Degenerative Disc Disease

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Description:

Thinning Disc Degeneration - Spine problemDegenerative disc disease (DDD) is one of the most common causes of low back pain and neck pain. It describes the symptoms of pain and possibly radiating weakness or numbness stemming from a degenerated disc in the spine. Minor injuries to a disc may occur and not cause pain at the time of the injury. These repeated daily stresses and minor injuries can add up over time and begin to affect the discs. The disc eventually begins to suffer from the wear and tear, losing its water content gradually, thus the ability to act as a cushion. It begins to degenerate. When a disc degenerates, it loses its height, causing vertebrae to have less space in between, i.e disc space narrowing/collapse. This causes the openings (foramina) on each side of the vertebral column to get smaller, thus causing some pressure on the exiting spinal nerves. Bone spurs, osteophytes, may also begin to form around the disc space, causing more pressure

Symptoms:

As  described before, DDD can cause pressure on the exiting spinal nerves, which may cause symptoms that are similar to those of a herniated disc, such as:

  • Back or neck pain, depending on the location of the degeneration
  • Shooting Pain radiating into legs or arms on one or both sides
  • Numbness and/or tingling in arms and/or legs
  • Muscle weakness and/or spasms in arms and legs normal activities and also minimize further degeneration
Causes:

  • Genetics
  • Aging process
  • Trauma can also trigger DDD
  • Obesity/ unhealthy life styles

Screening and Diagnosis:

Complete medical history and physical examination is key in the diagnosis of a bulging disc. X-ray, CT or MRI may be ordered for further evaluation.

Treatment:

Non-surgical options for facet joint pain include:

  • Physical therapy
  • Non-steroidal anti-inflammatory medications, muscle relaxants, and some cases pain medication.

Injection Therapy:

  • Epidural steroid Injection, which can help decrease the inflammation of compressed spinal nerves, with proper management and physical therapy.

Goal of treatment is to decrease symptoms, such as pain, get back  to  normal activities and also minimize further degeneration.

Peer-Reviewed Supportive Studies:

McAuley, J., et al. (2013). “A questionnaire-based study on patients’ experiences with rechargeable implanted programmable generators for spinal cord stimulation to treat chronic lumbar spondylosis pain.” Neuromodulation 16(2): 142-146.

OBJECTIVE: The latest generation of rechargeable implantable programmable generators (IPGs) for spinal cord stimulation may greatly extend IPG lifespan compared with previous nonrechargeable devices. This study explores patients’ experiences with these devices. MATERIALS AND METHODS: Twenty-five patients attending the Department of Neurostimulation, Royal London Hospital, who were implanted with a rechargeable IPG (SC-1110; Boston Scientific, Minneapolis, MN, USA) to provide pain relief from post-surgical lumbosacral spondylosis were surveyed using a questionnaire. RESULTS: Patients reported a mean (SD) benefit from stimulation of 43.7% (32.6%). On a 1 (worst) to 5 (best) scale, the median score was 5 for ease of recharging. Eight patients who had previously had nonrechargeable IPGs felt the rechargeable system was better (p= 0.0143). A particular issue with nonrechargeable batteries was that, while patients considered 5 years an acceptable interval for battery replacements and the procedure itself not too inconvenient, they felt an acceptable wait for replacement after failure to be only 1 week, much shorter than actual waiting times. CONCLUSIONS: Patients found the rechargeable IPG easy to recharge and those who had had previous experience with nonrechargeable devices preferred using the rechargeable device. Its benefits in terms of pain relief fell within the range expected from previous studies using nonrechargeable batteries. The main disadvantage of nonrechargeable devices as reported by the patients in this study was concern over the length of time they would have to wait without pain relief between battery replacements.