FAQs on Degenerative Disc Disease (DDD) from a top Phoenix Pain Clinic
Progressive degeneration of the spine and intervertebral discs is known as degenerative disc disease (DDD). Every movement depends on the spine’s ability to support your body weight. With time, repeated stress and minor injuries affect the spinal discs. The discs can suffer wear and tear and start to deteriorate.
What causes degenerative disc disease?
The discs between each of the vertebra of the spine absorb pressure and keep the spine flexible. These cushions act as shock absorbers during movement and walking. With loss of full cushion ability, the bones cannot sustain high stress repeatedly without damage occurring.
The central portion of the disc is called the nucleus pulposus, which contains much water content. With loss of fluid, excessive pressure or injuries to the disc damage the outer ring of the disc (annulus). When this occurs, the discs lose their ability to function as a cushion. When two vertebra move closer to one another, the facet joints can shift. In addition, bone spurs form around the disc space, causing nerve compression.
What are the symptoms of DDD?
The most common early symptom of degenerative disc disease is pain. The pain can spread to the buttocks, upper thighs, and legs. Discogenic pain is a term that specialist used to describe the discomfort associated with damaged discs. In addition to pain, symptoms associated with DDD include leg tingling, numbness, and weakness.
How is DDD diagnosed?
To diagnose degenerative disc disease, the doctor will take a detailed medical history and conduct a physical examination. The doctor will ask specific questions about your condition, specifically related to the pain and other symptoms. In addition, diagnostic tests will be ordered to assess the spine and associated structures. These include x-rays, computed tomography (CT), and magnetic resonance imaging (MRI).
How is degenerative disc disease treated?
The treatment of degenerative disc disease depends on the duration and severity of your symptoms. The term “conservative treatment” is used to describe any option that does not involve surgery. For degeneration, simple therapies are often effective, but interventional pain management is used when pain persists. Options include:
Medications – Medicines used include nonsteroidal anti-inflammatory drugs (NSAIDs), such as fenoprofen, ketoprofen, and sulindac. Other non-narcotic options include acetaminophen and aspirin. Narcotic agents are prescribed for severe pain. These act as a numbing anesthetic to the central nervous system. Topical agents include capsaicin, menthol, and anesthetic gels. For patients with muscle spasms, muscle relaxants can be issued, including baclofen and robaxin.
Epidural steroid injection (ESI) – To relieve irritated nerve roots associated with stenosis, an ESI can be performed. This involves injection of a corticosteroid into the epidural space, which lies between the spinal cord and epidural layer. According to clinical studies, ESI has a 90% efficacy rate.
Physical therapy – Treatment modalities include heat/ice, massage, electrical stimulation, and ultrasound treatment. Bracing involves use of a simple corset or plastic body jacket. Flexibility and strength training is used to improve poster and alleviate pain.
Intradiscal injections – Using x-ray guidance, the pain specialist will inject the disc with one or more medications. A recent research study found that corticosteroid intradiscal injections were a safe, effective measure for treating back pain associated with discs. Additional option for intradiscal injections includes stem cell therapy with either bone marrow or amniotic derived stem material.
Disc regenerative therapy – This procedure involves injecting a solution of glucosamine and dextrose into the disc. This stimulates new collagen group and improves the strength of the disc. In a clinical study, DRT was shown to significantly improve disc strength.