indications for this type of surgery. Dr. Webb can discuss this with you at your visit and determine if you are a candidate for this procedure. Read more about lumbar artificial disc replacement.