Degenerative Disc Disease
A common cause of low back pain, degenerative disc disease is not really a disease at all but rather a term used to describe the normal changes in the discs in the spine as people age. The discs between the bones (or vertabraes) in the spine are soft jelly like discs covered by a tough outer layer. These discs act as shock absorbers between the vertabraes. Because the lumbar spine is one of the strongest areas of the spine, it is able to withstand terrific forces and yet still allows the body to be very flexible and mobile.
Although some disc degeneration is normal and expected as people age, lumbar degenerative disc disease may start with a sudden injury such as a fall or a torsional (or twisting) injury to the lower back.
Degenerative disc disease may result in lower back pain however this varies from person to person. Some people may have no pain while others with the same amount of degeneration may have severe pain. Other symptoms of lumbar disc degeneration may include:
- Pain in the lower back region
- Pain and numbness in the buttocks or leg.
- Pain that worsens with movements such as twisting, reaching up, bending over, etc.
- Difficulty walking
Diagnosis of lumbar degenerative disc disease is done by first collecting the medical history of the patient in order to rule out other conditions. A physical examination will also be done with careful attention paid to the back and lower extremities to evaluate flexibility, range of motion, and any signs that the nerve roots are being affected such as numbness or weakness.
X-rays or MRIs may be ordered to further evaluate your condition and rule out or pinpoint other issues such as fractures, tumors or an infection.
In many cases, degenerative disc disease can be treated conservatively with medication for pain and inflammation, physical therapy, a supervised exercise program and modified activity. Heat treatments may also be recommended for stiff muscles or joints as well as the use of ice packs to numb the area when flare-ups occur. Our multidisciplinary approach at SCCNS allows us to also use our pain management team for steroid injections to manage pain while patients are undergoing therapy treatment.
In circumstances where patients have not had any relief after six months of conservative treatment, a lumbar fusion surgery - Anterior Lumbar Interbody Fusion (ALIF) may be an option to reduce the pain as it will stop the motion at a painful motion segment. Although this is considered a major surgery, it is one of the most common spine surgery and it can be a very effective option for patients so that they can enjoy their normal daily activity and improve their quality of life. The success of lumbar fusions has increased now that minimally invasive surgical techniques are used. Our expert neurosurgeons at SCCNS are at the forefront of minimally invasive fusion surgeries and our goal is to reduce or eradicate pain, decrease post-operative discomfort and downtime as well as preserve more of the normal lower back anatomy.
Artificial disc replacement surgery may also be an option and the benefits and risks will be evaluated by your doctor. This surgery is used to replace the disc instead of fusing the disc space together resulting in the patient having more normal motion in the lumbar spine. This may reduce the chance that adjacent levels of the spine will break down due to increased stress from the lack of mobility associated with fusion surgeries.
Other options are also available and will be evaluated and discussed on a case by case basis to determine what option is the most beneficial for the patient.