Millions of Americans deal with low back pain on a daily basis. Young to middle-aged individuals are often affected with degenerative disc disease, which can cause back pain on a daily basis. It may have some days where it’s not bothersome at all and others where the patient cannot get out of bed.
The intervertebral discs are located between the vertebral bodies at every level of the lumbar, thoracic, and cervical spines. The disc is comprised mostly of water at 80%, and act as shock absorbers when a person walks or jumps or really does any range of motion of the spine.
There is been significant research looking at how many people have degenerative disk disease. 40% of those over the age of 40 have significant signs of it on x-rays and MRI, but very few of those actually have back pain. Even if x-rays and MRI look horrible with degenerative changes, the person may not be bothered at all by back pain.
For individuals who do have horrible back pain from degenerative disc disease the initial question to answer is “Why is this problem affecting me?”
Individuals who develop degenerative disease don’t always have it from an injury. It could just be simply genetics that caused that disc level to start dehydrating earlier than others and leads to lack of water, a loss of height of the disc, and subsequent pain.
In other individuals, it may simply be that they had an injury to the disk and as a post traumatic issue degenerate disk disease arose. It could also be that the individual had a disc herniation that potentially needed surgery and as an after-effect the rest of the disk began to degenerate more rapidly and caused back pain from it.
Beginning treatments for pain from a degenerative disc should involve activity avoidance and Tylenol and anti-inflammatory over-the-counter pain medications. Activities that are stressful to the disk such as jogging should be avoided in favor of cycling or swimming which are not as directly stressful.
Over-the-counter medications include Tylenol and anti-inflammatory medications such as naproxen and ibuprofen. You should always take the medication in accordance with the manufacturer’s recommended dosing. It may make all the difference in a patient who suffers with a low level of pain from degnerative disc disease.
If these initial treatments do not do the trick, patients may add in physical therapy, treatment with a chiropractor, spinal decompression therapy, acupuncture and massage. These treatments can be tried simultaneously as putting it together may alleviate back pain substantially. They also have a very low risk profile.
Chiropractic treatment has been shown in the research to have over 85% satisfaction rate in this country. In addition to this, spinal decompression therapy has shown over and 85% effectiveness as well. This treatment is highly effective, low risk, and cost under 5% what spine surgery does.
A physical therapy program can teach individuals lumbar strengthening and core stabilization and provide patients with a home program to keep future back pain problems at a lower incidence of occurring.
Along with these treatments, treatment with an interventional pain management physician may help tremendously. Chronic narcotics for degenerate disc disease is not a good idea. They maybe utilized in the short term for an acute flare up of the back pain, but the long-term risks tend to outweigh the benefits.
Injection treatments for degenerative disc disease can work really well. One treatment that is not used much anymore is intra-discal electro thermal therapy which was never shown to have exceptional results. The treatment involves burning inside part of the disk.
There are some pain management physicians who will inject steroid medication along with a numbing agent right into the disk. This action has been shown in some research to be beneficial for months over a year. Patients often have abnormal motion of the spine as a result of the degenerative disc which leads to facet related pain as well.
Because of this, facet treatments including radiofrequency ablation or direct facet injections are often needed and have provided substantial pain relief. There are also some stem cell injection critical trials going on in the US which provide the potential for regeneration inside the disc.’s initial results have been promising.
These treatments have been showing promise for degenerative disc disease. Aerobic exercise has been shown to be an excellent treatment for the problem. Over 75% of patients are able to successfully avoid surgery.
Other than these nonsurgical options, surgery for degenerative disease is truly only a last resort. Surgical outcomes tend to be a roll of the dice, and the person may only get rid of part of the problem or potentially be worse off than they were before the surgery.
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