Disc Disease

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The vertebrae (bones) of the spinal column are separated from each other by cartilaginous cushions known as intervertebral discs.  The discs provide structural support to the spine and act as shock absorbers, taking in the stress created by movement.  The discs are mostly water, allowing them to be very elastic and absorb stress.  However, age, repetitive strain, and (possibly) genetics cause disc wear and tear.  Because there is little blood supply to the disc, it cannot repair itself if injured.

Degenerative disc disease can produce pain as a worn disc becomes thin, narrowing the space between the vertebrae.  With less space available, nerves may become compressed, causing them to swell and signal pain.  Pieces of the damaged disc may also break off and cause irritation of the nerves.  As the disc loses its ability to absorb stress and provide support, other parts of the spine become overloaded, thus leading to irritation, inflammation, fatigue, muscle spasms, and back pain. 

Diagnosis

The amount of pain from degenerative disc disease can vary from naggingly irritating to severely debilitating.  Most patients have some underlying chronic low back pain with intermittent episodes of severe pain.  Usually, sitting worsens the pain more than standing.  Bending, twisting, and lifting generally worsen the pain and lying down reduces it by relieving the strain on the disc space. In addition to back pain, there may also be pain, numbness, and tingling in the legs if the disc degeneration is located in the lower spine.  Pain in the neck, shoulder blades, arms, and hands as well as numbness and tingling in the shoulder and arms may be present for disc degeneration in the upper spine.

Treatment

Conservative Options

  • Medication
  • Acupuncture
  • Physical Therapy

Surgical Treatments

  • Artifical Disc Replacement
  • Spinal Fusion
  • Epidural Injection

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