Lumbar Degenerative Disc Disease

 


Degeneration of the discs in our spine is a normal aging process, and in most cases disc degeneration does not cause significant symptoms. However, for some people, a degenerated disc can cause long-term debilitating back pain. When this occurs, we call this syndrome “Lumbar Degenerative Disc Disease, or DDD”.

Symptoms

  • Lower back pain with radiation into hips and buttocks
  • Radiculopathy – radiating leg pain or numbness caused by the bulging disc compressing or irritating a spinal nerve

Natural History (“Doing Nothing”)

  • Not all degenerated discs cause symptoms
  • Back pain may not be coming from a disc even if it is degenerated
  • Symptoms may resolve without treatment
  • Symptoms may be short-lived and infrequent
  • Rarely, patients develop more persistent and debilitating pain
  • Discs have very little ability to repair themselves or regenerate

Three Phases of Treatment:

  • Phase I – Non-Invasive Treatments
  • Phase II – Spinal Injections
  • Phase III – Surgery
  • Goals of Each Phase:
    • Relieve Pain
    • Improve Function

Treatment Options: Phase I – Non-Invasive Treatments

  • Physical Therapy and Regular Home Exercise
  • Core and Back Strengthening
  • Flexibility and Stretching
  • Oral Medications
  • Steroids
  • Non-Steroid Anti-Inflammatories (NSAIDs)
  • Pain relievers
  • Muscle Relaxants
  • Ice and Heat
  • 4-6 weeks of Phase I treatment before MRI and going to Phase II

Treatment Options: Phase II – Epidural Steroid Injections

  • Outpatient procedure
  • Done with x-ray guidance
  • May relieve symptoms, but will not repair the disc
  • 1-3 injections may be needed

Treatment Options: Phase III – Surgery

  • Rarely needed for DDD
  • Back pain from DDD can be treated non-surgically in most cases

Surgical Options for Advanced Lumbar DDD