Treatment Options for Degenerative Disc Disease
What is Degenerative Disc Disease?
Degenerative disc disease is a condition in which the discs, located between the individual vertebra, deteriorates and break down. The discs no longer provide support between the vertebrae, which leads to pain and other symptoms.
What is Treatment?
Treatment is the management and care of an individual to control or lessen the effects of a condition, disorder or disease. An individual who is undergoing treatment is not automatically going to be cured at the completion of treatment. For individuals who are unsure about their treatment and it’s goals, it is important to talk with the doctor who has ordered or is performing the treatment.
In general, doctors follow a progression when starting treatment for any condition, including degenerative disc disease. It starts with the simplest and least invasive treatment options, such as over-the-counter medication, slowly increasing in complexity and invasiveness until it reaches the most invasive option - surgery.
Treatments Goals for Degenerative Disc Disease
Degenerative disc disease is a progressive disorder and the main goals are to manage pain and prevent further damage.
Early Treatment Options
Early treatment options often involve the use of over-the counter medication. Medications such as ibuprofen or naproxen are used to treat inflammation and medications such as acetaminophen to treat pain. The use of a cold compress can help with reducing inflammation and pain. The use of a hot compress can help relax tight muscles and ligaments.
The doctor may allow a day or so of bed rest, to take pressure off of the back. Long-term bed rest is no longer advisable with any back condition, such as degenerative disc disease. Movement is required to keep the back muscles strong and flexible.
When early interventions are unsuccessful, doctors consider options that are stronger, may be more invasive, and require more time on the part of the individual.
Prescription medications to reduce pain and inflammation may be prescribed. This can include: pain medications, anti-inflammatory medications, muscle relaxants, antidepressants and sleep aids.
A referral may be made to a physiotherapist, chiropractor, or acupuncturist. The goal of the physiotherapy is to help reduce pain while strengthening back muscles and improve flexibility. Physiotherapist may use devices such as TENS units or ultrasound to help with the pain. The teaching of stretches and other exercises to be continue at home is often part of the treatment as well. A chiropractor can use delicate spinal manipulation to restore function and reduce pain. Acupuncture referrals are general for pain control.
Injections may be used to deliver medication straight to the area around the affected disc. Two types of injections are mainly used: epidural steroid injection and facet joint injection or a facet block. An epidural steroid injection is when a corticosteroid is injected into the epidural space. It’s goal is to reduce the inflammation of spinal nerve roots. Facet joint injection is when local anesthetic and corticosteroid is injected into the capsule of the facet joint. It’s goal is reduce pain and inflammation.
Surgery is not an option used often for degenerative disc disease. Individuals must have undergone at least 6 months of other treatments that have not helped with the pain, have disc degeneration at just 1 or 2 levels, and be judged by a surgeon to be appropriate for the procedure.
There are three main types of surgery that can be done for degenerative disc disease. Decompression surgery is when tissue that is putting pressure or pressing on a nerve is removed. Stabilization surgery or a fusion is a technique where 2 or more vertebrae are joined together. Artificial disc replacement or intervertebral disc arthroplasty involves the removal of a degenerated disc which is replaced by an artificial disc.