Degenerated disc disease is a term used to signify changes in the intervertebral disc, as part of normal aging or as a part of injury (annular tear). This is one of the most common causes of lower back pain. Degenerated disc disease perse, causes pain in the midline back. If the degenerated disc disease is associated with disc herniation (prolapse which is a common occurrence, the pain can radiated down the leg (sciatica).
What causes disc degeneration?
Normal aging can cause disc degeneration. This usually does not cause much pain. When there is an injury leading to tears in the outer layer of disc (annulus), this can cause loss of fluid and new nerve formation. This causes a few inflammatory changes leading to pain.
What are the symptoms?
Usually back or neck pain, wherever the disc is degenerated. If there is lumbar disc degeneration, the pain is there in midline lower back, buttocks and back of the thigh. The degenerated disc pain increases during maneuvers like bending forward, lifting weights, twisting, coughing etc.
How is degenerated disc disease diagnosed?
# Medical history and physical examination
# Imaging : X ray, CT, MRI
What is the treatment?
For moderate pain, interventional pain procedures are suggested.
- Caudal epidural injections.
- Grey Rami communicantes RF ablation.
- Nucleoplasty. Disc decompression techniques.
What are the surgical options available for disc prolapse?
These pain procedures are minimally invasive ( not open spine surgeries), done under X ray guidance on a day care basis. Your pain physician will decide which is best suitable for you. Post pain intervention, physical therapy and spine strengthening is essential.
For severe pain, open surgical techniques are available. They include discectomy and fusion, dynamic stabilizations, laminectomies, TLIFS and disc replacements. These are open surgeries done under general anesthesia.
If there is associated disc prolapse with the disc degeneration, that has to be treated as well. These are rough guidelines and individual procedures are chosen only after consulting your pain physician.